Premature ejaculation (PE) is defined by Doctors as ejaculation in less than 2 minutes from penetration. Many men experience an issue at some time in their life of feeling that they 'come' too soon. With premature ejaculation there is usually ejaculation with minimal sexual stimulation, before the man wants, and this can lead to relationship difficulties. It is more common in younger men and is often triggered by stress, anxiety, or depression, which leads to a lowering of serotonin levels in the brain. It can be treated by psychological support, direct physical creams to reduce sensitivity, and by Priligy (dapoxetine), which is a drug that increases serotonin levels in the brain.

Priligy tablets are for PE in men aged 18 to 64 years. Priligy delays ejaculation and increases control.

Taking Priligy

There are two strengths of Priligy tablets: 30mg and 60mg.

Start with 30mg tablets and only increase to 60mg if required.

Tablets are taken 1-3 hours before intercourse as an on-demand treatment before anticipated sexual activity. Swallow tablets whole with a full glass of water. The tablets can be taken with or without food.

Do not drink grapefruit juice in the 24 hours before taking Priligy.

Do not take this medicine more than once every 24 hours and not every day.

If Priligy causes dizziness or lightheadedness, have a drink of water and sit with your head between your knees or lie down with your legs raised on a cushion until feeling better. Take no further doses without advice from a doctor.

Effectiveness of Priligy

Approximately one in three men report that they have a good or very good response to Priligy. Average times to ejaculation normally increase from around 1 minute to 3 to 3.5 minutes. Results are slightly better with the higher strength tablet, but there is also an increase in side effects.

Who can benefit

Priligy is likely to be of benefit if:

• The time to ejaculation after penetration is less than two minutes.
• Ejaculation occurs with minimal sexual stimulation before, on, or shortly after penetration and before the patient wishes.
• Marked personal distress or interpersonal difficulty as a consequence of PE.
• Poor control over ejaculation.
• A history of premature ejaculation in the majority of intercourse attempts over the prior 6 months.

Who should NOT take Priligy

Priligy should NOT be taken by men who have:

• Heart problems, such as heart failure or problems with the heart rhythm.
• A history of fainting or dizzy episodes due to low blood pressure or are taking medication which may lower their blood pressure.
• Ever had mania (symptoms include feeling over-excited, irritable, or not being able to think clearly).
• Ever had severe depression.
• Moderate or severe liver problems.
• Over 65 years of age.

Priligy with other medicines

Some medicines should NOT be taken with Priligy. Checks are included in the online consultation.

Cautions

Men should NOT take Priligy without further advice if they:

• Also have another sexual problem, such as erectile dysfunction.
• Use recreational drugs such as ecstasy, LSD, narcotics, or benzodiazepines.
• Drink excessive alcohol.
• Have ever had a mental health problem such as depression, mania (symptoms include feeling over-excited, irritable, or not being able to think clearly), bipolar disorder (symptoms include serious mood swings between mania and depression), or schizophrenia (a psychiatric disease).
• Have epilepsy.
• Have a history of bleeding or blood clotting problems.
• Have kidney problems.
• Have, or are at risk of, high pressure in the eye (glaucoma).

If any of the above apply to you (or you are not sure), talk to your doctor or pharmacist before taking this medicine.

Side effects of Priligy

As with all medicines, side effects are possible.

Common side effects of Priligy (may affect up to 1 in 10 men):

• Dizziness.
• Headache.
• Low blood pressure/fainting.
• Altered mood.
• Feeling numb or having 'pins and needles'.
• Difficulty getting or keeping an erection.
• Sweating more than normal or flushing.
• Diarrhoea, constipation, or having wind.
• Stomach pain, indigestion, bloating, nausea, or being sick.
• Problems sleeping or strange dreams.
• Feeling tired or sleepy, yawning.
• Blocked nose (nasal congestion).
• Difficulty concentrating.
• Shaking or trembling.
• Lower interest in sex.
• Ringing in the ears.
• Blurred vision.
• Dry mouth.

If you develop mood changes, fits (seizures), fainting, lightheadedness, thoughts of suicide or self harm, then stop the medication and consult with your doctor immediately.

Alternative treatments for PE

Priligy is the only medicine licensed in the UK for the treatment of premature ejaculation.

Some doctors prescribe SSRI (Selective serotonin reuptake inhibitor) antidepressant medication to treat PE. This is 'off label' prescribing as it is outside the licence for use of those medications.

It is also possible to use extra thick condoms or anaesthetic creams to reduce penile sensitivity and stimulation, so delaying ejaculation. These can be bought from pharmacies without a prescription.

A disposable patch has recently been marketed which provides direct electrical stimulation to the perineal muscles just behind the testes. This new device helps control PE by increasing perineal muscle activity, but has not undergone extensive UK medical trials. Nerve stimulation has been used in trials in the past with some success.

PE is associated with stress and anxiety and can lead to relationship difficulties. Psychological treatments can be a good option for some men.