What are the most reliable scientific achievements, evidence based, to help with men that want to last longer during sexual intercourse?

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Premature ejaculation has variable definitions, which cause some difficulties in diagnosis. The main treatment methods are psychological counseling, behavioral therapy, drug therapy and surgical treatment.

Drug therapy including topical drugs, serotonin reuptake inhibitors (SSRi), receptor blockers, type 5 phosphodiesterase inhibitors (PDE5i), etc., of the latest medications can choose hydrochloric acid of dapoxetine (Priligy) treatment.

The oxytocin antagonists shows good results, but they demands further reserches.

Oxytocin is a peptide hormone that is believed to shorten ejaculatory latency times through central and peripheral pathways in animal models. The ejaculatory delay observed with SSRIs may be mediated by alterations in the central release of oxytocin. This has formed the basis of the development of oxytocin receptor antagonists. The first drug used in human clinical trials was epelsiban. This is a highly selective oxytocin receptor antagonist with rapid absorption and elimination. It had been shown to delay ejaculatory latency in animal models. In this multicentre study, men were randomly assigned to placebo or epelsiban (50 mg/150 mg). Study inclusion was based on the ISSM definition of PE, and IELT was measured with the use of a stopwatch. There was no significant difference in the baseline IELT measurements between the groups. Following 8 weeks of treatment, there were no significant clinical or statistically significant differences in IELT between the groups. The authors speculated that efficacy may be linked to centrally acting oxytocin antagonist activity. There is some evidence from animal studies to support this hypothesis. This has led to the development of the most recent oxytocin antagonist. This is a small molecule with good central penetration and rapid absorption with potent antagonism of the oxytocin receptor. A total of 88 men with LPE were randomly assigned to either placebo or active drug (400 mg/800 mg). Inclusion appeared to be based on ISSM criteria. Following 8 weeks of treatment, IX-01 resulted in a 3-fold increase in IELT (1.6 in the placebo group). This improvement was observed as early as 2 weeks after starting treatment. The drug was well tolerated with no serious or severe adverse events; 21% reported at least one adverse event (30% in the placebo group). The dropout rate was high: 21% with the active drug and 27% in the placebo arm. This is obviously encouraging news for the field, and we should expect larger trials involving a more diverse population.

The combination of drug and behavioural therapy shows more effective results.

MATERIALS AND METHODS: 18 patients were enrolled, aged between 25 and 55 (mean: 40), all with primary PE, free of comorbidities and with their partners involved. Six patients were prescribed 30 mg dapoxetine two hours before sexual relations for 3 months (group A); 6 patients began the dynamic rehabilitative treatment (group B); 6 other couples were assigned to pharmacological treatment in association with dynamic rehabilitative behavioural treatment for 3 months (group C). Division of subjects was carried out by simple randomisation, excluding patients with a short frenulum, phimosis, ED, chronic prostatitis or experiencing results from previous treatment.

RESULTS: Outcomes of treatment were evaluated at the end of the 3 months of treatment and 3 months after discontinuing treatment. In Group A 75% of patients were cured at 3 months and 25% at 6 months. In Group B 25% patients were cured at 3 months and 25% at 6 months. In Group C 75% of patients were cured 3 months and 50% at 6 months. "Cured" means a Premature Ejaculation Diagnostic Tool (PEDT) score reduced from an average of 12 to an average of 6 and Intravaginal Ejaculation Latency Time (IELT) values from < 1 to > 6 minutes.

Sometimes keeping to healthy lifestile can prevent medical treatment. First of all the diet that helps cure premature ejaculation includes such foods as green onions, boiled asparagus, ginger, almonds, honey etc. The study devoted to the connection between physical activity and premature ejaculation is being conducted (completion date is January 31, 2017).

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