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The newly formed cysteinylglycine S -conjugates are further processed by dipeptidases/aminopeptidases to remove the glycyl group and produce cysteine S -conjugates
Medications While no oral medication is FDA-approved specifically for premature ejaculation, several pharmacological options are commonly prescribed off-label: SSRIs (Selective Serotonin Reuptake Inhibitors): Antidepressants such as paroxetine, sertraline, and fluoxetine are widely used to increase serotonin levels, which helps prolong orgasm
Prescription decisions are made by independent licensed providers who review each patient's intake individually
Varatharaj and Galea, 2017
Lignans from flaxseed, converted to enterolactone (EL) and enterodiol by gut microflora within the intestines, possess weak estrogenic activity that competes with endogenous oestrogens for ER binding causing decreased mitogenic stimulation and lower circulating estrogen concentrations via upregulation of sex hormonebinding globulin (SHBG) (189, 190)
Microdosing falls entirely outside MHRA and NICE guidance, and off-label use is not routinely NHS-funded
