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    In addition, this risk was found to be significantly higher in patients with depression and anxiety symptoms, followed by those with diabetes, hypertension and dyslipidemia.

    According to the hypothesis proposed by Jannini et al. In order to test this hypothesis, Jannini et al. PE can also develop secondarily to the increased stimulation for the creation and maintenance of erection in ED patients or accompanying anxiety 8.

    In parallel to this hypothesis, it was suggested that there is a higher risk of developing PE-associated ED for cases in which there is a direct correlation between ED and symptoms of anxiety or depression, and for those who do not have a stable sexual partner and experience stressful sexual relationships 19.

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    Lifelong PE reduces sexual stimulation in patients, thus resulting in sexual intercourse accompanied by ED. On the other hand, McMohan et al.


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    Today, the available PE treatment options include behavior therapy, topical anesthetics, and more predominantly SSRIs. However, studies concerning PDE 5 inhibitors have also reported the clinical efficiency of these drugs in the treatment of PE.

    Studies investigating the therapeutic effects of PDE 5 inhibitors alone and in combination with SSRIs have reported the benefits of these inhibitors for PE treatment 14 - 17.

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    In a well-designed, randomized and double blind study, sildenafil was compared to a placebo 21. Other studies 22, 23 have demonstrated that the combination of PDE 5 inhibitors and SSRIs are more efficient in increasing IELT and overall sexual satisfaction compared to the individual use of these medications.

    These studies used sildenafil 50 mg as the main PDE 5 inhibitor.


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    In a randomized study, Salonia et al. In addition, sildenafil, clomipramine, paroxetine and the pause-squeeze technique were found to increase IELT by 1 to 15 min, 4 min, 3 min, 4 min and 3 min, respectively in comparison to the baseline values 24.

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  • It works in the same way and has the same effects as Cialis. Cialis is also available in 2.

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