Male sexual function II

Stimulates urogenital sphincter constriction and contractility of the vas deferens 

Premature ejaculation is defined as persistent or recurrent ejaculation with minimal sexual stimulation before, on, or shortly after penetration and before the person wishes it. Behavioral therapies include the stop-start technique, the squeeze technique, and other psychotherapeutic interventions. However, it has been shown that the initial positive effects of behavioral techniques disappear after 3 years. 

Pharmacotherapy is also used to delay ejaculation. Initially, local anesthetic ointments were recommended, but later case reports and open trials described the beneficial effects of monoamine oxidase inhibitors (MAOIs), clomipramine, benzodiazepines, and selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine, paroxetine, and sertraline. 

The involvement of central serotonergic neurotransmission in human ejaculation has been investigated mainly in animal studies. To date, it seems that the beneficial effect of SSRI treatment in premature ejaculation results from 5-HT2C receptor stimulation. Among the SSRIs, paroxetine has been demonstrated to be more effective than clomipramine and the other SSRIs. Moreover, it has been suggested that long-term SSRI administration is much more efficient than short-term treatment. -  

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