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The growing world of sexual dysfunction: From erectile dysfunction to premature ejaculation? In March, 1998, Pfizer launched sildenafil (Viagra) for the treatment of erectile dysfunction. This move had an explosive effect on Pfizer's financial figures. More generally, this pharmaceutical milestone changed public awareness of sexual dysfunction and boosted basic research activity relating to improved understanding and treatment of this problem. Just over 4 years later LeadDiscovery has produced a state of the art analysis of sexual dysfunction focusing on therapeutic and commercial opportunities that exist for the treatment of erectile dysfunction and female sexual dysfunction which affect approximately 31% and 43% of men and women respectively. Like erectile dysfunction, premature ejaculation represents a major market, and indeed in the age-range of 18-59 years old, premature ejaculation represents the predominant sexual dysfunction affecting 28.5% of men. Today, there is no approved medical therapy for the treatment of premature ejaculation and successful pharmaceutical development in this field may therefore reap immense rewards. It is of interest therefore that University of Cincinnati researchers appear to have identified a population of lumbar spinothalamic cells that relay ejaculation-related signals from reproductive organs to the brain. These neurons express neurokinin-1 receptors, and their ablation results in a complete disruption of ejaculatory behavior. In contrast, other components of sexual behavior remained intact. These results suggest that this population of spinothalamic cells plays a pivotal role in generation of ejaculatory behavior and may be part of a spinal ejaculation generator. LeadDiscovery has recently produced a DiscoveryDossier outlining the therapeutic potential of tachykinin receptors antagonists and the role that these receptor play in ejaculatory behavior should be considered when assessing side-effect profiles. On the other hand, although the therapeutic use of receptor agonist in the treatment of premature ejaculation is likely limited by side-effects relating to multiple roles of tachykinins, the identification of a spinal ejaculation generator should now allow further studies into its physiological and therapeutic control. The latter holds immense potential benefits. Adapted from Truitt & Coolen, Science 2002 Aug 30;297(5586):1566-9
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