Abstract

“Ejaculatory control” and “bother/distress” are key criteria for diagnosing men with premature ejaculation (PE), yet compared with ejaculatory latency (EL), these constructs have received only minimal attention. In addition, they have not been characterized in men having different sexual orientations or subtypes of PE. This study aimed to characterize relationships among ejaculatory control, bother/distress, and EL; to assess differences across men having different sexual orientations, PE status, and PE subtypes (i.e., lifelong vs. acquired); and to determine the importance of ejaculatory control to men’s sexual partners. In total, 1071 men and sexual partners of men rated their ejaculatory control and bother/distress and estimated their EL; these measures were compared across sexual orientation, PE status, PE subtype, and male and female partners of men. Results revealed a monotonic though slightly curvilinear relationship between ejaculatory control and bother/distress. These PE criteria differed significantly between PE and non-PE men, to a lesser extent between gay and straight men, and not at all between men having lifelong vs. acquired PE. Female and male partners of men affirmed the importance of ejaculatory control during partnered sex, indicating lack of control as a potential reason for ending a relationship.

Highlights

  • It has been more than 12 years since the International Society of Sexual Medicine (ISSM)—and 8 years since the American Psychiatric Association (APA: DSM-5)—first laid out the three-pronged diagnostic criteria for premature ejaculation (PE): a short ejaculatory latency (EL); the inability to control, delay, or postpone ejaculation; and bother or distress about the condition [1,2,3]

  • Non-straight men were slightly younger than straight men, and compared with men, women reported fewer lifetime sexual partners and were more likely to be in a relationship

  • This study has (1) provided a clearer characterization of the relationship between ejaculatory control and bother/distress; (2) reiterated the large differences in these measures between men with and without PE; (3) demonstrated that straight and non-straight men do not differ in their understanding/assessment of ejaculatory control and bother/distress, straight and gay men do differ on the importance of ejaculatory control; (4) shown that men with lifelong PE do not differ from men with acquired PE in their assessment of ejaculatory control or bother/distress; and (5) elaborated on the partner’s perspective regarding the detrimental effects of PE on the dyadic relationship

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Summary

Introduction

It has been more than 12 years since the International Society of Sexual Medicine (ISSM)—and 8 years since the American Psychiatric Association (APA: DSM-5)—first laid out the three-pronged diagnostic criteria for premature ejaculation (PE): a short ejaculatory latency (EL); the inability to control, delay, or postpone ejaculation; and bother or distress about the condition [1,2,3] The inclusion of these specific criteria relied on several seminal studies that lent preliminary support to each prong of the definition; subsequently, these criteria became benchmarks for establishing the efficacy of various treatment strategies for men with PE, e.g., [4,5].

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