Premature ejaculation Old story new insights

Ejaculatory control is culturally acquired, and premature ejaculation is the most common male sexual complaint. Integrating the new pharmacologic and traditional psychologic treatments is the best management strategy.

Emmanuele A. Jannini, M.D., Giacomo Ciocca, Ph.D., Erika Limoncin, Ph.D., Daniele Mollaioli, Ph.D., Stefania Di Sante, M.D., Daniele Gianfrilli, M.D., Ph.D., Francesco Lombardo, M.D., Andrea Lenzi, M.D.

Volume 104, Issue 5, Pages 1061-1073


Conventional theories and therapies for premature ejaculation (PE) are based on assumptions not always supported by evidence. This review of the current literature on the physiology of the ejaculatory control, pathogenesis of PE, and available therapies shows that PE is still far from being fully understood. However, several interesting hypotheses have been formulated, and solid, evidence-based clinical data are currently available for dapoxetine, the unique, first-line, officially approved pharmacotherapy for PE. Further growth in the field of PE will occur only when we shift from opinion-based classifications, definitions, and hypotheses to robust, noncontroversial data grounded on evidence.

  • Vincenzo Puppo

    RE: Premature ejaculation Old story new insights. A rebuttal: premature ejaculation is not a disease.
    Jannini et al. stated: “PE is still far from being fully understood”.
    Is PE really a male sexual dysfunction?
    PE is considered the cause of the partner’s failure to achieve vaginal
    orgasm, with negative psychological consequences for the male, but vaginal
    orgasm does not exist.
    In all women, orgasm is always possible if the female erectile organs
    are effectively stimulated during masturbation, cunnilingus, or partner
    masturbation, or during vaginal intercourse if the clitoris is simply
    stimulated with a finger. Many men think prolonged intercourse is the key to
    orgasms, but it is not helpful for women. PE does not occur if both partners
    agree that the quality of their sexual encounters is not influenced by efforts
    to delay ejaculation, and some females may be grateful to get it over with
    As a matter of fact, the vaginal orgasm has no scientific basis, so
    the duration of penile-vaginal intercourse is not important for a woman’s
    orgasm. Sexual dysfunctions are conditions in which the ordinary physical
    responses of sexual function are impaired: it is important for men (and sexual medicine experts, endocrinologists, urologists, andrologists, physicians, sexologists) to understand that in “premature” ejaculation the physiology of ejaculation and orgasm is not impaired, and that PE is normal in adolescent males especially during their first sexual encounters, due to their inexperience in sexual matters.
    “E.A. Jannini has received personal fees from Menarini, Bayer, Ibsa, GSK, and Pfizer”.
    PE has become the center of a multimillion dollar business: is PE – and female sexual dysfunction – an illness constructed by sexual medicine experts under the influence of drug companies?
    PE is not a disease and must not be classified as a male sexual
    dysfunction. Teens and men by masturbation can understand their sexual response and learn ejaculatory control with the stop-start method and the squeeze technique, without a drug therapy.
    Male ejaculation does not automatically mean the end of sex for most
    women. Touching and kissing can be continued almost indefinitely; non-coital sexual acts after male ejaculation can be used to produce orgasm in women.
    Dr. Vincenzo Puppo, M.D.
    Centro Italiano di Sessuologia, Italy.
    Puppo V. Puppo G. 2015. Comprehensive review of the anatomy and physiology of male ejaculation: Premature ejaculation is not a disease. Clinical Anatomy. Doi: 10.1002/ca.22655
    Article selected to feature in Wiley’s News Round-Up (it is a biweekly mailing sent to over 1,800 subscribing journalists). Wiley Press Release:
    Free pdf in Researchgate:

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