Abstract

Premature ejaculation (PE) is associated with decreased quality of life, lower confidence and self-esteem, and higher levels of depression, anxiety, and interpersonal difficulties. Here we investigated the effectiveness of vibrator-assisted start–stop exercises for treatment of PE, and whether the treatment effect could be enhanced by an additional psychobehavioral intervention. Fifty participants with a mean age of 41.7 years were included and randomized into two treatment groups and a waiting list control group. Participants were instructed to perform start–stop exercises while stimulating the penis with a purpose-made vibrator, 3 times a week for 6 weeks. Additionally, participants in one of the treatment groups received additional psychoeducation and performed mindfulness meditation-based body scan exercises three times a week. Data were gathered through online questionnaires before and after treatment, as well as 3 and 6 months after treatment. The interventions reduced PE symptoms with large effect sizes (partial η2 = .20 across the three groups, d [95% CI] = 1.05 [.27, 1.82] and 1.07 [.32, 1.82] for treatment groups compared to waiting list control group). The additional psychobehavioral intervention did not further reduce PE symptoms, but did decrease PE-associated negative symptoms such as levels of sexual distress, anxiety, and depression. No side effects were reported. Vibrator-assisted start–stop exercises can be offered as an adequate treatment option for PE.

Highlights

  • The aim of the present study was to investigate the efficacy of vibrator-assisted start–stop exercises for treatment of Premature ejaculation (PE), and whether the treatment effect could be enhanced by an additional psychobehavioral intervention consisting of psychoeducation and training of interoceptive awareness

  • In accordance with our hypothesis, we found that a 6-week intervention consisting of vibrator-assisted start–stop exercises significantly reduced self-reported PE symptoms

  • Large treatment effect sizes were found when looking at only the items of the measure that pertain to sexual functioning (ELT, feeling of control, frequency of ejaculation with little stimulation)

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Summary

Introduction

PE is negatively associated with the partner’s sexual satisfaction (Riley & Riley, 2005), partner’s orgasmic frequency (Hartmann, Schedlowski, & Krüger, 2005), and interpersonal difficulties (Giuliano et al, 2008; Patrick et al, 2005; Rowland et al, 2007), including avoiding discussing sexual issues with one’s partner (Rowland et al, 2004), and even refraining from establishing new relationships (Symonds et al, 2003). While about 20–30% of the population report subjective complaints of premature ejaculation, it is unlikely that more than 4% meet more stringent diagnostic criteria for lifelong PE, including an IELT under 1 min (Althof et al, 2014)

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