Generalized acquired retarded ejaculation in a young man with opium dependency: A rare case report

Introduction: Retarded ejaculation (RE) es-pecially acquired RE is a non common sexual dysfunction in men with some complications and there is low data for treatment. In this case report we introduce a opium addict patient with generali-zed acquired RE that presented as late onset hypo-gonadism. Case report: The patient was a 35 year-old married emigrant worker. His chief complaint was decrease of libido and RE without previous hi-story. He was addicted to opium. He was bored, his weight increased and had sleep disturbance. Physi-cal examination was normal and laboratory tests show hypogonadism (High level of LH and low Testosterone level).Treatment started with diagno-sis of late onset hypogonadism by Testosterone de-canoate (25mg weekly IM) but the results was not satisfying. Because he did not want to discontinue opium use, we prescribed him Bupropion (75 mg/ daily PO) and the patient treated successfully. Discussion: Among acquired causes of RE, opium and opiate addiction is lesser investigated. Consequently there is not a coherent instruction for treatment. Discontinuation of opium is difficult and sometimes leads to premature ejaculation. Bupro-pion may be useful to decrease RE but it did not assessed in opium induced RE. We treated a case of this problem by oral Bupropion 75mg/daily. Conclusion: In conclusion it seems that Bupro-pion (75mg/daily PO) is effective in patients with acquired RE who are addicted to opium and have no desire to discontinue it. A clinical trial is nece-ssary to assess this finding.