Premature ejaculation is one of the most prevalent sexual disorders affecting men today. The lack of approved
therapies has resulted in the prescription of many ‘off-label’ treatments to manage the condition. Selective serotonin
reuptake inhibitors have an interesting side effect of prolonging ejaculatory latency. Consequently, these agents are often
considered a first line treatment for patients suffering from premature ejaculation. Erectile dysfunction is another common
side effect reported by men treated with selective serotonin reuptake inhibitors. Nitric oxide is the primary mediator of
erectile function. Preclinical studies have provided evidence that selective serotonin reuptake inhibitors decrease nitric
oxide bioavailability. This invited mini-review aims to examine the physiology of the erectile and ejaculatory responses,
discuss the indicated and ‘off-label’ clinical utility of selective serotonin reuptake inhibitors, and to summarize evidence
from basic science and clinical studies pertaining to mechanisms of how selective serotonin reuptake inhibitor therapy
modifies ejaculatory and erectile function.
Keywords: Erectile dysfunction, PE treatment, premature ejaculation, selective serotonin reuptake inhibitor, SSRI.
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