Global perspectives on the three criteria for premature ejaculation: An observational study of ejaculatory latency, ejaculatory control and bother/distress

Abstract

Criteria for premature ejaculation (PE) were established using Western‐based samples, yet these criteria are applied worldwide for its diagnosis. This study (a) determined whether men from various world regions differ/agree on their views of ejaculation latency (ELT) and their perceptions of ejaculatory control and bother/distress, the three criteria for PE, and (b) compared PE and non‐PE men across worldwide regions on these measures. 1,065 participants were recruited via social media to respond to a survey about men's typical, ideal and PE ELTs, about their own ELT, and about perceptions of ejaculatory control and bother/distress related to PE. Responses from men from four worldwide regions were compared to a reference group of North American/European men, and PE men were compared with non‐PE men across three world regions. Results showed that most world region groups showed similarity in ELT estimations. The Sub‐Saharan group focused more heavily on the importance of ejaculatory control. Both ELT and ejaculatory control differed between PE and non‐PE groups in all regions assessed. In conclusion, perceived ELTs and ejaculatory control show substantial consistency across world regions despite geo‐cultural variations and traditions. Such findings argue for the universality of the concepts of ELT, control and bother/distress related to PE.

Diagnostic Criteria for Premature Ejaculation: Clarifying the Role of “Ejaculatory Control” and “Bother/Distress”

“…The great majority of men with PE (86%) also reported the desire to last longer during partnered sex. Even so, 37% of men without PE desired this same outcome, a finding consistent with previous analyses in which estimations of the ideal EL in a sample of men were consistently longer than estimations of the typical EL, usually by around 5-7 min [21,22]. The longer ideal vs. typical EL in that study, and the general desire to last longer in the current study by both PE and non-PE men, suggest that many men, even those with normal-range ELs, see benefit to either themselves or their partners (or both) in being able to prolong sexual intercourse.…”

“…This analysis was part of a more extensive survey designed to address multiple questions regarding sexual response and PE, with other analyses focusing on issues related to ejaculatory latency [21] and worldwide similarities and differences in ejaculatory latency, control, and bother/distress [22]. Only the outcome measures and group/organizing variables used in this analysis are included here.…”

“…Ejaculatory control during partnered sex was considered somewhat to very important to the majority of male and female partners of men. Female partners deemed ejaculatory control more important than male partners, and female partners were more likely than male partners to consider ending a long-term relationship if the man's EL was consistently less than 1 min, a finding that showed consistency when analyses were focused on similarities and differences across various world regions [21]. These findings indicate that ejaculatory control and adequate ELs are important to the partner's sexual satisfaction [14,17], and even more so for women partners who likely rely on clitoral and vaginal stimulation during intercourse to become sufficiently aroused to reach orgasm.…”

Does Bother/Distress Contribute to the Diagnosis of Premature Ejaculation?

“…Previous research has affirmed the primacy of poor ejaculatory control as a sine qua non for a PE diagnosis. 26,27 Not only have studies indicated significant and strong differences in ejaculatory control between men diagnosed with PE (either clinically or via self-report) and men without PE, 8,17,18,27,36 but perceived control over ejaculation-in contrast with EL-has significant direct effects on both sexual satisfaction and personal distress related to the PE and has emerged as the most important explanatory variable in models predicting PE status and PE severity. Short ELs are also symptomatic of men who have difficulty delaying their ejaculatory response.…”

“…More inclusive analysis using the terms "bother, concern, upset, frustration, or feeling guilt" revealed reliably strong differences between PE and non-PE men, yet the overall percentage of men endorsing moderate-tovery high "bother" was still only about 70%. 8 Thus, a significant portion of men with PE symptomology appears to be "distress-free," suggesting that a role for bother/distress in defining and diagnosing PE has been far less clear than for that of the other 2 criteria, ejaculatory control and EL. Despite this ambiguous role, PE-related Patient-Reported Outcomes (PROs) 21−24 tend to place strong emphasis on the "bother/ distress" dimension of PE, with more items assessing negative consequences (although not necessarily "distress" per se) than either ejaculatory control or EL.…”