leptin and Premature-Ejaculation

To investigate the possible role of serum norepinephrine (NE), leptin, and 5-hydroxytryptamine (5-HT) and their correlations with sympathetic skin response located in the penis (PSSR) in primary premature ejaculation (PPE).. We compared the serum level of NE, leptin, and 5-HT, intravaginal ejaculatory latency time (IELT) and the premature ejaculation diagnostic tool (PEDT) scores between 57 PPE patients and 42 healthy control men as controls, who were recruited between September 2016 and January 2019. Additionally, the amplitude and latency of PSSR were measured and compared between the two groups.. Compared with healthy men, both leptin and NE increased significantly in PPE patients (P = .003, P = .005), while serum 5-HT remarkably decreased (P = .002). Serum leptin, NE, and 5-HT were significantly correlated with the diagnosis of PPE, PSSR amplitude, and latency. Moreover, compared with single serum indicator, NE/5-HT and leptin/5-HT had a stronger correlation with both PSSR amplitude (r = .8377, P < .001; r = .9323, P < .001, respectively) and latency (r = -.8058, P < .001; r = -.8901, P < .001, respectively).. Significant differences in leptin, NE, and 5-HT are observed between PPE patients and the controls, which supports the hypothesis of hyperactive sympathetic nerve system (SNS) in PPE. Additionally, leptin/5-HT ratio may serve as an ideal indicator for reflecting SNS activity and predicting treatment response in PPE patients in the future.

Topics: Adult; Electrophysiological Phenomena; Humans; Leptin; Male; Norepinephrine; Penis; Premature Ejaculation; Serotonin; Skin; Sympathetic Nervous System

Nonresponse to any selective serotonin reuptake inhibitor (SSRI) treatment is rare. In this study, we aimed to investigate ejaculation delay nonresponse to paroxetine treatment in men with lifelong premature ejaculation (PE) who were also known to be nonresponders to other SSRIs.. Five males with lifelong PE who were known nonresponders to paroxetine and other serotonergic antidepressants and eight males with lifelong PE who were specifically recruited were included. Blood sampling occurred 1 month and 1 day before the start of treatment and at the end of three consecutive series of 4 weeks of daily treatment with 10-, 20-, and 30-mg paroxetine, respectively. Blood samples for measurement of leptin and paroxetine were taken at 8:30 AM, 9:30 AM, 10:30 AM, and 11:30 AM, respectively. At 9:00 AM, one tablet of 10-, 20-, or 30-mg paroxetine was taken during the first, second, and third month, respectively. Intravaginal ejaculatory latency time (IELT) was measured with a stopwatch. The main outcome measures were the fold increase in the geometric mean IELT, serum leptin and paroxetine concentrations, body mass index (BMI), 5-HT1A receptor C-1019G polymorphism, and CYP2D6 mutations.. Between the 7 paroxetine responders and 6 nonresponders, the fold increase in the geometric mean IELT was significantly different after daily 10-mg (p=0.003), 20-mg (p=0.002), and 30-mg paroxetine (p=0.026) and ranged from 2.0 to 8.8 and from 1.1 to 1.7, respectively. BMI at baseline and at the end of the study was not significantly different between responders and nonresponders. Serum leptin levels at baseline were similar in responders and nonresponders and did not change during treatment. The serum paroxetine concentration increased with increasing dosage and was not significantly different between responders and nonresponders. There was no association between the fold increase in the geometric mean IELT and serum paroxetine levels during the three treatment periods nor between leptin levels during the treatment periods and serum paroxetine levels. For the 5-HT1A receptor C-1019G variation, all responders had the CC genotype and all nonresponders had the GC genotype, respectively.. Complete absence of paroxetine-induced ejaculation delay is presumably related to pharmacodynamic factors and perhaps to 5-HT1A receptor gene polymorphism.

Topics: Adolescent; Adult; Aged; Body Mass Index; Cytochrome P-450 CYP2D6; Humans; Leptin; Male; Middle Aged; Mutation; Paroxetine; Polymorphism, Genetic; Premature Ejaculation; Receptor, Serotonin, 5-HT1A; Risk Factors; Selective Serotonin Reuptake Inhibitors; Time Factors; Treatment Outcome; Young Adult

To study the significance of measurements of plasma leptin and 5-hydroxytryptamine (5-HT) levels in the diagnosis of premature ejaculation (PE).. We compared plasma leptin and 5-HT levels, intravaginal ejaculation latency time (IELT) and Chinese Index of Premature Ejaculation-5 (CIPE-5) scores between 59 patients with PE and 64 healthy control men without PE. We then analyzed the correlations of plasma leptin and 5-HT levels with the IELT and CIPE-5 scores. The patients with PE were administered sertraline (50mg daily) for 8 weeks, and their plasma leptin and 5-HT levels, CIPE-5 scores and IELT were measured again. Comparative analyses of the data were performed between the experimental and control groups and between the pre- and post-treatment values.. Plasma leptin levels were significantly higher (P <.0001), whereas plasma 5-HT levels (P <.0001), IELT (P <.0001), and CIPE-5 scores (P <.0001) were significantly lower in the experimental group than in the control group. Significant changes in leptin and 5-HT levels, IELT and CIPE-5 scores were observed after treatment in the experimental group. Plasma leptin levels negatively correlated with 5-HT levels, CIPE-5 scores, and IELT, whereas 5-HT levels positively correlated with IELT and CIPE-5 scores.. Plasma leptin and 5-HT levels indicate the presence of PE and can be used as diagnostic markers for PE.

Topics: Adult; Humans; Leptin; Male; Premature Ejaculation; ROC Curve; Serotonin; Young Adult

The objective of our work was to evaluate the effect of sertraline hydrochloride on serum levels of leptin and sexual function in patients with premature ejaculation (PE). A total of 124 patients with a history of PE at least 6 months, aged 20-50 years, were treated with sertraline hydrochloride. One hundred and four age-matched normal males without a history of PE were included control subjects and were untreated. Before and after the 8 week experiment, sexual performance parameters including the intravaginal ejaculation latency time (IELT) and the Chinese premature ejaculation index (CIPE) were collected from both PE patients and control subjects through a questionnaire survey and analyzed. Serum levels of leptin were measured. Correlations of serum leptin with Body Mass Index (BMI) were analyzed. Before sertraline treatment, serum levels of leptin were significantly higher (32.9 vs 8.8 μg/L, p<0.001) but IELT and CIPE score were significantly lower (54 vs 590, p <0.001; 8.7 vs 22.3, p <0.0001) in PE patients than control subjects. After 8 weeks of treatment with sertraline, serum levels of leptinl in PE patients were decreased markedly to 8.0 μg/L, which was not significantly different from the levels in control subjects (p >0.05); and IELT and CIPE score in PE patients were increased to the values similar to those in control subjects. The sensitivity and specificity values were 87.5% and 96.3% for leptin as a diagnosis target. These observations suggest sertraline as a selective serotonin reuptake inhibitor may offer an effective option for treating premature ejaculation.

Topics: Adult; Case-Control Studies; Humans; Leptin; Male; Middle Aged; Premature Ejaculation; Selective Serotonin Reuptake Inhibitors; Serotonin; Sertraline; Young Adult