Topical Agent for Premature Ejaculation

SOURCE: Mark KP, Kerner I. Event-level impact of Promescent on quality of sexual experience in men with subjective premature ejaculation. Int J Impot Res 2016;28:216-220.

Premature ejaculation (PEJ) reportedly is the most common sexual dysfunction in men, even outstripping the prevalence of erectile dysfunction. This may surprise clinicians, since patients do not present often with that complaint, nor is it routine — except when encounters specifically are focused on sexual health — for clinicians to inquire about PEJ.

Currently, there are no drugs specifically approved for PEJ; instead, clinical trials documenting the efficacy of selective serotonin reuptake inhibitors (SSRIs) and tramadol for PEJ have led to their off-label use as often effective treatments.

In this open label trial in which patients (n = 91) were their own control, investigators invited study subjects who self-designated as PEJ and fulfilled criteria of a PEJ diagnostic tool to try topical Promescent (trade name) spray on their penis prior to intercourse. The active ingredient in Promescent is lidocaine.

According to the pre-set parameters of the study, Promescent was efficacious in that it essentially doubled the time to ejaculation; additionally, study subjects believed that the product was easy to use, with minimal interruption of sexual activity.

On the other hand, the latency time (time from intromission until ejaculation) was quite atypical compared to most of the PEJ trials in the literature. That is, in the Promescent trial, baseline ejaculatory latency time was 6.81 minutes, increasing to 11.16 minutes with treatment. Previous trials with SSRIs enrolled PEJ subjects with an ejaculatory latency time of 30 seconds, which would typically increase to three to four minutes with treatment. In any case, Promescent was effective in prolonging time to ejaculation, and was well tolerated.