Background
Recent developments in the study of men’s sexual health have raised problems with the current definition of premature ejaculation (PE). This definition is essential for accurate diagnosis, and estimation of incidence and prevalence rates.
Much of the debate surrounding this issue has focused on defining the period of time that constitutes ‘premature’; little is known about men’s perceptions of PE and the factors they attribute to it.
Aim
The authors aimed to examine (a) men’s perceived reasons for ejaculating before they desired, (b) whether they endorsed multiple reasons within the same broad category or whether reasons crossed categories, and (c) whether reasons differed across younger and older men.
Methods
Participants: Potential participants were men aged at least 18 years recruited through forums on reddit.com and from the research home page on facebook.com.
Participants relevant to this paper were those who indicated that they ejaculated before they wanted to on half or more of the occasions they had had sexual intercourse.
Procedure: Participants completed an anonymous 24-item online survey on men’s sexual health.
Items assessed men’s ejaculatory patterns and included two questions listing 10 optional self-reported reasons for their quick ejaculation; one item allowed respondents to endorse multiple reasons while the other forced participants to pick the most prominent reason.
Data analysis: The sub-sample was divided into two groups; those who indicated ejaculation in less than 1-2 minutes and distress about this (Probably PE), and those who indicated ejaculating before they wanted to but not under 2 minutes (Just Dissatisfied).
Data was first eyeballed graphically and then groups (Probably PE vs Just Dissatisfied; younger vs older) were compared using z-tests. Concordance among reasons was examined with cross-tabulations.
Results
Conclusion
Men overwhelmingly attributed their quick ejaculation to causes that reflected self-efficacy.
The large majority of men who indicated that they ejaculated before desired but not before 1-2 minutes (i.e. the Just Dissatisfied group) suggests that the diagnostic cut-off for ejaculatory latency as 1 or 2 minutes may not reflect men’s lived experiences.
The perceived causes for ejaculating quickly were similar across the Probably PE and Just Dissatisfied groups suggesting that (at least conceptually) these groups are only divided by the arbitrary cut-off of 1 or 2 minutes.
The authors state that this finding supports the importance of clinical judgement when making a diagnosis of PE; health care providers may want to give greater weight to issues of lack of control and psychological distress when considering a patient for treatment (compared to the time cut-off only).
Overall, these findings suggest that current definitions of PE need to be updated to include ‘lack of self-efficacy’ (e.g. issues with controlling or delaying ejaculation).
