Premature Ejaculation: Counting The Seconds
36 CommentsBy Ed Silverman // December 14th, 2009 // 9:14 am
This is the sort of condition that doesn’t come up at dinner parties, or too many other places, we imagine. Yet the recent push to develop a med to treat the problem is getting more press, not surprisingly. The New York Times, for instance, ran a quickie round-up this weekend (see here).
Johnson & Johnson, for instance, is developing a pill called Priligy, and Sciele Pharma is working on a spray (see here). But as the Times notes, a key issue is whether premature ejaculation will be seen as a truly serious disorder. The International Society for Sexual Medicine defines it as the inability to delay ejaculation for more than 1 minute after vaginal penetration and, supposedly, up to one-third of US men suffer.
“Marketers know you don’t sell the steak, you sell the sizzle,” Alan Cassels, a health policy researcher at the University of Victoria and the co-author of ‘Selling Sickness: How the World’s Biggest Pharmaceutical Companies Are Turning Us All Into Patients,’ tells the Times. “It will come down to convincing physicians that this is a serious disease and convincing most men that, if they have unsatisfactory intercourse and they don’t last up to a minute, they have a medical problem.”
So we’re curious. What do you think?
Is Premature Ejaculation A Real Disorder?
- No (53%, 84 Votes)
- Yes (47%, 75 Votes)
Total Voters: 158
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Dan
Another great title, Ed.
From Wikipedia:
iagnostic criteria for Premature Ejaculation DSM-IV-TR (American Psychiatric Association)
A. Persistent or recurrent ejaculation with minimal sexual stimulation before, on, or shortly after penetration and before the person wishes it. The clinician must take into account factors that affect duration of the excitement phase, such as age, novelty of the sexual partner or situation, and recent frequency of sexual activity.
B. The disturbance causes marked distress or interpersonal difficulty.
C. The premature ejaculation is not due exclusively to the direct effects of a substance (e.g., withdrawal from opioids).
pharmavet
This definition is so highly individualized that it will be interesting to see how Pharma designs its trials. I doubt they a co. can just get away with “ejaculation diaries”. They’ll have to do something like “time to detumescence”. I enountered the same problem with HRT trials. Couldn’t just use hot flash diaries. Had to use electrophysiologic measurements, i.e, changes in skin temp, galvanic skin resistence, etc.
pharmavet
I stand corrected. The primary outcome measure per clinicaltrials.gov has been something called “intravaginal ejaculatory latency time” as measured by a stopwatch. Pretty wild.
Lisa Van Syckel
A stopwatch,.. How Romantic.
Melissa
Premature ejaculation is for women what hypoactive sexual desire disorder is for men. If persistent, these disorders interfere greatly with the sex lives of partners.
Women generally take longer to reach climax in the first place. Statistically speaking, a good number of men can’t last more than 30 seconds without ejaculating. That just won’t cut it for most women. I can see treatments for this disorder benefiting men (increased confidence, etc.) and women (increased satisfaction with their sex lives.
Climinax And Premature Ejaculation
Premature ejaculation is a disorder if it persists. Every man is bound to experience it sooner or later due to a number of reasons. This is most common in the adolescent stages as a result of over anxiety but if it happens to an adult, my opinion is that this may be a cause for worry.
Thanks for sharing this article.
pharmavet
Melissa, I can see your point with regard to unfulfilled female sexual response due to PE. But you have two challenges as I see it: 1) a willingness of the female to convey to her male partner about her unfulfilled sexual needs due to PE, which the vast majority of women won’t do for fear of rejection, and 2) a still prevailing attitude among men of “slam bam, thank you mam” that would have to be overcome.
As for the marketability of such a product, Paxil is the currently most widely prescribed (off label), it is generically available and dirt cheap. Even if it is only for a new indication (i.e. dapoxetine), personally as a pharma executive I wouldn’t spend the money develop and market a product only to compete with a generic product that’s effective, safe for short-term use and costs only pennies/day.
Lisa Van Syckel
Sure Pharmavet, just what Society needs, more men and women on Paxil.
pharmavet
Lisa, everyone on these boards knows that you are an activist for an international anti-pharma organization, with a particular axe to grind on SSRI’s. Why would anyone consider your comments to be objectively based?
Yikes!
“Statistically speaking, a good number of men can’t last more than 30 seconds without ejaculating.”
Wow. Glad to know I’m way ahead of the curve on this one…
Would be fun to see the dude deciding whether to “talk with his doctor” and then suddenly crumbling onto the sidewalk.
Lisa Van Syckel
Pharmavet,
If Im an anti-pharma activist, then you must be an Industry Apologist, who profits from disease mongering,..Yes?
riv
Thinking that it’s all about the penis is the real disorder here.
Perhaps we could give out copies of “She Comes First” and direct men to anatomy books for illustrations of the clitoris.
Paxil? Prozac? Don’t need to be an anti/activist to know SSRIs kill libido. Of course, if you’re a woman with a partner who thinks sex begins and ends with his d*ck then you don’t need Paxil to kill your interest.
pharmavet
Yes, Lisa, I’m a proud pharma apologist who made lots of money developing life-saving drugs, some of which admittedly had some untoward side effects. I’ve admitted my bias, so why don’t you admit yours. The Citizen’s Commission for Human Rights, which is a direct offshoot of the Church of Scientology International, list the International Coalition for Drug Awareness, of which you are a member on it’s web site. The anti psychiatric drug bias of all of these groups has been well known for years. I don’t have a problem with bias as long as people are up front about their biases.
Lisa Van Syckel
Pharmavet,
I havent gained financialy, Im not a Scientologist, and needless to say, the scientology attack, that’s so old, and as far as drugawareness is concerned, the overwhelming majority of the group, are parents whose chidren were harmed or killed by an “SSRI” antidepressant.
The Industry deceived parents, not just in the US but around the world, and children died horrific deaths. “untoward side effects”, thats sad, a perfect example of why Industry continues to have a bad rep.
May I suggest, that in the future, you ask one of your PR folks to post for you.
Evelyn Pringle
During these great sexual encounters, whose job is it to keep an eye the stop-watch?
HelicalZz
Perhaps not a disorder, in that it may not have physical health consequences (does ED though?). But is it a situation that can be affected pharmaceutically? Sure it is, and I expect there would indeed be a market, though one that would almost certainly require some DTC advertising.
Lisa Van Syckel
Evelyn,. According to Man,..Its a Woman’s Job..
harpy
Could you rewrite the poll question, Ed? It’s obvious that premature ejaculation happens, therefore it could be classified as a “condition” or “disorder” but the real question is whether or not it should be treated by drugs. Condoms have the same desensitizing effect (or so I’ve heard) and there is at least one device that can be used to prolong erections. Not to mention therapy, practice, and other techniques such as tantric yoga and orgasm control.
The real issue, as I see it, is that a lot of people are disconnected from their bodies and uncomfortable talking about teh secks or what their partner can do to make it better. And, of course, wanting a quick fix that requires little to no effort on their part.
riv
Please list those “life-saving” drugs, pharmavet.
I and Pharmalot lurkers want to know. Of course, so does the Nobel committee.
Lay it down.
patrons99
Awesome, Liv. You’ve really thrown down the gauntlet. As a practicing physician, I find myself in agreement with pharmavet. Pharma has produced some truly “life-saving” drugs, in quite a few therapeutic areas of medicine. However, that is not to say that I in any way condone the ca. half of marketed drugs today which only serve to deplete health care budgets globally. To individually itemize the “bad apples” here would take too long.
Pharma Clarifier
As a pharmaceutical industry executive I admit that we have probably developed more than our share of me-too drugs, patent extenders and line extensions that have may not be great scientific and medical advancements. However, it is revenues from these drugs that is required to fund the dvelopment of the truly life-saving drugs that pharmavet and patrons99 allude to. The Tufts study, which is now about four years old estimated the cost of developing a New Chemical Entity at approximate $800 million. It is probably over one billion dollars currently. The Tufts study has been oft-cited, so don’t take my word for it. Are drugs expensive as a result? Yes, but any physician posting on this board will tell you that you can’t put a price on human life. Before you launch torpedoes at Pharma, ask the patient with terminal non small cell carcinoma of the lung if he would be willing to shell out $3000 for a drug that will extend his/her life by two months. The vast majority wouldn’t think twice about saying yes.
John
Yes, Yes, Yes - this problem has sever consequences and can lead to life-long psychological and emotional problems that only someone who has this problem persistently would know about. The feelings of insecurity and inferiority can be oppressive and the hesitation in becoming involved in a relationship or pursuing a sexual encounter are demeaning and defeating. Yes, this is a serious medical problem
Cheech
Dudes, we already have at least two drugs that work great for this. If this is a medical condition, than one of them will become legal.
Do it!
Oedipus Wrecked
John writes about “sever” consequences.
That would also be a cure.
Where is Freud when we need him?
riv
The study that buried Tufts is somewhere on PLoS or No Free Lunch (archived). You can go fetch. Pathetic, trying to pass that off as having any validity, here of all places where even the Short People know better.
Most of the “research” budget goes to advertising and “development”. About 60 percent I think it was that the non-industry funded study found. It was all Nemeroffed. Capice?
@pharmaClarifier (snort)
Please explain lead time bias.
Lisa Van Syckel
Pharma Clarifier
“You cant put a price on human life” That is the only smart thing you’ve said. Now, you and Pharmavet, could add validity, and integrity to what you have stated, by telling the Pharmalot readers, what companies you work for, and the positions you’ve held. Corporate Executives dont go on internet blogs and brag about how much money they make.
patrons99
The ends don’t justify the means. You cannot put a price on human life. That is precisely what’s wrong with the system under the PDUFA and FDCA. While life-saving treatments are a completely admirable goal, you can’t just trample the rights (to drug safety) of everyone else to get there. Pharma shills (economists) have used economic arguments to gain serial reenactments of the PDUFA. It’s the system (under the PDUFA and FDCA) that needs to be changed. The PDUFA should be repealed. Drug safety needs to be completely separated from FDA and pharma. FDA and pharma have failed miserably at ensuring drug safety. Waves of dangerous drugs in the marketplace are directly attributable to the PDUFA. Many thousands of lives have been lost because of a system that encourages misconduct in drug development and drug marketing.
pharmavet
Lisa, I would love to self-identify. However, the last time I did that on another blog, my family received hate mail from an activist group that I will not mention, because I don’t want their families to experience the same thing.
pharmavet
Riv, instead of relying on “No Free Lunch” as your knowledge source for the Tufts study, why don’t you read the study itself. It is entitled “The Price of Innovation; New Estimates of Drug Development Costs. JA DiMasi, RW Hansen, and HG Grabowski. Journal of Health Economics 22 (2003) 151-185. This article details the cost structures. Part of the confusion stems from out-of-pocket costs versus fully capitalized costs. The actual out-of-pocket costs are indeed lower than $802 million/new approved drug. However this lower number fails to take account of opportunity costs, which are significant owing to a long lead times for drug approval(avge 72.1 months from preclinical to NDA submission. All industries with R&D costs factor in opportunity costs into the total cost projections. This is why, for example new model automobiles, like new drugs are not inexpensive. To summarize the data from Di Masi et al. The fully capitalized expenditures for R&D clinical costs are $467 million. Costs for preclinical are $335 million, for a total of $802 million. To read the article, go to http://www.cptech.org/ip/health/econ/dimasi2003.pdf. It is free.
Big Pharma Fan
News Flash! At 5:00 PM today the United States Senate rejected reimportation of drugs as part of the healthcare reform package! My buds in Big Pharma can breath a sigh of relief. Whew! That was a close one.
marge
You all don’t really get the end game; but you will soon. WE’RE the disease.
carlos
Yo tuve que probar priligy para que se me quitara la eyaculación precoz y gracias a priligy la eyaculación precoz se me desaparecio
stop premature ejaculation
there are lots of techniques presented in the internet about this PE… i have seen that in some cases it is better to take the advice of a psychiatrist..
Nobleman
“Tao of Sexology
The Book Of Infinite Wisdom”
By Steven Chang
http://mhlnk.com/B82776D8
crestere pofta
I’ve heard that garlic increases ejaculation power and taste.
Is this right?? Don’t joke, cus if true, i’d really to work every day smelling bad :P
Thanks