The following factors may be relevant in the evaluation of any sexual dysfunction: 1) partner factors (e.g., partner’s sexual problems, partner’s health status); 2) relationship fac- tors (e.g., poor communication, discrepancies in desire for sexual activity); 3) individual vulnerability factors (e.g., poor body image, history of sexual or emotional abuse), psychiatric comorbidity (e.g., depression, anxiety), and stressors (e.g., job loss, bereavement); 4) cultural/ religious factors (e.g., inhibitions related to prohibitions against sexual activity; attitudes toward sexuality); and 5) medical factors relevant to prognosis, course, or treatment.
Estimates of the prevalence of premature (early) ejaculation vary widely depending on the definition utilized. Internationally, more than 20%-30% of men ages 18—70 years report concern about how rapidly they ejaculate. With the new definition of premature (early) ejaculation (i.e., ejaculation occurring within approximately 1 minute of vaginal penetra- tion), only 1%—3% of men would be diagnosed with the disorder. Prevalence of premature (early) ejaculation may increase with age.
By definition, lifelong premature (early) ejaculation starts during a male’s initial sexual ex- periences and persists thereafter. Some men may experience premature (early) ejaculation during their initial sexual encounters but gain ejaculatory control over time. It is the persis- tence of ejaculatory problems for longer than 6 months that determines the diagnosis of pre— mature (early) ejaculation. In contrast, some men develop the disorder after a period of having a normal ejaculatory latency, known as acquired premature (early) ejaculation. There is (early) ejaculation. The acquired form likely has a later onset, usually appearing during or af— ter the fourth decade of life. Lifelong is relatively stable throughout life. Little is known about the course of acquired premature (early) ejaculation. Reversal of medical conditions such as hyperthyroidism and prostatitis appears to restore ejaculatory latencies to baseline values.
Lifelong premature (early) ejaculation begins with early sexual experiences and persists throughout an individual’s life. In approximately 20% of men with premature (early) ejacu- lation, ejaculatory latencies decrease further with age. Age and relationship length have been found to be negatively associated with prevalence of premature (early) ejaculation.
Temperamental. Premature (early) ejaculation may be more common in men with anx- iety disorders, especially social anxiety disorder (social phobia).
Genetic and physiological. There is a moderate genetic contribution to lifelong prema- ture (early) ejaculation. Premature (early) ejaculation may be associated with dopamine transporter gene polymorphism or serotonin transporter gene polymorphism. Thyroid disease, prostatitis, and drug withdrawal are associated with acquired premature (early) ejaculation. Positron emission tomography measures of regional cerebral blood ﬂow dur- ing ejaculation have shown primary activation in the mesocephalic transition zone, includ- ing the ventral tegmental area.
Perception of what constitutes a normal ejaculatory latency is different in many cultures.
Measured ejaculatory latencies may differ in some countries. Such differences may be ex— plained by cultural or religious factors as well as genetic differences between populations.
Premature (early) ejaculation is a sexual disorder in males. Males and their sexual partners may differ in their perception of what constitutes an acceptable ejaculatory latency. There may be increasing concerns in females about early ejaculation in their sexual partners, which may be a reﬂection of changing societal attitudes concerning female sexual activity.
Ejaculatory latency is usually monitored in research settings by the sexual partner utilizing a timing device (e.g., stopwatch), though this is not ideal in real-life sexual situations. For vaginal intercourse, the time between intravaginal penetration and ejaculation is measured.