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Psychological treatment strategies for rapid ejaculation: rationale, practical aspects, and outcome

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Abstract

The landscape has dramatically changed for patients seeking treatment for rapid ejaculation. Previously, psychotherapy or behavioral treatment was considered to be the treatment of choice for this troubling sexual dysfunction. Since the early 1990s, an efficacious alternative treatment has emerged—the off-label administration of SSRI medications. Currently, several short-acting SSRI compounds are in phase III clinical trials and are likely to receive approval as the first medical treatment for rapid ejaculation. Given the presumed efficacy of these new compounds and the off-label use of the current SSRIs, one might conclude that psychotherapy\behavior therapy for rapid ejaculation is an obsolete and antiquated intervention. On the contrary, psychotherapy is now more relevant than ever. The two aims of this paper are to review psychological/behavioral therapies for rapid ejaculation and to discuss the important role of combined psychological and medical treatment. In the new age of SSRI treatment for rapid ejaculation, some form of psychological/behavioral intervention is essential to help patients/couples make better use of medical therapies, to learn skills to delay ejaculation once off medication, to bolster sexual confidence, and to enhance patient and partner sexual satisfaction.

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References

  1. Althof S, Wieder M (2004) Psychotherapy for erectile dysfunction: now more relevant than ever. Endocrine

    Google Scholar 

  2. Althof S (2003) Therapeutic weaving: the integration of treatment techniques. In: Levine S, Risen C, Althof S (eds) Handbook of clinical sexuality for mental health professionals. Bruner-Routledge, New York, pp 359–376

  3. Althof SE (2002) When an erection alone is not enough: biopsychosocial obstacles to lovemaking. Int J Impot Res 4 [Suppl 1]:S99–104

    Google Scholar 

  4. Althof S (2000) Erectile dysfunction: treatment of men and couples. In: Lieblum S, Rosen R (eds) Principles and practices of sex therapy, 3rd edn. Guilford Press, New York, pp 242–275

  5. Bancroft J, Coles L (1976) Three years experience in a sexual problems clinic. Br Med J 1:1575–1577

    CAS  PubMed  Google Scholar 

  6. DeAmicus L, Goldberg DC, LoPiccolo J, Friedman J, Davies L (1985) Clinical follow-up of couples treated for sexual dysfunction. ArchSex Behav 14:467–489

    Article  Google Scholar 

  7. Donahey K, Miller S (2001) What works in sex therapy: a common factors perspective. New directions. In: Kleinplatz P (ed) Sex therapy innovations and alternatives. Bruner Routledge, Philadelphia, pp 210–233

  8. Gagnon J, Rosen R, Leiblum S (1982) Cognitive and social aspects of sexual dysfunction: sexual scripts in sex therapy. JSex Marital Ther 8:44–56

    CAS  Google Scholar 

  9. Hawton K, Catalan J, Faff J (1992) Sex therapy for erectile dysfunction: characteristics of couples, treatment outcome, and prognostic factors. Arch Sex Behav 21:161–175

    Article  CAS  PubMed  Google Scholar 

  10. Hawton K, Catalan J, Martin P, Fagg J (1986) Long-term outcome of sex therapy. Behav Res Ther 24:665–675

    Google Scholar 

  11. Hawton K (1998) Integration of treatments for male erectile dysfunction. Lancet 351:728

    Article  PubMed  Google Scholar 

  12. Heiman JR, LoPiccolo J (1983) Clinical outcome of sex therapy. Arch Gen Psychiatry 40:443–449

    Google Scholar 

  13. Kaplan HS (1989) PE: how to overcome premature ejaculation. Brunner/Mazel, New York

  14. Kilman P, Auerbach R (1979) Treatments of premature ejacuation and psychogenic impotence: a critical review of the literature. Arch Sex Behav 8:81–100

    Article  PubMed  Google Scholar 

  15. Levine S (1992) Sexual life, a clinicians guide. Plenum, New York

  16. Masters W, Johnson V (1970) Human sexual inadequacy. Little Brown, Boston

  17. McCarthy B (1993) Relapse prevention strategies and techniques in sex therapy. J Sex Marital Ther 19:142–147

    CAS  PubMed  Google Scholar 

  18. McCarthy B (1990) Cognitive-behavioral strategies and techniques in the treatment of early ejaculation. In: Leiblum SR, Rosen RC (eds) Principles and practice of sex therapy: update for the 90s. Guilford Press, New York, pp 141–167

  19. McMahon CG, Meston C, Abdo C, Hull E, Incrocci L et al. (2004) Disorders of orgasm in men and women, ejaculatory disorders in men. In: Lue TF, Basson R, Rosen R, Giuliano F, Khoury S, Montorsi F (eds) Sexual medicine: sexual dysfunctions in men and women. Health Publications, (in press)

  20. Metz M, McCarthy B (2003) Coping with premature ejaculation: how to overcome PE, please your partner and have great sex. New Harbinger, Oakland

    Google Scholar 

  21. Nathan PE, Gorman JM (eds). (2002). A guide to treatments that work, 2nd edn. Oxford, New York

  22. Perelman M (2003) Sex coaching for physicians: combination treatment for patient and partner. Int J Impot Res 15 [Suppl 5]:s67–s74

    Google Scholar 

  23. Rosen R, Leiblum S, Spector I (1994) Psychologically based treatment for male erectile disorder: A cognitive-interpersonal model. J Sex Marital Ther 20:67–85

    CAS  PubMed  Google Scholar 

  24. Semans J (1956) Premature ejaculation. Southern MedJ 49:352–358

    Google Scholar 

  25. St. Lawrence J, Madakasira S (1992) Evaluation and treatment of premature ejaculation: a critical review. Int J Psychiatry 22:77–97

    Google Scholar 

  26. Symonds T, Roblin D, Hart K, Althof S (2003) How does premature ejaculation effect a man’s life. J Sex Marital Ther 29:361–370

    Article  CAS  PubMed  Google Scholar 

  27. Waldinger MD, Zwinderman AH, Schweitzer DH, Oliver B (2004) Relevance of methodological design for the interpretation of efficacy of drug treatment of premature ejaculation: a systematic review and meta-analysis. Int J Impot Res 1–13

    Google Scholar 

  28. Zilbergeld B (1999) The new male sexuality. Bantam, New York

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Authors and Affiliations

  1. Case Medical School, Executive Director, Center for Marital and Sexual Health of South Florida, 1515 N Flagler Drive, West Palm Beach, Florida 33401, Suite 540, USA

    Stanley E. Althof

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  1. Stanley E. Althof
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Correspondence to Stanley E. Althof.

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Althof, S.E. Psychological treatment strategies for rapid ejaculation: rationale, practical aspects, and outcome. World J Urol 23, 89–92 (2005). https://doi.org/10.1007/s00345-004-0489-6

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  • DOI: https://doi.org/10.1007/s00345-004-0489-6

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