Currently, our approach to premature ejaculation consists of a history, physical examination specifically geared towards neurological problems and the amount of sensitivity of the penis. Rarely have we found a physical abnormality with the exception of hypersensitivity of the penis as previously mentioned.

Recently there have been reports in the urology literature of successful treatment of premature ejaculation through the use of low dose antidepressants including Anafronil, Prozac and Zoloft. One of the known side effects of these medications when used for depression is significantly delayed ejaculation. In the studies, extremely low doses of the antidepressant medication have prolonged ejaculation by at least 5-10 minutes with very few side effects. Currently this is the most popular treatment alternative selected by our patients. The medication is given approximately four hours before intercourse and will result in a significant delay of ejaculation. Few patients have described any side effects with this treatment. On certain occasions, the medication is given on a daily basis. It should be pointed out that this medication is not approved by the FDA for treatment of premature ejaculation. We have found that combining the medication with the exercises in Dr. Kaplan's book, potentially can result in a man obtaining control over his ejaculation time.

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