Premature Ejaculation: Breaking the Silence (cont.)

I just got an email message today from somebody from Australia for instance, who said that the premature ejaculation was so devastating to him that it was affecting not just what happened in the bedroom, but beyond. It was affecting his whole relationship with his wife and family and he felt terrible about it.

I have personally seen in my clinic, many patients who have premature ejaculation. It's not just something that affects you at the time of intercourse but for many people it extends beyond that event -- it tends to taint how they think about themselves in their daily lives.

MODERATOR:
You are talking about the impact of PE; please tell us more.

PRYOR:
It can be a big impact for people. I think that that's the primary reason why we need to treat it. This is a condition that affects so many people -- approximately 30% of men at any one time can have premature ejaculation and up to 70% of men during their life time will get it at one point or another.

In the past we didn't have effective therapies and it was really bothering people. They would come in to see me and other physicians and there was nothing that we could do that was satisfactory. There were treatments, but they didn't tend to work very well and they tended to have some side effects. People needed our help and there wasn't any good answer for them up until now.

MODERATOR:
Do you find that most men are silent about PE because of the stigma attached to the condition?

PRYOR:
Yes, I do. I think they are silent for several reasons. One is exactly as you state, because of the stigma. Men want to feel like they are good in the bedroom and if they have premature ejaculation, it bothers them; it bothers their self-perception.

In addition, I think people are silent about it because they thought it was something that affected only them. We clearly recognize that it affected many, many people. Again, it affected more people than have erectile dysfunction. I think that's one of the purposes of shows like this, to get this out there and let people know that they are not alone, that this affects many people.

I think finally, the other reason why people tended to suffer in silence is that they didn't know that there was good treatment available. If you have got a problem but you don't think there's any treatment you tend not to say anything about it.

I think stigma is part of it, but also those other reasons of thinking that it's just them, that they are the only ones suffering with it, and the fact that there's not good therapy available.

MODERATOR:
Are there any FDA-approved treatments for PE?

PRYOR:
No, currently there are no FDA treatments approved for PE. But, there is the one medication, dapoxetine, which Johnson & Johnson research and development has been working on. It has been submitted to the FDA, hopefully for approval to treat people with premature ejaculation.

MODERATOR:
Tell us more about dapoxetine. What kind of medication is it?

PRYOR:
It's called a serotonin transport inhibitor, very similar to an SSRI, in the category of drugs like Paxil. What it does is increase those serotonin levels in the brain and prevents ejaculation, or hopefully slows down ejaculation, so you don't have premature ejaculation.

MODERATOR:
Are any other medications designed to treat PE currently being studied?

PRYOR:
I don't know if there are any others. The only medication that I know for sure that has been studied and actually submitted to the FDA specifically for premature ejaculation is dapoxetine.

There are other off-label therapies out there that people use, but they are not indicated specifically for premature ejaculation and there are problems with them, including some potential side effects.

MEMBER QUESTION:
Is there an age at which PE is most common?

PRYOR:
I haven't seen it broken down specifically by decade, but I know that premature ejaculation really affects men at every decade of life.

I can say anecdotally, from my personal experience, I have seen people who are in their young 20s, people in their 30s, 40s, 50s and people in their 70s and 80s with it. It really can affect people at any point in their life. We tend to think of it as something that just affects young men maybe because of the inexperience of having sex, but it really can affect people at any age.

I would also like to point out that we divide premature ejaculation into two categories. It can be lifelong premature ejaculation or something that may just happen at a particular point in someone's life. So, some people have it their entire lives -- from their very first sexual experience to their very last, other people may not have it and all of a sudden get it.

"There's numerous data out there to suggest, in general, that if ejaculation is in less than two minutes, people are not happy with that."

MEMBER QUESTION:
Is rubbing something on the penis to numb it helpful? If so, what do you recommend?