St. John’s Wort (Hypericum Perforatum) for the Treatment of Premature Ejaculation


UroToday Int J. 2010 Jun;3(3). doi:10.3834/uij.1944-5784.2010.06.21

INTRODUCTION: Premature ejaculation (PE) is one of the most prevalent forms of male sexual dysfunction. The benefits of Hypericum perforatum for treatment of PE are unknown, although it is hypothesized that its effect on depression and neurotransmitter activity may be beneficial. The authors assessed the efficacy and safety of H. perforatum for the treatment of PE.

METHODS: A prospective, double-blind, randomized, placebo-controlled design was used. Participants were 50 married men with PE. They were 18-50 years old and were evaluated between January 2007 and December 2008. Patients were randomly assigned to one of 2 equal groups. Group 1 received 3 daily tablets of hypericum extract (150 mg per tablet). Each tablet contained 160μg of hypericin. Group 2 received a placebo. All participants recorded intravaginal ejaculation latency time (IELT) and completed the International Index of Erectile Function (IIEF-5) questionnaire before and after treatment. Side effects were self-reported using a questionnaire. Results were compared using chi-square and paired t tests.

RESULTS: Forty-two patients completed the study. Hypericum extract was discontinued due to anejaculation (n = 2) and erectile dysfunction (n = 1); 5 patients taking the placebo were lost to follow-up. There was a significant group difference in mean IELT (P < .001); IELT increased from 1.17 minutes to 5.8 minutes in the group taking hypericum extract. Patients taking hypericum extract also had significantly higher IIEF-5 ratings for the measures of intercourse satisfaction and overall satisfaction (P < .001). There were no significant group differences in mean IIEF-5 ratings of orgasmic function, erectile function, or sexual desire. Mild adverse events of headache, constipation, and photosensitivity were seen in 6 patients (27%) taking hypericum extract.

CONCLUSION: H. perforatum (St. John’s wort) may be an effective and safe treatment for PE, possibly because of its effect on neurotransmitters such as serotonin.

KEYWORDS: Hypericum perforatum; Premature ejaculation; IELT; IIEF-5; Drug therapy.

CORRESPONDENCE: Siavash Falahatkar, MD, Urology Research Center, Guilan University of Medical Sciences, Razi Hospital, Sardare Jangal Street, Rasht, Guilan 41448, Iran (

CITATION: UroToday Int J. 2010 Jun;3(3). doi:10.3834/uij.1944-5784.2010.06.21

ABBREVIATIONS AND ACRONYMS: 5HT, 5-hydroxytryptamine; IELT, intravaginal ejaculation latency time; IIEF-5, International Index of Erectile Function; PE, premature ejaculation; SJW, St. John’s wort; SSRI, selective serotonin reuptake inhibitors.

To cite this article: Asgari SA, Falahatkar S, Sharifi SH, Enshaei A, Jalili MF, Allahkhah A. Safety and Efficacy of the Herbal Drug Hypericum Perforatum for the Treatment of Premature Ejaculation.
UroToday Int J. 2010 Jun;3(3). doi:10.3834/uij.1944-5784.2010.06.21