Interventions to treat erectile dysfunction and premature ejaculation: an overview of systematic reviews
Open accessAbstract
INTRODUCTION: Sexual dysfunction in men is common, and optimal treatment is complex. Although several systematic reviews concerning treatment approaches exist, a comprehensive overview without limitations concerning the population, interventions, or outcomes is lacking. AIM: To conduct a "review of reviews" to compare the effectiveness of pharmacologic, non-pharmacologic, and combined interventions. METHODS: 9 electronic databases, relevant journals, and reference lists up to July 2018 were searched. For each intervention, only the most recent and comprehensive meta-analysis or systematic review was included. The methodologic quality of the reviews was appraised using the Assessment of Multiple Systematic Reviews-2 tool. MAIN OUTCOME MEASURE: Sexual functioning (via intravaginal ejaculatory latency time and international index of erectile function), sexual satisfaction, and adverse effects. RESULTS: 30 systematic reviews were included. For premature ejaculation, several treatments, including oral pharmacotherapy (selective serotonin inhibitors, phosphodiesterase type 5 [PDE5] inhibitors, tricyclic antidepressants, and opioid analgesics), topical anesthetics, and combined drug and behavioral therapies demonstrated significant improvements of 1-5 minutes in the intravaginal ejaculatory latency time. Pharmacologic interventions (PDE5 inhibitors, penile injection, and testosterone), shockwave therapy, lifestyle modifications, and combined therapies (PDE5 inhibitors and psychological intervention) were effective in treating erectile dysfunction. Most pharmacologic therapies were associated with adverse effects. CONCLUSIONS: There is suggestive evidence that pharmacologic interventions or combined therapies are more effective than non-pharmacologic interventions for treating sexual dysfunction in men; however, a range of treatment options should be presented to individual patients so they may consider the risks and benefits of treatments differently. Evidence related to behavioral and psychological interventions is insufficient compared with that related to drug trials, highlighting the necessity for larger and better randomized controlled trials. Ciocanel O, Power K, Eriksen A. Interventions to Treat Erectile Dysfunction and Premature Ejaculation: An Overview of Systematic Reviews. Sex Med 2019;7:251-269.
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Patients may prefer medical treatment over psychological treatment because they consider medication or sexual aids a quick fix and less invasive than facing emotional and relational issues.
“The patients themselves may also prefer a medical treatment over psychological treatment because they consider the use of medication or other sexual aids as a quick fix and less invasive than being exposed to emotional and relational issues.105”
From A Psychosocial Approach to Erectile Dysfunction: Position Statements from the European Society of Sexual Medicine (ESSM) (2021) · cites this paper as [105]
The Discussion (page not provided) says some patients may prefer a pharmacologic approach while others favor a behavioral one. It does not say patients view medication or sexual aids as a quick fix, or as less invasive than addressing emotional and relational issues. (LLM, conf=0.88)
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RESEARCH‐INFORMED PRACTICE IN COUPLE AND FAMILY THERAPY
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- Authors
- Ciocanel, O., Power, K., & Eriksen, A.
- Affiliations
- NHS Tayside (GB)
- Corresponding author
- Ciocanel, Oana
- ORCID
- Power, Kevin
- Venue
- Sexual Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2019-07-09
- Volume
- 7
- Issue
- 3
- Pages
- 251-269
- ISSN
- 2050-1161 (ISSN-L)
- PMC
- PMC6728733
- OpenAlex
- W2956359583
- Cited by
- 55
- References
- 89
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 8 · 2023: 11 · 2022: 12 · 2021: 10 · 2020: 4 · 2019: 1
- FWCI
- 1.13
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Sexual Medicine (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
- Social Sciences › Psychology › Clinical Psychology › Sexuality, Behavior, and Technology
- Health Sciences › Medicine › Urology › Urological Disorders and Treatments
- Keywords
- erectile dysfunction, premature ejaculation, male sexual dysfunction, pharmacotherapy, non-pharmacological treatment, phosphodiesterase-5 inhibitors, selective serotonin reuptake inhibitors, topical anesthetics, intravaginal ejaculatory latency time, International Index of Erectile Function, sexual satisfaction, adverse effects, penile injection, testosterone, shock wave therapy, behavior therapy, psychological intervention, treatment effectiveness
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