June 2, 2010 -- Author and New York-based sex therapist Ian Kerner has something in common with hundreds of his current and former clients. He suffers from premature ejaculation.
"Premature ejaculation is the number one sexual problem that men deal with," he said. "I'm very aware of the feelings, the emotions and the stigma," he added.
It's often the butt of jokes, but for the men who have to deal with it, it's no laughing matter.
"In my case, it definitely hurt my relationships. It caused me to remove myself from intimacy, led to embarrassment and led me to see a sex therapist with a girlfriend who was very distressed that she was not enjoying sex with me," said Kerner.
Though the incidence of premature ejaculation varies depending on how the condition is defined, estimates suggest anywhere from 5 to 30 percent of men suffer from it.
"Rates of premature ejaculation potentially eclipse rates of erectile dysfunction, so a lot of men suffer from it, but there's not currently a solution that addresses the problem," said Kerner.
That's why he's excited about the news that came out of a session today at the American Urology Association's annual meeting.
Researchers found that men with primary premature ejaculation who used an experimental topical spray called PSD502 had ejaculation times more than five times longer than men who used a placebo spray. PSD502 is a combination of two common numbing agents – lidocaine and prilocaine.
"Combined results from the PS502 pivotal studies are very exciting and this is a significant milestone," said Dr. Ira Sharlip, lead investigator and clinical professor of urology at the University of California, San Francisco in a press release.
Experts See Treatment As Promising
"I'm really hopeful and optimistic, because there isn't really an existing behavioral therapy technique that works out there," he said.
"The data look very solid. The men had increased latency times that looked clinically relevant," said Dr. Anthony Smith, professor and chief of the division of urology at the University of New Mexico.
Dr. Jason Greenfield, director of the New York Center for Human Sexuality at New York-Presbyterian/Columbia, said he's used EMLA cream, another topical treatment with the same ingredients as PSD502, and it's been effective. But he thinks PSD502 offers more advantages.
"There's less of a risk of the partner becoming numb as well," said Greenfield. "It also works faster and there are no side effects," he added.
There are currently no prescription therapies approved by the U.S. Food and Drug Administration that treat premature ejaculation. If PSD502 does get approved by the FDA, it will be the first such treatment.
Treatment Should Be Multi-Faceted
Right now, most urologists prescribe selective serotonin uptake inhibitors (SSRIs) for premature ejaculation. In addition, many men also undergo psychological treatment or use behavior modification techniques at the same time.
That's what Kerner did to help him take control of his premature ejaculation. He believes that the most effective regimen is one that includes oral medication, topical medication, communication and behavior modification – such as finding alternative ways to pleasure your partner and trying different sexual positions.
"A combination approach is always the best. Treating the whole of the patient is always going to be more effective than treating just one aspect," said Greenfield.
Still, he believes that the medical approach works the best.
"I think oral medications are the most consistently effective," he said. "Behavior modification is always nice and there are no side effects, but it's rarely effective, especially for men who have primary premature ejaculation."
"I think if patients have options, they're going to want to use a pill or a spray," said Smith.
Results Can Give Many Men Hope
In addition to its ease of use and potential effectiveness, PSD502 may offer another major benefit.
"I'm hoping that just by virtue of becoming news that some men will step forward, open up to their physicians and get treatment," said Greenfield.
That's exactly what happened when Viagra hit the market. Men realized it helped their erectile dysfunction, and now, they're speaking out about their problem, spurred on by celebrities such as former U.S. Senator Bob Dole and former Baltimore Orioles outfielder Rafael Palmeiro.
As for Kerner, he remembers when new treatments came on the market.
"I've had premature ejaculation since I was 18. I would have tried anything, and I've probably tried many things that weren't medically recommended."
Because he's been there, he wants other premature ejaculation sufferers to know that while there's no cure for the condition, there is hope.
"There is help and answers and there will be further solutions down the line," he said.