Deleterious effects of selective serotonin reuptake inhibitor treatment on semen parameters in patients with lifelong premature ejaculation
International Journal of Impotence Research: The Journal of Sexual Medicine, Exclusive Author Commentary

Koyuncu H et al. – Although no drug for premature ejaculation (PE) has been approved by regulatory bodies, chronic selective serotonin reuptake inhibitors proved to be effective in treating lifelong PE. Despite the rising use and known effects of antidepressants on ejaculation, only a few reports have evaluated the impact of these drugs on the male fertility.

Following View Author Commentary page

Premature ejaculation (PE), the most common sexual dysfunctions in men and is characterized by the loss or absence of ejaculatory control. The prevalence rate of PE has been reported to be between 21% to 31% and is recognized to impact on a man’s life in many ways, such as reducing self-esteem, affecting interpersonal relationships, causing anxiety, embarrassment, depression and reducing overall quality of life. Recent guidelines have proposed chronic use of SSRIs (e.g. fluoxetine, sertraline, paroxetine and citalopram) for the treatment of lifelong PE. The SSRIs block 5-hydroxytriptamine (5-HT) transporter mechanisms and thereby increase 5-HT within the synapses. This in turn activates 5-HT1A and 5-HT1B receptors resulting in inhibition of serotonin release into the synapse. With chronic administration of SSRIs, the receptors become desensitized and there is a reduction of inhibitory action on serotonin release. The end result is more serotonin release into the synapse, of the ejaculatory set point, and delay in the ejaculatory reflex. In spite of their efficacy, adverse effects are the major drawback in chronic use of SSRIs in PE patients. Well known adverse effects of SSRIs include sexual dysfunction (sexual desire and arousal difficulties, anejaculation, absent and delayed orgasm), dizziness, nausea, constipation, insomnia and fatigue. Few studies have addressed the impact of SSRIs on spermatozoal function and fertility. Published data clearly show that chronic SSRI treatment has a detrimental effect on spermatogenesis and sperm transport, damages the sperm membrane, alters sperm DNA and has an impact on hormonal homeostasis. These effects may not be important for men undergoing treatments for severe depression; however they must be taken into consideration when SSRIs are administered to a sexually active man with PE. In summary, the potential advers effects of SSRIs on male fertility needs to be considered when treating a young man with PE.

Please login or register to follow this author.
Are you sure you want to Unfollow this Author?
► Click here to access PubMed, Publisher and related articles...
<< Previous Article | Next Article >>

Your Unread Messages in Urology

See All >> Messages include industry-sponsored communications and special communications from MDLinx

Most Popular Urology Articles

1 Prostate cancer antigen 3 test for prostate biopsy decision: A systematic review and meta analysis Full Text Chinese Medical Journal, May 22, 2014    Free full text    Evidence Based Medicine    Review Article

2 Pomegranate juice and prostate cancer: Importance of the characterisation of the active principle Phytotherapy Research, June 10, 2014    Clinical Article

3 Prostate cancer and the influence of dietary factors and supplements: A systematic review Full Text Nutrition & Metabolism, June 20, 2014    Free full text    Review Article

4 Prospective evaluation of MRI-guided in-bore prostate biopsy versus systematic transrectal ultrasound (TRUS)-guided prostate biopsy in biopsy-naïve men with elevated prostate-specific antigen (PSA) levels The Journal of Urology, June 13, 2014    Clinical Article

5 Modeling and analysis of Gleason score 8-10 prostate cancers in the REDUCE study Urology, June 12, 2014    Clinical Article

6 Effect of tadalafil once daily on prostate blood flow and perfusion in men with lower urinary tract symptoms secondary to benign prostatic hyperplasia: A randomized, double-blind, multicenter, placebo-controlled trial Urology, June 17, 2014    Clinical Article

7 Evolution of repeat prostate biopsy strategies incorporating transperineal and MRI-TRUS fusion techniques World Journal of Urology, June 16, 2014    Clinical Article

8 Margin involvement at prostatectomy for clinically localized prostate cancer: Does a low-risk group exist? Practical Radiation Oncology, June 6, 2014    Clinical Article

9 Efficacy and safety of fesoterodine 8 mg in subjects with overactive bladder after a suboptimal response to tolterodine ER International Journal of Clinical Practice, June 11, 2014    Clinical Article

10 Prospective study of diagnostic accuracy comparing prostate cancer detection by transrectal ultrasound–guided biopsy versus magnetic resonance (MR) imaging with subsequent MR-guided biopsy in men without previous prostate biopsies Full Text European Urology, June 26, 2014    Free full text    Clinical Article

11 Screening for prostate cancer with the prostate-specific antigen test: A review of current evidence JAMA, March 20, 2014    Evidence Based Medicine    Clinical Article

12 Is there an anti-androgen withdrawal syndrome with enzalutamide? BJU International, June 18, 2014    Clinical Article

13 Processed meat intake is unfavorably and fish intake favorably associated with semen quality indicators among men attending a fertility clinic The Journal of Nutrition, May 30, 2014    Clinical Article

14 Metabolic syndrome-like components and prostate cancer risk: Results from the REDUCE Study BJU International, June 19, 2014    Clinical Article

15 Low detectable PSA after radical prostatectomy: Treat or watch? The Journal of Urology, June 4, 2014    Clinical Article

16 Health care costs for prostate cancer patients receiving androgen deprivation therapy: Treatment and adverse events Full Text Current Oncology, June 24, 2014    Free full text    Clinical Article

17 Long-term treatment patterns of testosterone replacement medications The Journal of Sexual Medicine, June 12, 2014    Clinical Article

18 Comparison of image-guided targeted biopsies versus systematic randomized biopsies in the detection of prostate cancer: A systematic literature review of well-designed studies World Journal of Urology, June 16, 2014    Review Article

19 Chemoprevention of prostate cancer Annual Review of Medicine, March 13, 2014    Review Article    Clinical Article

20 Antibiotics are not beneficial in the management of category III prostatitis: A meta-analysis Full Text Urology Journal, June 10, 2014    Free full text    Evidence Based Medicine    Review Article

Indexed Journals in Urology: Urology, Journal of Urology, European Urology, The Prostatemore

Register now to view all the MDLinx contents (FREE)!

  • Stay current on the latest literature, research and clinical news
  • Get special communications and offers from MDLinx and our sponsors
  • Receive invitations to paid market research
View Samples and Register

Connect with us, stay current.

Receive the latest mecial news
updates for free via email

Sign up!

Subscribe to our free RSS feeds:

Get the latest news in your specialty automatically added to your newsreader or your personal My Yahoo!, Google, My MSN or My AOL page. Learn More

Close