Cognitive and partner-related factors in rapid ejaculation: Differences between dysfunctional and functional men.

Abstract

Despite the high prevalence of rapid ejaculation in community samples, there is still a paucity of data on cognitive and other relevant aspects of the subjective experience of premature ejaculation (PE) patients and their functional counterparts. Therefore, the main aim of this study was to expand our understanding of the complex nature of rapid ejaculation disorders by providing a detailed characterization of ejaculatory patterns, behavioral aspects, cognitive, and partner-related factors in a sample of unselected PE patients compared to a group of functional men. To explore the areas that might differentiate PE men from their sexually functional counterparts, a multidimensional self-administered questionnaire, the PEQuest, was created. This 36-item instrument addresses a number of domains relevant to ejaculatory function and dysfunction such as ejaculatory latencies and ejaculatory control, cognitions and feelings during sexual intercourse, factors interfering with ejaculatory control, techniques to delay ejaculation, and partnership factors. A total of 45 PE patients (mean age: 41.8 years) and 72 non-patients (mean age: 37.1 years) were included. The results show significant group differences in the majority of PEQuest domains. In the functional group, an average intravaginal latency time of 12.8 min (median: 10 min) was reported compared to 3.7 min (median: 2 min) in the patient group with 87% of PE patients ejaculating within 2 min and 100% within 5 min after penetration. In their subjective experience in sexual situations, PE patients were totally preoccupied with thoughts about controlling their orgasm, with the anxious anticipation of a possible failure, and thoughts about keeping their erection while the inner experience of functional men is focused on sexual arousal and sexual satisfaction. The factors that maximally impede the control of ejaculation are similar for both groups, but functional men normally succeed in adapting their sexual behavior to these factors whereas PE men fail in their efforts. Regarding partner-related factors, PE patients felt less secure and experienced with respect to female sexuality than their functional counterparts, and more often reported a discrepancy between their own limited experience and the more extensive sexual experience of their partner. In conclusion, a number of salient differences in ejaculatory behavior, cognitive-affective patterns, and partner-related factors between PE patients and functional men could be delineated in this study, indicating that chronic rapid ejaculation is a serious disorder with a profound impact on the man's life and his partnership.

The impact of premature ejaculation on the subjective perception of orgasmic intensity: validation and standardisation of the ‘Orgasmometer’

“…Specifically, some authors have demonstrated the negative impact of cognitive factors on ejaculation and orgasmic pleasure. Among these, the most frequent negative thoughts include preoccupation about controlling the orgasm, anticipation of a possible failure, distracting thoughts and thoughts about keeping the erection, concentration about satisfying the partner rather than himself (Hartmann et al, 2005). One may infer that a man not distressed by his prematurity regarding ejaculation does not perceive a reduced orgasmic intensity.…”

Which are the male factors associated with female sexual dysfunction (FSD)?

“…Similar findings have been reported for PE, a largely recognized partner-oriented male sexual symptom. Indeed, female partners of patients with PE are more likely to suffer from sexual problems and dissatisfaction than partners of non-PE men (Byers & Grenier, 2003;Hartmann et al, 2005;Hobbs et al, 2008;Graziottin & Althof, 2011;Limoncin et al, 2013). Interestingly, a previous study evaluating the associations between intimacy, quality of life, and sexual dysfunction in men, demonstrated that all aspects of intimacy were lower in men reporting PE than in men not reporting PE (McCabe, 1997).…”

Critiques and Challenges to Old and Recently Proposed American Psychiatric Association's Website DSM 5 Diagnostic Criteria for Sexual Dysfunctions

“…It shows the increasing tendency to diagnose a sexual problem as a disorder only when it causes personal distress rather than interpersonal difficulties. Another important reason for emphasizing personal distress might be that some individuals suffering from sexual disorders do not have partners and therefore partner distress or interpersonal difficulties may not be universally applicable to all people (14,15).…”