Fast Five Quiz: Sexual Dysfunction

Bradley Schwartz, DO; Michel E. Rivlin, MD


August 12, 2019

According to guidelines from the ISSM, off-label daily doses of paroxetine, sertraline, citalopram, fluoxetine, and clomipramine have been effective and safe in the treatment of both lifelong and acquired premature ejaculation. Although tramadol may be an effective option for treatment of premature ejaculation, the ISSM recommends it only after other therapies have failed, owing to the risk for addiction and side effects. It should not be combined with an SSRI because of risk for serotonin syndrome.

The ISSM determined that evidence was inadequate to recommend screening or case finding for premature ejaculation, either in the general population or in any subpopulation. However, men with erectile dysfunction should be screened for premature ejaculation. A physical examination is advisable for patients with lifelong premature ejaculation but is not considered mandatory.

Read more about guidelines for premature ejaculation.