Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Escitalopram treatment for premature ejaculation has a negative effect on semen parameters

International Journal of Impotence Research volume 23, pages 257–261 (2011)Cite this article

Subjects

Abstract

The aim of this study was to determine the impact of long-term escitalopram treatment on semen parameters of patients with lifelong premature ejaculation (PE). Between November 2008 and January 2010, patients admitted to urology outpatient clinic with a self-reported complaint of PE were evaluated. Medical and sexual history of patients were recorded and patients with lifelong PE (a total of 25 patients) who met the International Society of Sexual Medicine definition were asked to record their intravaginal ejaculatory latency time (IELT) for 1 month, complete Premature Ejaculation Diagnostic Tool (PEDT) questionnaire and give semen samples. Afterwards, patients received 10 mg escitalopram daily for 12 weeks and were invited for control visits at first and third month of treatment. During control visits, PEDT was administered again whereas IELTs were recorded and semen samples were re-examined. PEDT scores, arithmetic means of IELTs and results of semen analyses, which were recorded at baseline, first and third month were compared. At the third month of treatment, a significant increase in mean IELTs and a significant decrease in PEDT scores were detected. However there was a significant decrease in sperm concentration, motility and morphology when compared with the baseline semen measures. Daily escitalopram treatment effects the semen parameters of patients with lifelong PE. Further investigations with larger series are needed to see whether other serotonin reuptake inhibitors have similar side effects and to expose the exact mechanism underlying it. Different treatment modalities should be suggested to patients who desire fertility.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Read S, King M, Watson J . Sexual dysfunction in primary medical care: prevalence, characteristics and detection by the general practitioner. J Public Health Med 1997; 19: 387–391.

    Article  CAS  Google Scholar 

  2. Porst H, Montorsi F, Rosen RC, Gaynor L, Grupe S, Alexander J . The Premature Ejaculation Prevalence and Attitudes (PEPA) survey: prevalence, comorbidites, and professional help-seeking. Eur Urol 2007; 51: 816–824.

    Article  Google Scholar 

  3. Patrick DL, Althof SE, Pryor JL . Premature ejaculation: an observational study of men and their partners. J Sex Med 2005; 2: 358–367.

    Article  Google Scholar 

  4. Guliano F, Patrick DL, Porst H . Premature ejaculation: results from a five country european observational study. Eur Urol 2008; 53: 1048–1057.

    Article  Google Scholar 

  5. Godpodinoff ML . Premature ejaculation: clinical subgroups and etiology. J Sex Marital Ther 1989; 15: 130–134.

    Article  CAS  Google Scholar 

  6. McMahon CG, Althof S, Waldinger MD, Porst H, Dean J, Sharlip I et al. An evidence-based definition of lifelong premature ejaculation: report of the International Society for Sexual Medicine ad hoc committee for the definition of premature ejaculation. J Sex Med 2008; 5: 1590–1606.

    Article  Google Scholar 

  7. Wespes E, Amar E, Eardly I, Giuliano F, Hatzichristou D, Hatzimouratidis K et al. Guidelines on male sexual dysfunction: erectile dysfunction and premature ejaculation. European Association of Urology Guidelines. Drukkerij Gelderlandbv: Arnhem-Netherlands, 2009; 33–46.

    Google Scholar 

  8. Montejo AL, Llorca G, Izquierdo JA, Rico-Willademoros F . Incidence of sexual dysfunction associated with antidepressant agents: a prospective multicenter study of 1022 outpatients. Spanish Working Group for the study of psycholotropic-related sexual dysfunction. J Clin Psychiatry 2001; 62: 10–21.

    CAS  Google Scholar 

  9. Lue TF, Giuliano F, Montorsi F, Rosen RC, Andersson KE, Althof S . Summary of the recommendation on sexual dysfunctions in men. J Sex Med 2004; 1: 6–23.

    Article  Google Scholar 

  10. Safarinejad MR . Sperm DNA damage and semen quality impairment after treatment with selective serotonin reuptake inhibitors detected using semen analysis and sperm chromatin structure assay. J Urol. 2008; 180: 2124–2128.

    Article  Google Scholar 

  11. Tanrikut C, Feldman AS, Altemus M, Paduch DA, Schlegel PN . Adverse effect of paroxetine on sperm. Fertil Steril 2010; 94: 1021–1026.

    Article  CAS  Google Scholar 

  12. Althof SE, Symonds T . Patient reported outcomes used in the assessment of premature ejaculation. Urol Clin North Am 2007; 34: 581–589.

    Article  Google Scholar 

  13. Serefoglu EC, Cimen HI, Ozdemir AT, Symonds T, Berktas M, Balbay MD . Turkish validation of the premature ejaculation diagnostic tool and its association with intravaginal ejaculatory latency time. Int J Impot Res 2009; 21: 139–144.

    Article  CAS  Google Scholar 

  14. American Psychiatric Association. Diagnostic criteria from DSM-IV-TR. American Psychiatric Association: Washington, DC, 2000.

  15. McMahon CG . Clinical trial methodology in premature ejaculation observational, interventional, and treatment preference studies-part I-defining and selecting the study population. J Sex Med 2008; 5: 1805–1816.

    Article  Google Scholar 

  16. McMahon CG . Clinical trial methodology in premature ejaculation observational, interventional, and treatment preference studies-Part II-Study design, outcome measures, data analysis, and reporting. J Sex Med 2008; 5: 1817–1833.

    Article  Google Scholar 

  17. Porst H, Vardi Y, Akkus E, Melman A, Park NC, Seftel AD et al. Standards for clinical trials in male sexual dysfunctions. J Sex Med 2010; 7: 414–444.

    Article  CAS  Google Scholar 

  18. Symonds T, Perelman M, Althof S, Giuliano F, Martin M, Abraham L . Further evidence of the reliability and validity of the premature ejaculation diagnostic tool. Int J Impot Res 2007; 19: 521–525.

    Article  CAS  Google Scholar 

  19. Arafa M, Shamloul R . Efficacy of sertraline hydrochloride in treatment of premature ejaculation: a placebo-controlled study using a validated questionnaire. Int J Impot Res 2006; 18: 534–538.

    Article  CAS  Google Scholar 

  20. Giuliano F, Clement P . Serotonin and premature ejaculation: from physiology to patient management. Eur Urol 2006; 50: 454–466.

    Article  CAS  Google Scholar 

  21. Waldinger MD, Zwinderman AH, Schweitzer DH . Relevance of methodological design for the interpretation of efficacy of drug treatment of premature ejaculation: a systematic review and meta-analysis. Int J Impot Res 2004; 16: 369–381.

    Article  CAS  Google Scholar 

  22. Safarinejad MR, Hosseini SY . Safety and efficacy of escitalopram in the treatment of premature ejaculation: a double-blind placebo-controlled, fixed dose, randomized study. Int J Impot Res 2006; 18: 164–169.

    Article  CAS  Google Scholar 

  23. Arafa M, Shamloul R . A randomized study examining the effect of 3 SSRI on premature ejaculation using a validated questionnaire. Ther Clin Risk Manag 2007; 3: 527–531.

    PubMed  PubMed Central  Google Scholar 

  24. Safarinejad RM . Safety and efficacy of escitalopram in the treatment of premature ejaculation: a double-blind placebo-controlled, fixed dose, randomized study. J Clin Psychopharmacol 2007; 27: 444–450.

    Article  CAS  Google Scholar 

  25. Guiliano F, Hellstrom W . The pharmacological treatment of premature ejaculation. BJUI 2008; 102: 668–675.

    Article  Google Scholar 

  26. Tamam L, Ozpoyraz N . Selective serotonin reuptake inhibitor discontinuation syndrome: a review. Adv Ther 2002; 19: 17–26.

    Article  CAS  Google Scholar 

  27. Haddad P . The SSSRI discontinuation syndrome. J Psychopharmacol 1998; 12: 305–313.

    Article  CAS  Google Scholar 

  28. Lane R, Baldwin D . Selective serotonin reuptake inhibitor-induced serotonin syndrome: review. J Clin Psychopharmacol 1997; 17: 208–221.

    Article  CAS  Google Scholar 

  29. De Lamirande E, Gagnon C . Paradoxical effect of reagents for sulfhydryl and disulfide groups on human sperm capacitation and superoxide production. Free Radic Biol Med 1998; 257: 803–817.

    Article  Google Scholar 

  30. De Lamirande E, Gagnon C . Redox control of changes in protein sulfhydryl levels during human sperm capacitation. Free Radic Biol Med 2003; 35: 1271–1285.

    Article  CAS  Google Scholar 

  31. Wolf WA, Kuhn DM . Role of essential sulfhdryl groups in drug interactions at the neuronal 5-HT transporter. Differences between amphetamines and 5-HT uptake inhibitors. J Biol Chem 1992; 267: 20820–20825.

    CAS  PubMed  Google Scholar 

  32. Kumar K, Sharma LV, Tiwari P, Singh D, Maikhuri JP, Gupta G et al. The spermicidal and antitrichomonas activities of SSRI antidepressants. Bioorg Med Chem Lett 2006; 16: 2509–2512.

    Article  CAS  Google Scholar 

  33. Tanrıkut C, Schegel PN . Antidepressant-associated changes in semen parameters. Urology 2007; 69: 185–187.

    Article  Google Scholar 

  34. Amann RP . The cycle of the seminiferous epithelium in humans: a need to revisit? J Androl 2008; 29: 469–487.

    Article  Google Scholar 

  35. World Health Organization. WHO Manual for the Standardised Investigation and Diagnosis of the Infertile Couple. Cambridge University Press: Cambridge, 2000.

  36. Nieschlag E, Behre HM (eds), Andrology: Male reproductive health and dysfunction, 2nd ed. Berlin: Springer Verlag, Chapter 5, pp 83–87.

  37. McMahon CG . Dapoxetine for premature ejaculation. Expert Opin Pharmacother 2010; 11: 1741–1752.

    Article  CAS  Google Scholar 

  38. McMahon C, Kim SW, Park NC, Chang CP, Rivas D, Tesfaye F et al. Treatment of premature ejaculation in the Asia-Pacific region: results from a phase III double-blind, parallel-group study of dapoxetine. J Sex Med 2010; 7: 256–268.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Urology, Yeditepe University Medical School, Istanbul, Turkey

    H Koyuncu & K Sarıca

  2. Department of Urology, Kızıltepe State Hospital, Mardin, Turkey

    E C Serefoglu

  3. Department of Radiology, Haydarpasa Training and Research Hospital, Istanbul, Turkey

    E Yencilek

  4. Department of Psychiatry, Yeditepe University Medical School, Istanbul, Turkey

    H Atalay & N B Akbas

Authors
  1. H Koyuncu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. E C Serefoglu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. E Yencilek
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. H Atalay
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. N B Akbas
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. K Sarıca
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to H Koyuncu.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Koyuncu, H., Serefoglu, E., Yencilek, E. et al. Escitalopram treatment for premature ejaculation has a negative effect on semen parameters. Int J Impot Res 23, 257–261 (2011). https://doi.org/10.1038/ijir.2011.35

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ijir.2011.35

Keywords

This article is cited by

Search

Advanced search

Quick links