Why can antidepressants be used to treat premature ejaculation?

Author: Yuan Yifeng, deputy chief physician of the First Affiliated Hospital of Hunan University of Chinese Medicine

Reviewer: Peng Jing, Chief Physician, Peking University First Hospital

Some men suffer from premature ejaculation, which leads to sexual disharmony between husband and wife, and they have to go to the hospital for treatment. But unexpectedly, the doctor's advice is to take antidepressants. Is there any connection between premature ejaculation and depression?

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1. Is there any relationship between premature ejaculation and depression?

To answer this question, we need to first talk about the causes of premature ejaculation and what changes depression causes in the body.

It is generally believed that premature ejaculation is related to multiple factors such as psychological factors, environmental factors, endocrine factors and neurobiological factors. Premature ejaculation can be attributed to psychological factors to a large extent. For example, persistent psychological problems may aggravate premature ejaculation. This means that negative emotions can cause premature ejaculation to a large extent.

Neurobiological factors such as central nervous system serotonin (a neurotransmitter) disorders, genetic variation, erectile dysfunction, etc. are also related to premature ejaculation. Among them, serotonin plays an important role in regulating human emotions and can also accelerate the ejaculation process.

The main physiological factor of depression is the change of monoamine neurotransmitter levels, such as 5-hydroxytryptamine and dopamine levels. These changes in physiological factors affect people's emotions, so people with depression often fall into depression, often have negative thoughts, and stay in a bad mood for a long time.

To sum up, negative emotions caused by depression and changes in the levels of neurotransmitters such as serotonin may induce premature ejaculation.

2. Did the doctor give the wrong medicine?

As mentioned earlier, serotonin is associated with premature ejaculation, and low levels of serotonin can easily lead to premature ejaculation. Conversely, if serotonin levels rise, ejaculation will be delayed. Therefore, antidepressants have the effect of "killing two birds with one stone" in regulating emotions and delaying ejaculation. A large number of examples have proved that such drugs can not only treat depression and regulate patients' emotions, but also improve the problem of premature ejaculation.

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For example, 5-HT selective reuptake inhibitors are relatively effective drugs for the treatment of premature ejaculation. The mechanism of action of this type of antidepressant is to increase the amount of 5-HT, a substance similar to the "brake" management, in the brain, thereby physiologically enhancing the ability to control ejaculation, thereby prolonging ejaculation and solving the problem of premature ejaculation.

In addition, neurotrophic factors that play an important role in the central nervous system will also be remodeled and repaired by 5-HT selective reuptake inhibitors.

Neurotrophic factors can provide nutritional support for neurons and key brain areas in the central nervous system that regulate emotional behavior. When they are active and healthy, people's mood will also improve. When the mood improves and the mood is happy, the problem of premature ejaculation may be improved.

Therefore, it is not wrong for doctors to prescribe antidepressants to patients with premature ejaculation, but because such drugs have a certain effect on premature ejaculation.

3. What are the precautions during medication?

Even if patients know that antidepressants have a certain effect on premature ejaculation, they should not buy them secretly and take them on their own. Instead, they should seek medical attention in time, listen to the doctor's advice, and pay more attention to some matters when taking the medicine.

First, pay attention to the dosage . Take the lowest daily dosage first, and then increase the dosage until the lowest effective dosage is reached after no adverse reactions occur. In addition, patients with poor physical fitness, other diseases, or poor tolerance to drugs should consult a doctor to clarify the dosage and take it strictly according to the standard.

Secondly, pay attention to the time it takes to take effect . This type of drug generally takes effect 5 to 10 days after taking it, and stable therapeutic effects need to gradually appear over 3 weeks, so patients should be patient with treatment and maintain a relaxed attitude.

Secondly, pay attention to the course of medication . Some people can cure premature ejaculation after taking antidepressants for a short period of time and no longer need to take the medication [2]. However, some patients' symptoms recur after stopping the medication, which shows that continuous medication is necessary to achieve the goal of prolonging ejaculation time in the long term. However, considering the adverse reactions and medication tolerance of such drugs, it is recommended that patients stop taking the medication for 1 to 2 weeks after taking it for 1 to 2 months, so as to maintain the efficacy.

Finally, pay attention to adverse reactions . Antidepressants may cause adverse reactions in patients. Common adverse reactions include gastrointestinal reactions, mild headaches, dizziness, and may also lead to sexual dysfunction such as decreased libido and pleasure. Continuous use of such drugs for more than 3 months may also cause a decrease in sperm quality. Therefore, when patients experience some adverse reactions, they should go to the hospital in time and communicate with the doctor to modify the treatment plan, and never ignore it.

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It should be noted that there is a great correlation between premature ejaculation and psychological factors. It is recommended that patients adjust their mentality and lifestyle while taking medication, such as staying up late less and avoiding smoking and drinking as much as possible. This will help achieve better treatment results and restore a healthy life as soon as possible.

References

[1] Gao Guiyuan, Huang Jie, Liu Dan, et al. Research progress on the pathogenesis of depression and antidepressant drugs[J]. China Medical Herald, 2021, 18(1): 52-55, 70.

[2] Chinese Society of Traditional Chinese Medicine Information. Multidisciplinary Diagnosis and Treatment Guidelines for Premature Ejaculation with Integrated Traditional Chinese and Western Medicine (2021 Edition)[J]. Chinese Journal of Andrology, 2021, 35(3): 66-72.