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Penile Sensitivity - A Cause of Premature Ejaculation?

Penile Hypersensitivity

Penile hypersensitivity has long been debated as one of the leading causes of premature ejaculation. Some studies have shown no statistically-significant variation in the penis sensitivity between men with and without PE.

 Xin et al in the September 1996 Journal of Urology studied the difference in penile sensitivity in 120 patients with PE and 66 volunteers without PE using an instrument that is able to determine vibratory thresholds called a biothesiometer. They found that penile sensitivity as determined by vibratory thresholds was much greater in men with PE compared to volunteers without PE. Also of interest was a lack of the normal age-dependent decrease in penile sensitivity in those patients with PE.

In August 1997, Xin et al published a separate article in the Journal of Urology that measured penile sensitivity using a different device which measured somatosensory evoked potentials. This data was consistent with the earlier data in that men with PE had significantly greater evoked potentials consistent with penile hypersensitivity in comparison to normal men.

Contrary View of Penile Sensitivity and Relationship to PE

In contrast to the previously mentioned studies, other published articles have questioned the role of penile hypersensitivity in the etiology of PE. Rowland et al in 1993 studied 63 men and concluded that there appeared to be no role for hypersensitivity in the etiology of PE. More recently, Salonia et al looked at sensory thresholds in 42 patients with lifelong PE and 41 controls. Both warm and cold sensation thresholds were similar between patients with PE and controls.

Paick, JS, et. al. - Department of Urology, College of Medicine, Seoul National University, Korea - in a 1998 study titled:  "Penile sensitivity in men with premature ejaculation", concluded:

According to our results, penile hypersensitivity, as measured by an SMV-5 vibrometer, does not appear to be a major factor contributing to premature ejaculation.

Reduction in Oversensitivity / Prevention of PE

In spite of the conflicting data on the role of penis sensitivity and PE, The American Urological Association includes a prescription, off-label topical anesthetic as an accepted treatment option for reduce penile hypersensitivity in their consensus panel on PE published in 2004. 

Separately, the FDA has approved drugs produced under FDA monograph 21 CFR 348.10 for the prevention of PE. The following information in italics is taken straight from the Code of Federal Regulations, Title 21, Volume 5, Revised April 1, 2012, CITE 21 CFR 348.

Description:   Male genital desensitizing drug product.

Labeling:

(1)For products containing any ingredient identified in 348.10(a). (i) "Helps in the prevention of premature ejaculation."

(ii) "For temporary male genital desensitization, helping to slow the onset of ejaculation."

(iii) "Helps in temporarily" (select one of the following: "retarding the onset of," "slowing the onset of," or "prolonging the time until") followed by "ejaculation."

(iv) "For reducing oversensitivity in the male in advance of intercourse."