Other sexual dysfunctions. The presence of another sexual dysfunction does not rule out a diagnosis of male hypoactive sexual desire disorder; there is some evidence that up to one-half of men with low sexual desire also have erectile difficulties, and slightly fewer may also have early ejaculation difficulties. If the man’s low desire is explained by self—identification as an asexual, then a diagnosis of male hypoactive sexual desire disorder is not made.
Depression and other mental disorders, as well as endocrinological factors, are often co- morbid with male hypoactive sexual desire disorder.
Diagnostic Criteria 302.75 (F52.4)
A. A persistent or recurrent pattern of ejaculation occurring during partnered sexual activ- ity within approximately 1 minute following vaginal penetration and before the individ- ual wishes it.
Note: Although the diagnosis of premature (early) ejaculation may be applied to indi- viduals engaged in nonvaginal sexual activities, specific duration criteria have not been established for these activities.
B. The symptom in Criterion A must have been present for at least 6 months and must be experienced on almost all or all (approximately 75%—100%) occasions of sexual activ- ity (in identified situational contexts or, if generalized, in all contexts).
C. The symptom in Criterion A causes clinically significant distress in the individual.
D. The sexual dysfunction is not better explained by a nonsexual mental disorder or as a consequence of severe relationship distress or other significant stressors and is not at- tributable to the effects of a substance/medication or another medical condition.
Specify whether:
Lifelong: The disturbance has been present since the individual became sexually active.
Acquired: The disturbance began after a period of relatively normal sexual function.
Specify whether:
Generalized: Not limited to certain types of stimulation, situations, or partners.
Situational: Only occurs with certain types of stimulation, situations, or partners.
Specify current severity:
Mild: Ejaculation occurring within approximately 30 seconds to 1 minute of vaginal penetration.
Moderate: Ejaculation occurring within approximately 15—30 seconds of vaginal pen- etration.
Severe: Ejaculation occurring prior to sexual activity, at the start of sexual activity, or within approximately 15 seconds of vaginal penetration.
Premature (early) ejaculation is manifested by ejaculation that occurs prior to or shortly af- ter vaginal penetration, operationalized by an individual’s estimate of ejaculatory latency (i.e., elapsed time before ejaculation) after vaginal penetration. Estimated and measured intravaginal ejaculatory latencies are highly correlated as long as the ejaculatory latency is of short duration; therefore, self—reported estimates of ejaculatory latency are sufficient for diagnostic purposes. A 60-second intravaginal ejaculatory latency time is an appropriate cutoff for the diagnosis of lifelong premature (early) ejaculation in heterosexual men.
There are insufficient data to determine if this duration criterion can be applied to ac- quired premature (early) ejaculation. The durational definition may apply to males of varying sexual orientations, since ejaculatory latencies appear to be similar across men of different sexual orientations and across different sexual activities.
Many males with premature (early) ejaculation complain of a sense of lack of control over ejaculation and report apprehension about their anticipated inability to delay ejaculation on future sexual encounters.