Article Summary
The article highlights various aspects of male sexual health beyond erectile dysfunction, focusing on conditions like rapid ejaculation, delayed ejaculation, and arousal deficiency, which are often overlooked and undertreated. Approximately one in three men experiences rapid ejaculation, while an estimated 1-4% contend with delayed ejaculation, underscoring the need for comprehensive treatment solutions. Providers specializing in male reproductive health emphasize integrative approaches, combining PDE5 inhibitors with a range of ingredients to address diverse sexual wellness concerns, highlighting the importance of tailored therapies for men's overall vitality and quality of life.Much attention is paid to erectile dysfunction, but did you know there are other aspects of the male sexual response cycle that need attention as well? Specifically, rapid or premature ejaculation, delayed ejaculation, and arousal deficiency. One in three men experiences rapid ejaculation and an estimated 1-4% of men experience delayed ejaculation.[1][2] These conditions are underserved and undertreated but that can change. Many providers who are experts in male reproductive health specialize in combination therapies that are designed to take treatment beyond ED and address co-conditions like premature and delayed ejaculation.[1][2] Integrative solutions are key in helping men’s overall vitality.
PDE5 Inhibitors Explained
PDE5, or phosphodiesterase type 5, is an enzyme in the body that affects smooth muscle contraction. So, when PDE5 is inhibited, muscles may remain contracted.
Options for Sexual Dysfunction
Though FDA-approved treatments for erectile dysfunction exist, there are no commercially available options for rapid ejaculation or delayed ejaculation. For patient-specific options, providers may combine a unique variety of ingredients with some PDE5 inhibitors when they formulate treatments for conditions related to sexual health and overall quality of life. Urologists and men’s health practitioners have long used compounding pharmacies to source these options.
Combination Ingredients for Men’s Sexual Wellness
Prescribers using emerging therapies for male sexual wellness may often combine one or more of the following ingredients with PDE5 inhibitors:
| Apomorphine | Bremelanotide | Cabergoline |
| Dapoxetine | Dextromethorphan | Oxytocin |
| Phentolamine mesylate | Testosterone | Tramadol |
Prescribers may seek compounded PDE5 inhibitor medications because they are offered in a range of strengths, combinations and alternative dosage forms.
Empower Pharmacy offers 22 different PDE5 inhibitor options ranging from capsules and oral disintegrating tablets (ODTs) to troches, many of which are listed below. Providers who already work with Empower may talk to their Clinic Liaison if they are interested in these or other options. Providers who are interested in partnering with Empower may contact us about these products and anything else we can offer their practices and patients.
Compounded Oral PDE5 Inhibitor Combinations
Expert providers may turn to custom combination therapies to potentially address patients’ multiple issues, including ED.
Sildenafil Combination Products
Sildenafil 100 mg / Apomorphine HCl 6 mg Troche
Sildenafil 55 mg / Tadalafil 12.5 mg Capsule
Sildenafil 100 mg / Testosterone 100 mg Troche
Tadalafil Combination Products
Bremelanotide 1 mg / Oxytocin 100 IU / Tadalafil 10 mg Troche
Bremelanotide 1 mg / Oxytocin 100 IU / Tadalafil 20 mg Troche
Bremelanotide 2 mg / Oxytocin 100 IU / Tadalafil 20 mg Troche
Sildenafil 55 mg / Tadalafil 12.5 mg Capsule
Tadalafil 40 mg / Apomorphine HCl 6 mg Troche
Tadalafil 25 mg / Phentolamine Mesylate 3 mg Capsule
Tadalafil 20 mg / Tramadol HCl 30 mg Troche
Vardenafil Combination Products
Vardenafil 40 mg / Apomorphine HCl 8 mg Troche
- Premature ejaculation. Cleveland Clinic. Accessed July 27, 2022. https://my.clevelandclinic.org/health/diseases/15627-premature-ejaculation
- Chen J. The pathophysiology of delayed ejaculation. Transl Androl Urol. 2016;5(4):549-562. doi:10.21037/tau.2016.05.03
