Research progress on the treatment of premature ejaculation by integrated traditional Chinese and Western medicine

Progreso de la investigación en el tratamiento de la eyaculación precoz con la medicina tradicional China y occidental integrada

Premature ejaculation (PE) is a common condition that troubles men in today’s society, which significantly influences men’s mental health and the relationship between spouses. Both traditional Chinese medicine (TCM) and Western medicine are currently the preferred treatment options for PE. When treating PE with both traditional Chinese and Western medicine, two sets of treatment plans are briefly introduced: internal treatment and external treatment. In the internal treatment method, the popular TCM formulas in recent years were introduced, their therapeutic effects and principles on PE were described, and the results of analyzing the effective ingredients of TCM monomers from the perspective of molecular biology in recent years were also presented. Then the mechanism of their treatment of PE was explained and their efficacy and safety was compared with Western medicine in treating PE; in terms of external treatment, the current mainstream treatment schemes were introduced, such as acupuncture and moxibustion, liquid medicine external application, massage desensitization and behavioral psychotherapy, and their advantages and disadvantages were elaborated. Finally, the theoretical treatment of PE was put into practice through rational criticism and analysis to improve men’s physical health and promote the development of the TCM culture.

Resumen

La eyaculación precoz (PE) es una enfermedad común que afecta a los hombres en la sociedad actual y puede tener un impacto significativo en la salud mental y las relaciones conyugales de los hombres. En la actualidad, tanto la Medicina Tradicional Chinesa (MTC) como la medicina occidental son los tratamientos preferidos para la PE. En el tratamiento de la medicina tradicional china y occidental integrada, presentamos brevemente dos conjuntos de planes de tratamiento: tratamiento interno y tratamiento externo. En términos de tratamiento interno, hemos introducido las recetas de MTC que han sido populares en los últimos años, sus efectos terapéuticos y principios sobre el PE, y los resultados del análisis de los principios activos individuales de la medicina tradicional china desde la perspectiva de la biología molecular en los últimos años. Explicamos su mecanismo para tratar la PE y la comparamos con la eficacia y seguridad de la medicina occidental para tratar la PE; En términos de tratamiento externo, hemos presentado los programas de tratamiento convencionales actuales. Como la acupuntura y la moxibustión, la aplicación externa de pociones, la desensibilización por masaje y la psicoterapia conductual, y se introdujeron sus ventajas y desventajas. Por último, el tratamiento teórico de la EP se puso en práctica mediante la crítica y el análisis racionales para mejorar la salud física de los hombres y promover el desarrollo de la cultura de la MTC.

Premature ejaculation; Traditional Chinese medicine; Behavioral therapy; Acupuncture and moxibustion; Reproductive health

Palabras Clave

Eyaculación precoz; Medicina Tradicional Chinesa; Terapia conductual; Acupuntura y moxibustión; Salud reproductiva

[1] Niu C, Ventus D, Jern P, Santtila P. Premature ejaculation among Chinese urban men: prevalence and correlates. Sexual Medicine. 2023; 11: qfac015.

[2] Sajdlova R, Fiala L. Premature ejaculation and stress. European Psychiatry. 2022; 65: S282.

[3] Serefoglu EC, McMahon CG, Waldinger MD, Althof SE, Shindel A, Adaikan G, et al. An evidence-based unified definition of lifelong and acquired premature ejaculation: report of the second international society for sexual medicine ad hoc committee for the definition of premature ejaculation. The Journal of Sexual Medicine. 2014; 11: 1423–1441.

[4] Althof SE, McMahon CG, Rowland DL. Advances and missteps in diagnosing premature ejaculation: analysis and future directions. The Journal of Sexual Medicine. 2022; 19: 64–73.

[5] Horvath Z, Hevesi K, Kövi Z, Rowland DL. Identifying an optimal ejaculation latency for the diagnosis of men reporting orgasmic/ejaculation difficulty. The Journal of Sexual Medicine. 2023; 20: 821–832.

[6] Niu C, Santtila P. Effects of physical exercise interventions on ejaculation control. Sexual Medicine Reviews. 2023; 12: 106–113.

[7] Nguyen HB, Nguyen CT, Pham MQ, Hoang L, Sansone A, Jannini EA. Perceived intravaginal ejaculation latency time: the diagnosis of premature ejaculation among Vietnamese men. Andrology. 2024; 12: 618–623.

[8] Xi Y, Zhang H, Colonnello E, Limoncin E, Jannini EA, Zhang Y. The masturbatory premature ejaculation diagnostic tool (MPEDT): a novel psychometric tool to evaluate premature ejaculation during masturbation. Andrology. 2022; 10: 333–339.

[9] Perelman MA. The Sexual Tipping Point®: a mind/body model for sexual medicine. The Journal of Sexual Medicine. 2009; 6: 629–632.

[10] Wu HT, Lee CH, Chen CJ, Sun CK. Penile arterial waveform analyzer for assessing penile vascular function in young adults. Annals of Biomedical Engineering. 2011; 39: 2857–2868.

[11] Gao P, Liu X, Zhu T, Gao R, Gao J, Zhang Y, et al. Vital function of DRD4 in dapoxetine medicated premature ejaculation treatment. Andrology. 2023; 11: 1175–1187.

[12] Liu X, Zhu T, Gao P, Gao J, Gao R, Jiang H, et al. The role of tyrosine hydroxylase within dapoxetine-assisted therapy against premature ejaculation. Molecular Biology Reports. 2023; 50: 3515–3523.

[13] Clément P, Pozzato C, Heidbreder C, Alexandre L, Giuliano F, Melotto S. Delay of ejaculation induced by SB-277011, a selective dopamine D3 receptor antagonist, in the rat. The Journal of Sexual Medicine. 2009; 6: 980–988.

[14] Waldinger MD, Berendsen HHG, Blok BFM, Olivier B, Holstege G. Premature ejaculation and serotonergic antidepressants-induced delayed ejaculation: the involvement of the serotonergic system. Behavioural Brain Research. 1998; 92: 111–118.

[15] Arletti R, Bazzani C, Castelli M, Bertolini A. Oxytocin improves male copulatory performance in rats. Hormones and Behavior. 1985; 19: 14–20.

[16] Gul M, Bocu K, Serefoglu EC. Current and emerging treatment options for premature ejaculation. Nature Reviews Urology. 2022; 19: 659–680.

[17] Gamidov SIG, Popova AYP, Shatylko TVS, Li KIL, Safiullin RIS. Evaluation of the efficacy of dapoxetine in primary and secondary forms of premature ejaculation. Urologiia. 2022; 46–49. (In Russian)

[18] Virtanen S, Lagerberg T, Khemiri L, Suvisaari J, Larsson H, Lichtenstein P, et al. Association of selective serotonin re-uptake inhibitor (SSRI) treatment with acute substance misuse outcomes. Addiction. 2022; 117: 234–242.

[19] Sansone A, Yuan J, Hou G, Zhang L, Gao M, Zhang Z, et al. From waterloo to the great wall: a retrospective, multicenter study on the clinical practice and cultural attitudes in the management of premature ejaculation, in China. Andrology. 2024; 12: 247–258.

[20] Han Q, Guo J, Wang R, Li J, Wang F, Gao Q, et al. Mechanism of Shugan Yidan fan, a Chinese herbal formula, in rat model of premature ejaculation. Basic and Clinical Andrology. 2023; 33: 25.

[21] Cinar O, Durmus N, Aslan G, Demir O, Evcim AS, Gidener S, et al. Effects of the dopamine D3 receptor agonist 7-hydroxy-2-(di-N-propylamino) tetralin in hyperthyroidism-induced premature ejaculation rat model. To be published in Andrologia. 2018. [Preprint].

[22] Zhai X, Pang K, Li H, Yao X, Wang Z, Tang P, et al. Study on evaluation of toxicology and quality control of Yimusake tablet. Journal of Ethnopharmacology. 2020; 263: 111443.

[23] Jiang P, Aimaier M, Maimaitiyiming M, Liu F, Ma W, Sataer M, et al. Changes of microRNA profile after Yimusake treatment in ED rat model. Acta Biochimica et Biophysica Sinica. 2019; 51: 873-875.

[24] Guo J, Gao QH, Wang F, Yu GJ, Zhang JW, Zeng Y, et al. Efficacy and safety of Qiaoshao Formula on patients with lifelong premature ejaculation of Gan (Liver) depression and Shen (Kidney) deficiency syndrome: a randomized controlled trial. Chinese journal of integrative medicine. 2016; 22: 889–893.

[25] Wang M, Wang Q, Du Y, Zhang X. Network pharmacology-based strategy to investigate pharmacological mechanisms of Qiaoshao Formula for treatment of premature ejaculation. Evidence-Based Complementary and Alternative Medicine. 2020; 2020: 1418634.

[26] Uckert S, Bazrafshan S, Sonnenberg JE, Kuczyk MA. Effects of phosphodiesterase inhibitors on the contractile responses of isolated human seminal vesicle tissue to adrenergic stimulation. The Journal of Sexual Medicine. 2009; 6: 408–414.

[27] Lu J, Wang Z, Li S, Xin Q, Yuan M, Li H, et al. Quercetin inhibits the migration and invasion of HCCLM3 cells by suppressing the expression of p-Akt1, matrix metalloproteinase (MMP) MMP-2, and MMP-9. Medical Science Monitor. 2018; 24: 2583–2589.

[28] Li JX, Lu QG. Efficacy of Qilin Pills combined with sertraline in the treatment of secondary non-consolidated kidney qi premature ejaculation. National Journal of Andrology. 2015; 21; 443–446. (In Chinese)

[29] Yi ZM, Chen SD, Tang QY, Tang HL, Zhai SD. Efficacy and safety of sertraline for the treatment of premature ejaculation: systematic review and meta-analysis. Medicine. 2019; 98: e15989.

[30] Guo J, Wang F, Zhou Q, Geng Q, Gao Q, Zhang R, et al. Safety and efficacy of traditional Chinese medicine, Qiaoshao formula, combined with dapoxetine in the treatment of premature ejaculation: an open-label, real-life, retrospective multicentre study in Chinese men. Andrologia. 2021; 53: e13915.

[31] Niu C, Santtila P. Effects of physical exercise interventions on ejaculation control. Sexual Medicine Reviews. 2023; 12: 106–113.

[32] Cai T, Gallelli L, Verze P, Salonia A, Palmieri A. Prilocaine/lidocaine spray for the treatment of premature ejaculation: a dose- and time-finding study for clinical practice use. International Journal of Impotence Research. 2023; 35: 378–384.

[33] Boeri L, Pozzi E, Fallara G, Montorsi F, Salonia A. Real-life use of the eutectic mixture lidocaine/prilocaine spray in men with premature ejaculation. International Journal of Impotence Research. 2022; 34: 289–294.

[34] Shariev A, Savdie R, Hart K. The effects of steady freddy, a lidocaine-based pump spray for the treatment of premature ejaculation (PE). American Journal of Men’s Health. 2022; 16: 15579883221145245.

[35] Carson C, Wyllie M. Improved ejaculatory latency, control and sexual satisfaction when PSD502 is applied topically in men with premature ejaculation: results of a phase III, double-blind, placebo-controlled study. The Journal of Sexual Medicine. 2010; 7: 3179–3189.

[36] Cui YD, Hu SB, Wu B, Li SJ, Xiang K, Liao ZL, et al. Efficacy of combined traditional Chinese medicine spray with premature ejaculation desensitization therapy for the treatment of primary premature ejaculation. African Health Sciences. 2017; 17: 603–613.

[37] Zheng L, Wei LT, Tang QZ, Song CL, Liu WR, Wang KN, et al. The sensitivity difference between the glans penis and penile shaft in primary premature ejaculation. Asian Journal of Andrology. 2023; 25: 487–491.

[38] Philip F, Shishehbor MH. Current state of endovascular treatment for vasculogenic erectile dysfunction. Current Cardiology Reports. 2013; 15: 360.

[39] Zhang H, Colonnello E, Sansone A, Wang F, Guo J, Wang C, et al. Acupuncture for premature ejaculation: a systematic review and meta-analysis. Sexual Medicine. 2023; 11: qfad034.

[40] Colonnello E, Sansone A, Jannini EA. Acupuncture for male sexual dysfunction in the light of the new sexual traditional Chinese medicine. The Journal of Sexual Medicine. 2023; 20: 1228–1229.

[41] Lu X, Han H, Zhang Z, Chen H, Huang X, Zhang R. Study on the efficacy of electric acupuncture in the treatment of premature ejaculation based on testosterone level. Journal of Healthcare Engineering. 2022; 2022: 8331688.

[42] Sahin S, Bicer M, Yenice MG, Seker KG, Yavuzsan AH, Tugcu V. A prospective randomized controlled study to compare acupuncture and Dapoxetine for the treatment of premature ejaculation. Urologia Internationalis. 2016; 97: 104–111.

[43] Sunay D, Sunay M, Aydoğmuş Y, Bağbancı S, Arslan H, Karabulut A, et al. Acupuncture versus paroxetine for the treatment of premature ejaculation: a randomized, placebo-controlled clinical trial. European Urology. 2011; 59: 765–771.

[44] Bukhari SR. Psycho, pharmaco and sex therapy for the treatment of premature ejaculation. Pakistan Journal of Medical Sciences. 2022; 38: 2350–2355.

[45] Niu C, Wen G, Ventus D, Jern P, Nyman TJ, Li Y, et al. High-intensity interval training (HIIT) and slow breathing interventions alleviate premature ejaculation (PE) symptoms. International Journal of Clinical and Health Psychology. 2024; 24: 100457.

[46] Mamidi P, Gupta K. Efficacy of certain yogic and naturopathic procedures in premature ejaculation: a pilot study. International Journal of Yoga. 2013; 6: 118–122.

[47] Niu C, Wen G, Ventus D, Zhang Y, Jern P, Santtila P. A 2-week high-intensity interval training intervention improves ejaculation control among men with premature ejaculation. Andrology. 2024; 12: 164–178.

[48] Shechter A, Mondaini N, Serefoglu EC, Gollan T, Deutsch F, et al. A novel on-demand therapy for lifelong premature ejaculation using a miniature transperineal electrical stimulator-the vPatch: an as-treated analysis. The Journal of Sexual Medicine. 2023; 20: 22–29.