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Priligy in the Treatment of Premature Ejaculation
Priligy is the mainstay of pharmaceutical treatment for Premature Ejaculation (PE). This is a condition where a man ejaculates too quickly during sexual intercourse. It is the most common condition affecting male sexual function. Men with PE are thought to ejaculate by the same method as other men, but this happens more quickly and they feel less in control of their own ejaculation. It is hard to know how long ‘normal’ sex should last. Studies looking at around 500 couples found that the average time between entry of the penis into the vagina and ejaculation was five and a half minutes. However every couple should decide for themselves what the norm for them is. It is up to them to decide if they are happy and satisfied with the time that it takes for the man to ejaculate. Occasional PE can occur, and this is usually nothing to worry about. If over half of all attempts result in premature ejaculation, treatment is something that a man should consider, and it is likely to be of help. Treatment for PE is very important as it can adversely affect the quality of life of the man and his partner.1 Causes of PE are not well understood, but it is thought to result because of a number of factors including anxiety, penile hypersensitivity and serotonin receptor dysfunction.
Priligy-60-6Priligy, the brand name of the drug dapoxetine, is a selective serotonin reuptake inhibitor (SSRI). It was developed specially to treat PE. It is thought to be of more use in the treatment of PE than other drugs in the same class. This is because of several reasons. It is absorbed into the body very quickly, and so its effect is fairly rapid, allowing it to be taken on demand, a few hours before sexual activity. As a result of this, the chance of experiencing any adverse effects associated with this class of medications is much reduced as it is only being taken periodically, and stays in the system for only a short period of time. However, this negative side of this is that it can reduce the spontaneity of sex. Dapoxetine represented a breakthrough in the treatment of PE as it is the first drug to be licenced for its treatment.
Ejaculation is primarily mediated via the sympathetic nervous system. Serotonin is a neurotransmitter, a chemical, involved in passing messages between nerves in the nervous system. It is involved in many functions, one of these being the nerve messages that result in ejaculation. Priligy inhibits the reuptake of serotonin and so allows it to exert its effect for longer and helps to increase the time take to ejaculate and improve control over ejaculation. By affecting the time taken to ejaculate, it also aids towards reducing frustration or worry about fast ejaculation.
Take with waterPriligy can be used in men aged 18 to 64 years. It should be taken with a full glass of water, with or without food. Alcohol should be avoided while using this medication as the effects of alcohol such as feeling dizzy, sleepy and having slow reactions can be increased by taking these two at the same time. One tablet should be taken one to three hours before sexual activity. Men should start with the lower dose of 30mg, and see how this works for them. It is recommended to trial treatment for 4 weeks or at least six doses. If a greater effect is needed, and the lower strength was well-tolerated they can then try the 60mg strength. Only one tablet should be taken in any 24 hour period, and it is not indicated for daily use.
Trials looking at the effect of Priligy use the Intravaginal Ejaculatory Latency Time. This is a scientific term, basically looking at the length of time between the penis entering the vagina, and the man ejaculating. It has been found the Priligy at doses of 30mg and 60mg significantly improved IELT as compared to placebo. One large trial found that the average IELT was increased to three or four times the baseline when it was taken on demand. In the dosage groups of 30mg and 60mg, improved control over ejaculation was reported by 51 and 58% respectively. Priligy was found to dose-dependently improve patient perceptions over their control of ejaculation and their satisfaction with sexual intercourse. This trial also recognised the interpersonal difficulty that PE can cause, and looked at partner’s satisfaction, and found that this drug also increased partner’s satisfaction.7 Both doses tested showed an effect from the first dose that a patient took. All studies involving Priligy found that the medication was well tolerated with on demand dosing. The most common side effect, which was dose dependent, was nausea, however this was mainly mild, transient and related to how long the drug remains in the body for. However as this is a new drug, there is not any information on potential long term adverse effects.
In conclusion, PE is a very common male sexual dysfunction and can cause significant distress and relationship stress to the man affected and his partner. Therefore effective treatment for PE is very important. Prior to the development of Priligy, all treatments for PE were unlicensed, meaning they were not specifically designed to treat PE, and were a decision made by the prescriber and the patient. Priligy is an on demand treatment, which has been shown in trials to significantly increase the time taken to ejaculate, patient’s perceived control over their ejaculation and sexual satisfaction. The drug will work for some men and not others, but increases the options that a man has in the treatment of his condition. Priligy represents a breakthrough in the field of premature ejaculation and more developments should be in the pipeline.