Is heart rate variability a risk factor for premature ejaculation?

Abstract

Premature ejaculation (PE) is defined as the occurrence of ejaculation one minute or less after vaginal penetration. 1 Prevalence of PE in men is high and this sexual dysfunction affects 20%-30% of men. Although the aetiology of PE is not yet known clearly, many causes such as age and ethnicity have been blamed in its aetiology. 2 PE can negatively affect a person's psychological and emotional health by causing sexual avoidance and lack of self-confidence.Ejaculation is a spinal reflex under cerebral control, and this requires synergistic activation of somatic and autonomic nervous systems. The sympathetic and parasympathetic activities of the autonomic nervous system (ANS) regulate the peripheral events that initiate ejaculation. 3 The sympathetic effect is thought to be more dominant during ejaculation and provides contractile control of seminal tract smooth muscle. 4 Previous studies have shown that sympathetic innervation plays a key role in stimulating the contraction of the sex glands. 5 Although the role of the parasympathetic nervous system in ejaculation is unclear, it is thought to be effective in

A 2‐week high‐intensity interval training intervention improves ejaculation control among men with premature ejaculation

“…In line with findings regarding the role of HIIT in achieving the balance between sympathetic and parasympathetic activity, 26,29 it is plausible that the underlying mechanism is such that HIIT improves the PE symptoms in men by improving the sympathovagal imbalance, at least in men with PE. 13,17 For the daily PE symptoms measurement of CHEES-E for sexual events, first, in the first 7 days, there was no significant difference observed in CHEES-E between the HIIT intervention group and control group regardless of participants' PE status. Interestingly, after 7 days of intervention, in men with PE, the HIIT intervention group showed fewer PE symptoms than the control group.…”

“…Also, a recent study found that during a 24-h interval of heart-rate monitoring, men with PE have lower parasympathetic activity and higher sympathetic/parasympathetic ratio, an indicator of the sympa-thovagal imbalance in the autonomic nervous system, compared with a control group. 13 Finally, a sympathetic/parasympathetic ratio above 2.7 predicted PE with high sensitivity. 13 Therefore, we assumed that sympathovagal imbalance may explain at least some of the etiology of PE.…”

“…13 Finally, a sympathetic/parasympathetic ratio above 2.7 predicted PE with high sensitivity. 13 Therefore, we assumed that sympathovagal imbalance may explain at least some of the etiology of PE.…”

“…2 A recent review suggested that a possibly important factor in the etiology of PE may be sympathovagal imbalance. 13 Sympathovagal imbalance reflects an autonomic state with sympathetic overactivation and is associated with stress, cardiac morbidity, and mortality 14 as well as psychopathology. 15 While the autonomic nervous system's role in the male sexual response is not yet fully understood, a certain balance and timing of the sympathetic and parasympathetic nervous systems are necessary for a well-functioning sexual response.…”

“…The sum of the five items considered as the Pre-IIEF score. There are five categories of ED based on IIEF-5 scores: severe (5-7), moderate (8)(9)(10)(11), mild to moderate (12)(13)(14)(15)(16), mild (17)(18)(19)(20)(21), and no ED (22)(23)(24)(25). 45…”