A trial presented at the European Congress of Urology in Stockholm reports for the first time that pelvic floor exercises can be effective in treating premature ejaculation in men who have had lifelong problems.

Premature Ejaculation (PE) affects a significant minority of men at some point in their lives. There are a variety of treatments, some more effective than others, with some men not responding to treatment. Perceptions of PE are often subjective, with some men believing they have PE inappropriately, but the International Society of Sexual Medicine defines PE as "ejaculation within a minute."

A team led by Dr Antonio Pastore (Sapienza University of Rome), group took 40 men (aged 19-46) who were suffering from PE and trained them to exercise their pelvic floor muscles over a 12 week period. They also measured their time-to-orgasm over this period. Previously, the men had tried a variety of therapies, without any significant improvement. At the start of the trial the average ejaculation time was 31.7 seconds, but by the end of the 12-weeks of pelvic floor exercises this had risen to 146.2 seconds²- a more than 4-fold increase.

33 of the 40 men improved within 12 weeks. Only 5 men showed no significant improvement. 2 had dropped out of the trial early, after showing an improvement. 13 of the 33 patients continued the trial up to the 6 month mark, and they confirmed that they maintained their extended ejaculation time.

Pelvic floor exercises are often used to help male incontinence, especially after surgery such as operations for prostate cancer. Previously pelvic floor exercises had been tested in temporary impotence, but this is the first time that they have been tested over a longer term in men with lifelong impotence.

According to Dr Pastore: "This is a small study, so the effects need to be verified in a bigger trial. Nevertheless, the results are very positive. The rehabilitation exercises are easy to perform, with no reported adverse effects. Previously the men in the trial had tried a variety of treatments, including creams, behavioural therapy, SSRIs and psychological treatments -- with little success. However, we found that 33 of the 40 men in our trial improved their ejaculation time within 12 weeks. We also found that the fact that the men were able to improve their sex-lives through their own efforts helped their self-confidence. This technique seems to offer significant benefits over many existing techniques, including cost-savings and lack of side-effects. Although the exact exercises are still to be standardized, the results obtained in our patients with lifelong PE suggest that it may be considered as a therapeutic option for patients with premature ejaculation."

Speaking for the European Association of Urology, Professor Carlo Bettocchi (Bari) said "This is an interesting study. Premature ejaculation is a real problem for many men, and any way which we can find to help this condition is welcome. This method particularly welcome because it is the sufferers themselves who overcome the problem through their own efforts -- which will have additional psychological benefits."

The study has been accepted for publication after peer-review.

http://www.sciencedaily.com/releases/2014/04/140413135910.htm

New pill to tackle problem of men falling short in bed

Relationship troubles can often be caused by unhappy sex lives.

 Men whose love lives are falling short can try a new prescription pill to combat the problem.

The first drug made available in the UK for premature ejaculation, called Priligy, can reportedly triple the amount of time a man can last in bed.

It works by altering levels of serotonin in the brain, which should give men more control over ejaculation.

The pill is only available on the internet following a confidential online consultation with a doctor.

Priligy has been available and licensed for use in several European countries in recent months and is now coming to the UK following clinical tests on 6,000 men.

The treatment is sold in packs of three and costs £76 for a pack of three 30mg tablets.

It's designed to be taken between one and three hours before sex.

'Too embarrassed'

Premature ejaculation is thought to be the most common sexual disorder in men, affecting one in three men at some point in their lives.

Research has shown that sufferers avoid relationships and have a lower overall quality of life than men without the problem.

A recent European survey found that British, along with German, men are the most unhappy with their sex lives because of the problem.

Many men are also too embarrassed to discuss it with a loved one or even a doctor.

"By providing consultations online we hope to be able to help as many men as possible," said Nitin Makadia, head of male sexual health at Lloydspharmacy, which is running the service.

"Some men are understandably reluctant to discuss the problem with their GP so we are removing this barrier to treatment."

Doctors who are experts in sexual health assess patients' suitability for treatment through an online consultation. If appropriate, they make Priligy available for the patient to purchase.

The treatment is then sent securely through the post.

Priligy is not currently licensed in the UK, but clinicians can legally prescribe any 'unlicensed' medicine to patients if they consider it to be in the patient's best interest.

All doctors prescribing 'unlicensed' medicines are responsible for the patient's care and the consequences of the treatment.

Peter Baker, head of Men's Health Forum, said drugs should not be the first option for someone suffering from premature ejaculation.

"It's fantastic that this drug now exists and particularly if it gives men the confidence to acknowledge they have a problem. But we can't treat every problem with a drug, and there are a number of techniques men can try which can be effective."

http://news.bbc.co.uk/1/hi/health/8646075.stm