It's one of those topics many people feel uncomfortable discussing, but premature ejaculation is a problem a large percentage of the male population experience.
Local clinical research being conducted as part of a much larger trial study will hopefully shed some light on the topic and perhaps lead to a new treatment option.
General urologist Dr. B.W. Palmer says he is involved with clinical trials that are multi-national or international in scope that usually involve pharmaceutical companies. He isn't involved in laboratory research. Palmer is part of a nationwide research consortium involving community-based physicians conducting clinical trials.
These studies could involve any aspect of urology, including potential treatments for prostate cancer, kidney problems, bladder problems or matters dealing with erectile or ejaculatory function. Palmer said these clinical trials represent about 10 per cent of his practice and he is involved in a lot of different studies.
Palmer said they advertise to get patients with a particular disease or problem for certain studies, such as the premature ejaculation study. For example, Palmer said he couldn't simply contact general practitioners and ask them to send over all the guys they treat with the problem.
This has to do with a perceived lack of acceptance or openness to discussing sexual problems, and advertising for potential participants for premature ejaculation studies tends to result in some prank calls.
Open, frank discussion
However, Palmer said this whole dynamic has changed both with physicians and the public in the Viagra era. Wide-reaching advertising campaigns for this and other drugs to treat erectile dysfunction have had an impact in terms of overcoming societal barriers to open, frank discussion.
With premature ejaculation, like erectile dysfunction up until the age of Viagra, it was always thought the problem had to do with the psyche or with interaction with a partner. However, Palmer said this is rarely the case.
Early ejaculation and erectile dysfunction are two separate physiological problems. When studying drugs used to help depression by altering serotonin levels, some men experienced difficulty ejaculating. This was similar to when Viagra was being studied for use treating heart disease or angina. Some male patients didn't want to stop taking the drug because they had been experiencing problems achieving erections.
When it was discovered that drugs used to treat depression by altering serotonin levels had an effect on delaying ejaculation, it was discovered that premature ejaculation has something to do with serotonin uptake.
“It seems to be a problem across the board, probably from birth or a young age,” Palmer said. “It's a problem with uptake in the serotonin pathway.”
In the general population, 20 to 30 per cent of all men have a problem with early ejaculation. Premature or early ejaculation could be defined as achieving orgasm after one to one-and-a-half minutes of intercourse, opposed to the norm of eight to 12 minutes among the general population.
However, Palmer said only about 10 per cent of men in long-term, stable, monogamous relationships have a problem with premature ejaculation. Some men with the problem might not recognize that there is a problem because they know no difference. On the other hand, some men who think they have the problem are well within the range of what would be considered normal.
Erectile dysfunction is different in that it seems to start later in life. By age 50, some men have difficulty achieving an erection and, by age 70 or 80, a lot have difficulty or are unable to get an erection at all.
Various treatments
Treatments have typically involved the use of condoms or jellies to help dull sensation in the penis and this does work to delay ejaculation in some people.
Palmer was involved in a previous trial involving another medication to treat premature ejaculation and the couples that achieved benefits were amazed and very satisfied with the change. It helps if those involved in such studies are in stable, long-term, monogamous relationships because there are fairly stringent controls in clinical trials.
Palmer said they're looking for patients interested in going through the screening process for the premature ejaculation clinical trial. There are consent forms to sign before any testing is done so potential participants are aware of all the details. For this sort of trial, Palmer said there is a screening failure rate of about 50 per cent.
“The number of couples it does affect is probably fewer than we think, but for those that it's a problem, it is a problem,” Palmer said.
The company funding the trial has a product they feel will be beneficial to men experiencing premature ejaculation. However, they would have to go to the Canadian Drug Licensing Board or the Food and Drug Administration in the United States to have it approved for such use and this clinical trial is a step in that process.
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