Premature Ejaculation: Call for a Cure

Endocrine regulation in ejaculation control is still not well understood. Sex steroids (testosterone and estradiol), pituitary (prolactin and oxytocin), and thyroid hormones may regulate the ejaculatory process, but exact mechanisms are unclear.

Premature ejaculation is remarkably common among young men. Between 30% and 70% of men younger than 40 report premature ejaculation at one time or another, and the problem is also common in older men. Patients and their partners find it distressing, and historically, it has been considered a psychological problem. Increasing attention to male sexual dysfunction and a more receptive, open society has helped researchers elucidate this distressing problem.

Researchers from the Sapienza University of Rome, Italy bring clinicians up to date on this problem’s current status in a review published in the June 2015 issue of the journal Endocrine.

Men (and their partners) are more likely to seek medical care early when they experience premature ejaculation than ever before. The authors note that this specific partner-oriented sexual dysfunction often cannot be resolved without couples’ input.

Treatment demand—and not just for talk therapy or counseling—has also increased appreciably.

Three problems are still considered to be the most probable causes of premature ejaculation: chronic prostatitis, lack of privacy, and psychorelational/psychosexual issues. Emerging physiologic issues are being studied.

Endocrine regulation in ejaculation control is still not well understood. Sex steroids (testosterone and estradiol), pituitary (prolactin and oxytocin), and thyroid hormones may regulate the ejaculatory process, but exact mechanisms are unclear.

In terms of treatment, the researchers found evidence that oxytocin receptors blockade using highly selective antagonists is promising. Diagnosing and treating thyroid disorders—hypo or hyper—is critical, as it may resolve the problem.

In conclusion, the researchers recommend that differential diagnosis of premature ejaculation is the trained specialist’s purview, and specifically recommend that an endocrinologist be involved. The team leader should evaluate testosterone, estradiol, prolactin, leptin, adrenal hormones, and thyroid functioning if significant symptoms suggest underlying disease. The public, however, is calling for a real cure.