Experts discuss how to identify, fight premature ejaculation

“DAPOXETINE significantly improves control over ejaculation, enabling men to control and delay ejaculating, thereby enhancing sexual satisfaction of the couple while reducing personal distress and interpersonal difficulty,” said Dr. George Lee Eng Geap, consultant urological surgeon at the Gleneagles Hospital in Kuala Lumpur, Malaysia. From left are, Doctors Juliano Panganiban, past president of Philippine Urological Association (PUA); Digna Almeida, medical affairs director of A. Menarini Philippines; Ulysses Quanico, current president of PUA; and Lee.

One out of three men may be afflicted with this condition, but it remains underdiagnosed and undertreated.

Premature ejaculation, the inability to control ejaculation, can be very common in men, more prevalent than erectile dysfunction, but many of them are very reluctant of coming out, literally, to have it treated.

This is why the Philippine Urological Association and A. Menarini Philippines are actively pushing for awareness and treatment of this dysfunction. In a forum last July 10, titled “Media briefing on Premature Ejaculation” they sponsored, Dr. George Lee Eng Geap, consultant urological surgeon at Gleneagles Hospital in Kuala Lumpur, Malaysia, and Dr. Ulysses Quanico, PUA president, discussed how to identify and combat this sexual disorder.

Lee said: “Men with PE are often reluctant to discuss their condition or are in denial. Their partners, on the other hand, avoid raising the topic for fear of hurting their man’s feelings. This communication gap hinders diagnosis and treatment.”  Quanico added, “Because of the social stigma attached to PE, very few couples and even fewer men dare speak about it.”

Partner satisfaction

Characterized by short ejaculatory latency and inability to control ejaculation, PE is the most common male sexual dysfunction in Asia-Pacific, affecting nearly one in three men, or 31 percent.

In a study of 4,997 men aged 18-65 from 10 countries (Australia, New Zealand, China, Hong Kong, Indonesia, Malaysia, the Philippines, South Korea, Taiwan and Thailand), 31 percent had or probably had PE. In contrast, this same study found that only 20 percent of them had “mild to moderate,” “moderate” or “severe” erectile dysfunction.

Men can have PE from the first time they have sex (lifelong), or develop premature ejaculation later in life, even after many years of normal ejaculatory experience (acquired).

Although the exact cause of PE remains unknown, research has revealed that PE involves a complex interplay of both psychological and biological factors. But foremost of them is serotonin, which plays a central role, according to Lee.

Serotonin, a neurotransmitter, is a chemical messenger in the brain and nervous system. Studies have shown that adequate levels of serotonin in the synapses—the junctions between neurons or brain cells—help delay ejaculation. Men with PE have low levels of serotonin in the synapses.

The impact of PE on couples is evident, according to studies. The 2013 Asia-Pacific Sexual Behaviors and Satisfaction Survey said that 91 percent of men in the Philippines find it highly important to sexually satisfy their partners; men want their partners to feel happy, loved and satisfied.

Meanwhile, seven out of 10 Filipinos, or 72 percent, were concerned that they weren’t able to sexually satisfy their partners. And almost half, or 46 percent, were concerned about ejaculating too early or not being able to control when to ejaculate

The lack of ejaculatory control results in sexual dissatisfaction and emotional distress, including feelings of inadequacy, anxiety, disappointment and frustration. It can then lead to interpersonal problems and disrupted relationships. One in five, or 20 percent, of men with PE says it can lead to relationship breakdown or divorce.

No more hiding

Men with PE don’t have to hide anymore, because with prescription drug dapoxetine, they can now take control. During that same event, A. Menarini Philippines formally launched dapoxetine, the first and only drug specifically developed for PE.

“Dapoxetine works by inhibiting a protein that transports serotonin away from the synapses, thereby increasing the synaptic levels of serotonin and consequently controlling ejaculation,” Lee said.

A. Menarini Philippines said that dapoxetine is proven to work in the first dose, is well-tolerated, and significantly improves control over ejaculation, leading to sexual satisfaction for the couple. Taken 1-3 hours before intercourse, one can achieve optimal effect after approximately six doses within four weeks.

“This is  not just [about  longer] sex. It’s about control [and] satisfaction,” Lee said. Quanico meanwhile urged all men to consult with their urologists.