An Exploration of Emotional Response to Erotic Stimulation in Men with Premature Ejaculation: Effects of Treatment with Clomipramine

Emotions presumably play an important role in sexual response and dysfunction in men. Yet, few studies have investigated differences in affect between sexually dysfunctional and functional men or changes in dysfunctional men resulting from successful treatment. We compared men having premature ejaculation (PE) with sexually functional counterparts on positive and negative affects, and examined changes in their affective response to pharmacotherapeutic treatment with clomipramine, an ejaculation-retarding agent. Results indicated higher levels of specific negative affects in PE men than controls. Positive affect also differed among groups, and showed variation in response to erotic stimulation and drug treatment. When specific positive affects were analyzed, they diverged in their response to stimulus and drug manipulations. For example, all groups exhibited a decrease in arousal/sensual during clomipramine treatment, but only PE men who responded positively to pharmacological treatment exhibited significant elevation in their enjoyment of the sexual experience. The fact that alleviation of the dysfunction improved positive affect in PE men responsive to clomipramine argues for the efficacy of pharmacotherapy in promoting positive emotional experiences associated with sexual response. But the failure of negative affects to approximate the low levels typical of sexually functional men also suggests the need to consider nonpharmacological methods to ensure complete reinstatement of healthy sexual response.