International Society for Sexual Medicine’s Guidelines for the Diagnosis and Treatment of Premature Ejaculation

Abstract

Introduction Over the past 20 years our knowledge of premature ejaculation (PE) has significantly advanced. Specifically, we have witnessed substantial progress in understanding the physiology of ejaculation, clarifying the real prevalence of PE in population-based studies, reconceptualizing the definition and diagnostic criterion of the disorder, assessing the psychosocial impact on patients and partners, designing validated diagnostic and outcome measures, proposing new pharmacologic strategies and examining the efficacy, safety and satisfaction of these new and established therapies. Given the abundance of high level research it seemed like an opportune time for the International Society for Sexual Medicine (ISSM) to promulgate an evidenced-based, comprehensive and practical set of clinical guidelines for the diagnosis and treatment of PE. Aim Develop clearly worded, practical, evidenced-based recommendations for the diagnosis and treatment of PE for family practice clinicians as well as sexual medicine experts. Method Review of the literature. Results This article contains the report of the ISSM PE Guidelines Committee. It affirms the ISSM definition of PE and suggests that the prevalence is considerably lower than previously thought. Evidence-based data regarding biological and psychological etiology of PE are presented, as is population-based statistics on normal ejaculatory latency. Brief assessment procedures are delineated and validated diagnostic and treatment questionnaires are reviewed. Finally, the best practices treatment recommendations are presented to guide clinicians, both familiar and unfamiliar with PE, in facilitating treatment of their patients. Conclusion Development of guidelines is an evolutionary process that continually reviews data and incorporates the best new research. We expect that ongoing research will lead to a more complete understanding of the pathophysiology as well as new efficacious and safe treatments for this sexual dysfunction. Therefore, it is strongly recommended that these guidelines be re-evaluated and updated by the ISSM every 4 years.

Impact of erectile function and age in men with lower urinary tract symptoms on ejaculatory dysfunction and premature ejaculation

“…EjD increases with advancing age. 17,18 In our study, the factor most closely associated with EjD was age; as age increased, the incidence of EjD and PE increased. In other words, the ability to ejaculate during sex decreased and the frequency of dry ejaculation increased with aging.…”

“…15,16 Similar results by age groups were also reported by the Brazilian Sexual Life Study: PE was reported in 25.8% of 3332 Brazilian men. 17 JaspersenGastelum et al 18 reported a high prevalence rate in older age groups. They reported that PE was present in 46.9% of 1011 patients, and was more frequent in the age range of 51 --60 years (43.3%), followed by the age range of 61 --70 years (26%).…”

Coping with Premature Ejaculation: An Online Survey in a Representative Sample of the German Male Population Aged 18 to 64 Years

“…Since the first large-scale, systematic survey of sexual dysfunctions in 1998 [1], multiple studies have investigated various aspects of PE using a variety of PE definitions [2]. In the Premature Ejaculation Prevalence and Attitudes (PEPA) Survey, the overall prevalence of PE was 22.7% (20.3% in Germany) [3].…”

“…The International Society of Sexual Medicine (ISSM) definition of Lifelong PE [6] requires that ejaculation always or nearly always occurs before or within 1 minute of vaginal penetration. Three common constructs however underlie most definitions of PE: 1) a short ejaculatory latency, 2) a lack of perceived self-efficacy or control over the timing of ejaculation, and 3) distress and interpersonal difficulty related to the ejaculatory dysfunction [2]. To further understand PE in the adult male German population, we performed an anonymous online survey investigating the prevalence of PE in Germany, associated potential risk factors for PE and the methods that men use to cope with PE.…”

Safety and efficacy of tramadol hydrochloride on treatment of premature ejaculation

“…4 The International Society of Sexual Medicine (ISSM) recently published an evidence-based definition of lifelong (primary) PE as a male sexual dysfunction characterized by ejaculation that always or nearly always occurs prior to or within approximately 1 min of vaginal penetration, the inability to delay ejaculation on all or nearly all vaginal penetrations, and negative personal consequences, such as distress, bother, frustration and/or the avoidance of sexual intimacy. 5 In 1994, the concept of IELT was introduced. 6 IELT has been defined as the length of time between vaginal entry (IELT), anal (anal ejaculatory latency time) or oral penetration (oral ejaculatory latency time), or the initiation of masturbation (masturbatory ejaculatory latency time) and ejaculation.…”