Dapoxetine plus nonpharmacological approach improves lifelong premature ejaculation

Treatment with dapoxetine combined with nonpharmacological interventions is effective in improving sexual function in individuals with lifelong premature ejaculation (LPE), as shown in a study.

A team of investigators performed a systematic search using PubMed, PEDro, Cochrane, Web of Science, CINAHL, and Academic Search Ultimate from inception to October 2024 and identified relevant randomized controlled trials (RCTs). Eight RCTs, including 656 participants, met the eligibility criteria.

The intravaginal ejaculatory latency time (IELT) was the primary outcome, while self-perception improvements, as measured by the Premature Ejaculation Diagnostic Tool (PEDT), the premature ejaculation profile (PEP), and other instruments, was the secondary outcome.

In pooled analysis, dapoxetine combined with nonpharmacological therapies significantly improved IELT compared with dapoxetine monotherapy (standard deviation means [SDM], 1.6, 95 percent confidence interval [CI], 0.5–2.8; p=0.01), PEDT scores (SDM, 0.9, 95 percent CI, 0.4–1.4; p<0.001), and PEP subscales, with moderate certainty of evidence according to the GRADE guidelines.

The nonpharmacological therapies were as follows: shockwave therapy, biofeedback, electric stimulation, pelvic floor muscle training, desensitization techniques, psychotherapy, and behavioural therapy.

“Combination therapy increases IELT, reduces PEDT scores, and improves PEP scores,” the investigators said. “These findings suggest that combination therapy is more effective than dapoxetine monotherapy in improving functional outcomes and self-perception in patients with LPE, supported by moderate certainty of evidence.”