Introduction Into the Diagnostics and Treatment of Premature Ejaculation: Sexuality Has Many Facets

Abstract

This interesting article leaves many questions unanswered. Even though meaningful long-term studies are lacking, the authors neither discussed the course of premature ejaculation between individuals and in the same individual nor whether symptoms are due to a particular sexual partner or to the man’s form of the day. Etiologically, distress or particular personality traits were left out of the discussion, as were aspects of whether premature ejaculation is the cause or effect of a partner interaction that may be problematic only at second glance, whether the symptoms occur regularly, or whether the same man also has these problems while masturbating. And what about the influence of circumcision? It seems that the regions with a reportedly high prevalence of premature ejaculation – such as South America and Asia – represent typical macho cultures, rather than focusing on the female orgasm in particular, as the authors claim. If the high prevalence of 30% worldwide (1) is true then this could be due to a physiological variant to the norm. To suggest that this has the status of an illness – presumably in order to have reasons for (psycho)therapeutic or pharmacological interventions, financed by the health insurance companies – is something that should be subject to critical questioning (2). authors do not mention that human sexuality may have many more facets and be much more subtle (3) than the actual act of intercourse would reflect. From this perspective, in many men, the subjective experience of illness – which may well be zeitgeist-oriented and depend on their individual disposition – might even be increased. However, a man’s procreative ability does not seem to be appreciably affected by premature ejaculation. Further, at a time of high global promiscuity, premature ejaculation may be an advantage in terms of procreative strategy, pointedly formulated as in the tried and tested principle: The early bird catches the worm.