Selective Serotonin Re-Uptake Inhibitors for Premature Ejaculation in Adult Men: A Cochrane Systematic Review

Niranjan J Sathianathen, Eu Chang Hwang, Ruma Mian, Joshua A. Bodie, Ayman Soubra, Jennifer A. Lyon, Shahnaz Sultan, Philipp Dahm

Research output: Contribution to journalArticlepeer-review


Purpose: Selective serotonin re-uptake inhibitors (SSRIs) are frequently used to treat premature ejaculation (PE) in men. We performed a Cochrane review to assess the efficacy of SSRI treatment for PE. Materials and Methods: We extensively searched a range of databases up to May 2020 and only included randomized controlled trials. Results: A total of 31 studies with 8,254 men were included in this analysis. We found that SSRI treatment probably improves self-perceived PE symptoms (defined as a rating of ‘better’ or ‘much better’; risk ratio [RR], 1.92; 95% confidence interval [CI], 1.66–2.23; moderate-certainty evidence) and satisfaction with intercourse (defined as a rating of ‘good’ or ‘very good’; RR, 1.63; 95% CI, 1.42–1.87; moderate-certainty evidence) compared to placebo. Furthermore, SSRI treatment likely improve participants’ self-perceived control over ejaculation (defined as rating of ‘good’ or ‘very good’; RR, 2.29; 95% CI, 1.72–3.05; moderate-certainty evidence) and probably lessens distress (defined as rating of ‘a little bit’ or ‘not at all’) about PE (RR, 1.54; 95% CI, 1.26–1.88; moderate-certainty evidence). SSRI treatment may increase IELT compared to placebo (mean difference, 3.09 minutes higher; 95% CI, 1.94 higher to 4.25 higher; low-certainty evidence). However, SSRIs may increase treatment cessations due to adverse events compared to placebo (RR, 3.80; 95% CI, 2.61–5.51; low-certainty evidence). Conclusions: SSRI treatment for PE appears to substantially improve a number of outcomes of direct patient importance such as symptom improvement, satisfaction with intercourse and perceived control over ejaculation when compared to placebo.

Original languageEnglish (US)
JournalWorld Journal of Men's Health
Issue number2
StatePublished - 2022

Bibliographical note

Publisher Copyright:
Copyright © 2022 Korean Society for Sexual Medicine and Andrology


  • Meta-analysis
  • Premature ejaculation
  • Serotonin and noradrenaline reuptake inhibitors
  • Systematic review

PubMed: MeSH publication types

  • Journal Article


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