| Drug
firms look for treatment for premature ejaculation
July 4, 2004
The drug industry, which has done a masterful
job convincing men to get help for impotence,
is looking to the next frontier in male
sexuality -- premature ejaculation.
Johnson & Johnson, the big drug manufacturer,
plans to ask the federal Food and Drug Administration
next year to approve a pill for premature ejaculation,
which, by various estimates, affects 20 percent
to 30 percent of men at some point in their
lives.
Another company is developing a cream that's
placed into the tip of the penis.
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"There's a lot of interest in the area
of premature ejaculation," said Dr. Laurence
Levine of Rush University Medical Center.
The condition generally is defined as ejaculation
that occurs either before intercourse or within
one or two minutes of penetration. When asked
by researchers, men typically say they spend
10 to 15 minutes in sexual
intercourse. But guys tend to exaggerate,
said Dr. James Barada of the Albany Center for
Sexual
Health.
A few small studies, in which wives used stopwatches,
found that intercourse typically lasts four
to seven minutes. But those studies had small
sample sizes and other flaws, Barada said. Bottom
line: No one really knows what the norm is.
Barada is trying to find out in a stopwatch
study of 1,000 men.
Premature ejaculation might be the butt of
jokes in movies such as "American Pie"
and sitcoms such as "Friends," but,
in real life, it "can be quite devastating
to the sexual intimacy of the couple,"
said New York University urologist Dr. Andrew
McCullough. A survey of 1,239 men by McCullough
and colleagues found that premature ejaculators
were less satisfied with sexual intercourse,
more likely to have trouble getting aroused
and less likely to be relaxed during sex.
The problem affects people differently. Some
of the men McCullough treats are dragged in
by their frustrated partners. With other couples,
the man seeks treatment, even though his partner
isn't bothered.
Doctors are finding that drugs approved for
other conditions can treat premature ejaculation.
Lidocaine, an anesthetic skin cream often used
to ease the pain of shingles, can delay ejaculation
when applied to the penis. But men generally
don't like the reduced sensitivity. And unless
the man wears a condom, the cream will rub off
and numb his partner, too.
Viagra
sometimes helps. Some men can't maintain an
erection for long, so they hurry up in what
one patient calls a "two-minute drill."
Viagra and two new competing drugs, Levitra
and Cialis,
can prolong the erection, thereby allowing the
man to slow down. And after ejaculation, Viagra
can help a man get a second erection, which
tends to last longer before ejaculation. But
a 2000 study sponsored by the maker of Viagra
found it did not have a large benefit on premature
ejaculation.
A class of antidepressants known as SSRIs --
which includes Prozac, Paxil and Zoloft -- can
delay ejaculation. Some male users find they
either can't reach an orgasm, or take so long
that sex becomes work.
But for men who suffer premature ejaculation,
this side-effect can be desirable. Still, the
drugs are slow to take effect. A man has to
either take the pill four to eight hours before
having sex, or take the drug every day. And
SSRIs have other possible side-effects, including
nausea, dry mouth, drowsiness and reduced sex
drive.
An SSRI that failed as an antidepressant is
showing promise as a premature ejaculation drug.
Johnson & Johnson is developing a version
of the drug, dapoxetine, that kicks in after
only an hour or so. A small study of men with
premature ejaculation found that 40 percent
who took the drug reported their level of sex
satisfaction was good or very good, up from
15 percent before treatment. A larger study
is under way.
Farther down the road is an anesthetic cream
being developed by NexMed. The patient would
use an applicator to apply a drop or two into
the opening of the penis. The company says the
drug slows excitation without numbing. A small
study found it increased the length of intercourse
to four minutes from one minute. Side-effects
include a tingling or warming sensation.
The drug wears off quickly, so it would have
to be applied just before intercourse.
"It could affect the spontaneity,"
said NexMed vice president Kenneth Anderson
source:-http://www.suntimes.com
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