Tramadol And Premature Ejaculation Effectiveness

According to a new study reported in the BMC Urology (1) investigators suggested that tramadol can play a vital role in controlling the symptoms of premature ejaculation. Based on the results of the meta-analysis, investigators concluded that long term management for a period of up to 8 to 12 weeks with tramadol can increase the intra-vaginal ejaculatory latency time (IELT) in males with existing ejaculatory dysfunction. In other words, it can prolong the overall course of intercourse by delaying ejaculation. Study conducted in various centers also suggested that Tramadol was found more potent and effective than current traditional treatments for PE (premature ejaculation) management; such as Sildenafil, behavioral therapy, lidocaine gel or paroxetine.

The clinical criteria or definition of premature ejaculation varies; but clinicians believes that the diagnosis of primary premature ejaculation can be established if a men ejaculates within one minute of vaginal penetration, every single time (1). Secondary PE is characterized by inability to delay ejaculation or extremely short latency period (under 3 minutes). PE is perhaps the most common sexual dysfunction in sexually active males; with a prevalence ranging from 2 to 23% (1). Poorly managed premature ejaculation and sexual dysfunction can lead to aggression, frustration, and compromised quality of relationships in poorly managed cases.

What Is Tramadol And What Should You Know About It?

The opioid analgesic agent Tramadol is widely prescribed for the management of moderate to severe pain that does not responds to traditional over-the-counter analgesic agents. The circulation and distribution of this medicine is controlled in almost all parts of the world due to high potency (or risk of adverse drug reaction) and even higher potential for addiction.

Before opting for Tramadol, it is very important to discuss in detail with your primary care provider to learn more about the primary cause and pathophysiology of premature ejaculation in your case as well as possible side effects depending upon your existing health status. For example, if the cause of PE is depression or anxiety, you should avoid it as it may worsen PE.

Regular Use VS. Sporadic Use Of Tramadol

Investigators have carried out studies to identify the efficacy of tramadol in the long term management of PE when used regularly vs. sporadic/ occasional use. For example, according to a new study reported in Indian Journal of Psychological Medicine (2), Khan and colleagues compared the effects of administering 100mg/ day of Tramadol in 30 male patients (8 to 10 hours before intercourse each day, for a period of 4 weeks (and on request for a duration of another 4 weeks) against placebo in another group of 30 males for the same duration. Results suggested that regular use of this medicine improved the coital frequency in males from 2.44 times/week to 4.32 times/week and mean Intra-vaginal ejaculation latency time (IELT) from 59.2 seconds to 96.6 seconds.

Cautions And Concerns

The goal of premature ejaculation therapy is to improve the overall outcome and quality of sexual intercourse. Although Tramadol has been shown to yield promising results in the management of premature ejaculation; it is highly advised that clinicians take optimal caution while advising thus drug for extended periods of time; here’s why:

• Tramadol has been known to activate addiction pathway in the brain. In other words, the chances of developing addiction (or physical/ psychological dependence) on Tramadol are pretty high; especially in individuals who have a history or predisposition to drug addiction.
• It is very important to monitor the Tramadol dose; as higher than recommended dose can lead to breathing difficulty or even respiratory depression. It is imperative to opt for dose modification/ monitoring if you have a liver or renal condition.
• The risk of therapy mediated side effects is also high. For example, several studies have suggested that males who consume Tramadol for extended periods of time are more likely to develop erectile dysfunction and other related issues, such as drowsiness, nausea, mood swings and dizziness.

Additionally, so far very little data is available to determine the actual safe and effective dose of Tramadol for premature ejaculation, total duration of therapy and potential long term side effects on this population (4).

References

1. Martyn-St James, M., Cooper, K., Kaltenthaler, E., Dickinson, K., Cantrell, A., Wylie, K., ... & Hood, C. (2015). Tramadol for premature ejaculation: a systematic review and meta-analysis. BMC urology, 15(1), 6.

2. Khan, A. H., & Rasaily, D. (2013). Tramadol use in premature ejaculation: daily versus sporadic treatment. Indian journal of psychological medicine, 35(3), 256.

3. Yang, L., Qian, S., Liu, H., Liu, L., Pu, C., Han, P., & Wei, Q. (2013). Role of tramadol in premature ejaculation: a systematic review and meta-analysis. Urologia internationalis, 91(2), 197-205.

4. Wong, B. L., & Malde, S. (2013). The use of tramadol “on-demand” for premature ejaculation: a systematic review. Urology, 81(1), 98-103.