Tramadol and sexual dysfunction.

Sir,

Khan and Rasaily reported on the use of tramadol for treatment of premature ejaculation (PE) and concluded that “the sex life of patients improved and they reported greater satisfaction with the sporadic treatment”.[1] Indeed, there are several reports confirming the usefulness of tramadol for management of PE. Yang et al., performed a meta-analysis and reported that “tramadol may be effective in PE treatment, especially when patients have failed therapies, like selective serotonin reuptake inhibitors”.[2] However, there are many considerations on the use of tramadol. First, the long-term use can result in drug addiction.[2] In addition, despite its advantage for management of PE, tramadol can induce the sexual dysfunction as a side effect.[3] This should be kept in mind. Finally, tramadol can also cause other side effects. Before usage, it is required to carefully investigate the risk and benefit for each patient.