Premature Ejaculation & Testosterone Deficiency
Highlights from the European Society of Sexual Medicine Meeting
Dr. Savage attended the European Society of Sexual Medicine Meeting in Prague 23 – 26th January 2020.
One of the topics discussed was the management of premature ejaculation and in particular discussing some newer medications. One of the medications discussed was Fortacin. This is a topical local anaesthetic spray which is used on the tip of the penis prior to sexual intercourse. It is effective and popular with patients. Of the patients who had been prescribed it 60% of them were still using it at 6 month review whereas Priligy tablets (Depoxitine) patients were very disappointed and 90% of them were not using it at 12 month review. Other popular treatments are the use of daily SSRI anti- depressants such as Paroxetine 20mg which are very effective. Dr. Savage finds that treatment very popular with his patients.
Evidence again was shown of the dangers of leaving male Testosterone deficiency patients untreated. In the UK BLAST study of type 2 diabetics with Testosterone deficiency after 5 years in the untreated group of patients, 20% had died versus 3.6% in the patients treated with Testosterone. The best reduction in mortality was seen in the 70 – 80 year old age group.
Chronic use of opiate pain relievers, such Oxycontin, high strength Co-Codamol can produce a significant reduction in Testosterone in men and having a low level of Testosterone increases risk of death. A study showed that these male patients who have to continue on their pain relievers show a 40% reduction in mortality if treated with Testosterone.
For some time there has been a suggestion that environmental pollutants, especially chemicals leaking from plastics may be a cause of reduced Testosterone. Dr. Savage learned at the conference that there is some evidence that Testosterone deficiency is commoner in men in the urban population in support of that view.