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    BSSM Algorithm Premature Ejaculation v4

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    Laiba Gul
    The document presents a treatment algorithm for premature ejaculation (PE) from the British Society for Sexual Medicine. It begins by defining lifelong and acquired PE and noting that PE is the most common male sexual dysfunction. It then outlines a 3-step algorithm to guide treatment: 1) obtain a patient/partner history, 2) determine if PE is lifelong or acquired, and 3) recommend treatment options including pharmacotherapy, behavioral therapy, or a combination based on the type of PE and patient preference. The algorithm aims to help healthcare providers appropriately manage PE.

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    BSSM Algorithm Premature Ejaculation v4

    Uploaded by

    Laiba Gul
    101 views1 page
    The document presents a treatment algorithm for premature ejaculation (PE) from the British Society for Sexual Medicine. It begins by defining lifelong and acquired PE and noting that PE is the most common male sexual dysfunction. It then outlines a 3-step algorithm to guide treatment: 1) obtain a patient/partner history, 2) determine if PE is lifelong or acquired, and 3) recommend treatment options including pharmacotherapy, behavioral therapy, or a combination based on the type of PE and patient preference. The algorithm aims to help healthcare providers appropriately manage PE.

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    The document presents a treatment algorithm for premature ejaculation (PE) from the British Society for Sexual Medicine. It begins by defining lifelong and acquired PE and noting that PE is the most common male sexual dysfunction. It then outlines a 3-step algorithm to guide treatment: 1) obtain a patient/partner history, 2) determine if PE is lifelong or acquired, and 3) recommend treatment options including pharmacotherapy, behavioral therapy, or a combination based on the type of PE and patient preference. The algorithm aims to help healthcare providers appropriately manage PE.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    101 views1 page

    BSSM Algorithm Premature Ejaculation v4

    Uploaded by

    Laiba Gul
    The document presents a treatment algorithm for premature ejaculation (PE) from the British Society for Sexual Medicine. It begins by defining lifelong and acquired PE and noting that PE is the most common male sexual dysfunction. It then outlines a 3-step algorithm to guide treatment: 1) obtain a patient/partner history, 2) determine if PE is lifelong or acquired, and 3) recommend treatment options including pharmacotherapy, behavioral therapy, or a combination based on the type of PE and patient preference. The algorithm aims to help healthcare providers appropriately manage PE.

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    British Society for Sexual Medicine (BSSM)

    Treatment Algorithm for Premature Ejaculation (PE) July 2013

    Although reliable information on the prevalence of lifelong and acquired PE is lacking when based upon patient self-report, PE is the most common
    male sexual dysfunction. Lifelong PE is defined as:

    ‘A male sexual dysfunction characterised by ejaculation which always or nearly always occurs prior to or within about one minute of vaginal penetration and
    the inability to delay ejaculation on all or nearly all vaginal penetrations, and negative personal consequences, such as distress, bother, frustration and/or the
    avoidance of sexual intimacy.’

    To help you manage PE appropriately, we have proposed the following algorithm to guide you through the treatment options.

    It is important to distinguish between Erectile PATIENT/PARTNER HISTORY Six questions that can help to identify PE are:
    Dysfunction (ED) and PE so the following
    questions are useful: • Establish presenting complaint • Can you delay ejaculation before vaginal penetration?
    • Time taken to ejaculate after vaginal • What is the time between penetration and ejaculation?
    • Is your erection hard enough to penetrate? penetration • Can you delay ejaculation?
    • Do you have difficulty in maintaining your erection • Perceived degree of ejaculatory control • Do you and/or your partner feel bothered, annoyed,
    until you ejaculate during intercourse? • Degree of patient/partner distress and/or frustrated by your PE?
    • Do you ever rush intercourse to prevent loss of your • Onset and duration of PE • Is your PE affecting your relationship?
    erection? • Psychological history • Do you and/or your partner avoid sexual intercourse
    • Medical history because of embarrassment?

    NO YES

    PE
    PE LIKE
    EJACULATORY NATURAL
    VARIABLE YES
    DYSFUNCTION

    PE SECONDARY TO ED OR MANAGE PRIMARY


    YES
    OTHER SEXUAL DYSFUNCTION CAUSE
    TREATMENT

    • Reassurance NO
    • Education
    • Psychotherapy
    Lifelong and acquired PE can be
    • Behavioural therapy
    differentiated by enquiring:

    • When did you first experience PE?


    • Have you experienced PE since your first
    sexual experience on every/almost every
    attempt and with every partner?

    ACQUIRED PE LIFELONG PE

    TREATMENT TREATMENT

    • Behavioural/psychotherapy • Pharmacotherapy
    • Pharmacotherapy PATIENT • Behavioural/psychotherapy
    • Combination treatment PREFERENCE • Combination treatment

    Attempt graduated withdrawal of drug therapy in selected patients


    (generally acquired PE), after 6-8weeks

    TREATMENT OPTIONS
    Pharmacotherapy
    Oral therapies:
    • Short half-life on demand SSRIs specifically suggesting a role in treating PE e.g. dapoxetine - which is the only oral licensed medication for the treatment of PE
    • Off label SSRIs and TCAs that have been used as a daily treatment for PE e.g. paroxetine, sertraline, fluoxetine, citalopram and clomipramine
    • PDE5 inhibitors used on demand as a combination treatment with SSRIs, when PE co-exists with ED
    • Tramadol, an opiate derivative (usually used as an analgesic) but could be used where PE co-exists with a need for analgesia
    Topical therapies:
    • Off label lidocaine/prilocaine

    Behavioural/psychological
    Therapies have been incorporated for a number of years but quantitative research shows benefit is not forthcoming. Nevertheless many patients are understandably anxious and may appreciate
    psychotherapy.

    Algorithm is based on guidance from The International Society of Sexual Medicine (The Journal of Sexual Medicine 2010; 7:2947-2969)

    SSRI: Selective Serotonin Reuptake Inhibitor TCA: Tricyclic Antidepressant PDE5: phosphodiesterase type 5 This algorithm has been independently produced by BSSM. Support and funding has been provided by A. Menarini Farmaceutica Internazionale SRL

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