Premature ejaculation: old story, new insights

Jannini, Emmanuele A.; Ciocca, Giacomo; Limoncin, Erika; Mollaioli, Daniele; Sante, Stefania Di; Gianfrilli, Daniele; Lombardo, Francesco; Lenzi, Andrea

doi:10.1016/j.fertnstert.2015.08.035

Cited by 63 publications

(70 citation statements)

References 127 publications

(138 reference statements)

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“…On the other hand, many individuals with PE do not easily fit into a single class and a number of PE-subcategories may be individuated (Serefoglu et al, 2014) which do not fall into the diagnostic criteria internationally adopted. Therefore, it is clear that a number of key aspects characterising men with PE may be both unrecognised and understudied (Jannini et al, 2015). One of these unrecognised aspects may concern the way that men suffering from PE perceive their orgasmic pleasure.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2016

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SUMMARYTo the best of our knowledge, no psychometric tools have been specifically developed to measure if premature ejaculation (PE) is related to low sexual pleasure in terms of perception of orgasmic intensity. Hence, the aim of this study was to evaluate if men with PE suffer from a low perception of orgasmic intensity using a new tool, the 'Orgasmometer', to quantitatively measure the intensity of orgasmic pleasure. Among 329 subjects attending our andrological unit for suspected PE, 257 men fulfilled the inclusion criteria. Of these, 156 (60.7%; 156/257) were affected by PE (PE group) and 101 (39.3%; 101/257) did not have any sexual dysfunction (Control group). Men were requested to fill out the Premature Ejaculation Diagnostic Tool (PEDT) and the Orgasmometer, a new visual tool recording orgasm intensity on a Likert scale. Interestingly, MANCOVA analysis revealed a statistically significant difference between the two groups (p = 0.044) in the subjective perception of orgasm intensity with the PE group scoring lower on the Orgasmometer (mean 5.8; 95% CI 5.191-6.409) than the Control group (mean 7.95; 95% CI 7.033-8.87). In addition, multiple linear regression revealed an inverse correlation between the PEDT and the Orgasmometer scores (p < 0.0001). Hence, higher PEDT scores were associated with a lower subjective perception of orgasmic intensity. The Orgasmometer was well understood, had good test-retest reliability and a high AUC in differentiating between men with high and low orgasmic pleasure intensity. The ROC curve analysis showed that a cut-off ≤6 had 87.7% sensitivity (95% CI 79.6-92.6), 95% specificity (95% CI 88.7-98.4), 95.3% positive predictive value (PPV) and 86.4% negative predictive value (NPV). Men affected by premature ejaculation perceived significantly lower orgasmic intensity than sexually healthy men. The Orgasmometer is an easy-to-perform, user-friendly tool for measuring orgasmic intensity.

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Section: Introductionmentioning

confidence: 99%

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

et al. 2016

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“…The evolution of PE therapy has been influenced by the advances in the new understanding of physiology and etiology (4). Historically, PE was considered a psychosomatic problem; therefore, psychological behavioral therapies were the mainstay for PE management before the emergence of pharmacological therapies (57,58). Psychological behavioral therapies, such as the squeeze technique and the start-and-stop technique, help men in developing sexual skills to control or delay ejaculation, improve self-confidence, reduce performance anxiety, resolve psychological and interpersonal concerns, and promote communication between them and their partners (59,60).…”

Section: Why Do Patients With Premature Ejaculation (Pe) Require Actimentioning

confidence: 99%

“…Increasing the frequency of sexual activity may enhance sexual technique, self-confidence, and satisfaction thereby improving dapoxetine treatment outcomes. Before dose escalation, patients should be encouraged to perform at least six sexual attempts with dapoxetine 30 mg (58,71). …”

Section: Management Of Initial Non-response To Dapoxetine Treatment Imentioning

confidence: 99%

The office management of ejaculatory disorders

Jiann

2016

Transl. Androl. Urol.

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Premature ejaculation (PE), delayed ejaculation (DE), anejaculation (AE) and retrograde ejaculation (RE) are four main ejaculatory disorders (EjDs) observed in clinical practice. Despite their high prevalence, EjDs remain underdiagnosed and undertreated. Primary care physicians should incorporate the discussion of sexual health topics into routine visits to facilitate EjD diagnosis and treatment. Because the causes of EjDs are multifactorial, the management of EjDs is etiology-specific and may require a holistic approach. Dapoxetine, a selective serotonin reuptake inhibitor, is the only drug approved for on-demand treatment of lifelong and acquired PE. In clinical practice, scheduled follow-up visits, risk factor treatment, appropriate dose escalation, adequate sexual attempts, patient education, and partner involvement are critical factors responsible for optimal overall management of PE and dapoxetine treatment outcomes.

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“…Jannini et al in stated: “The pelvic floor muscles actively collaborate to achieve ejaculation, with from three to seven contractions… pelvic floor motoneurons, produces the pelvic floor contractions characteristic of ejaculation,” but the semen is expelled the full length of the penile urethra under strong pressure created by the involuntary but coordinated contractions of the perineal muscles. The semen is propelled from the prostatic urethra along the penile urethra mainly by the BC muscle, which covers the urethral bulb.…”

Section: Expulsion Phase Of Ejaculationmentioning

confidence: 99%

“…Physicians and clinicians should acknowledge the potentially harmful effects of timed intercourse on the physical and mental health of men. The impact of impending timed intercourse on sexual dysfunction and the behavior of male partners have only recently been investigated.” Jannini et al in stated: “the term ‘premature ejaculation’ would be introduced later in 1917 by a psychoanalyst. In the beginning, PE was considered as psychogenic in nature.…”

Section: Premature Ejaculation Is Not a Disease/sexual Dysfunctionmentioning

confidence: 99%

Comprehensive review of the anatomy and physiology of male ejaculation: Premature ejaculation is not a disease

Puppo¹,

Puppo

2015

Clinical Anatomy

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Human semen contains spermatozoa secreted by the testes and a mixture of components produced by the bulbo-urethral and Littre (paraurethral) glands, prostate, seminal vesicles, ampulla, and epididymis. Ejaculation is used as a synonym for the external ejection of semen, but it comprises two phases: emission and expulsion. As semen collects in the prostatic urethra, the rapid preorgasmic distension of the urethral bulb is pathognomonic of impeding orgasm, and the man experiences a sensation that ejaculation is inevitable (in women, emission is the only phase of orgasm). The semen is propelled along the penile urethra mainly by the bulbocavernosus muscle. With Kegel exercises, it is possible to train the perineal muscles. Immediately after the expulsion phase the male enters a refractory period, a recovery time during which further orgasm or ejaculation is physiologically impossible. Age affects the recovery time: as a man grows older, the refractory period increases. Sexual medicine experts consider premature ejaculation only in the case of vaginal intercourse, but vaginal orgasm has no scientific basis, so the duration of intercourse is not important for a woman's orgasm. The key to female orgasm are the female erectile organs; vaginal orgasm, G-spot, G-spot amplification, clitoral bulbs, clitoris-urethra-vaginal complex, internal clitoris and female ejaculation are terms without scientific basis. Female sexual dysfunctions are popular because they are based on something that does not exist, i.e. the vaginal orgasm. The physiology of ejaculation and orgasm is not impaired in premature ejaculation: it is not a disease, and non-coital sexual acts after male ejaculation can be used to produce orgasm in women. Teenagers and men can understand their sexual responses by masturbation and learn ejaculatory control with the stop-start method and the squeeze technique. Premature ejaculation must not be classified as a male sexual dysfunction. It has become the center of a multimillion dollar business: is premature ejaculation-and female sexual dysfunction-an illness constructed by sexual medicine experts under the influence of drug companies?

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Premature ejaculation: old story, new insights

Cited by 63 publications

References 127 publications

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

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

The office management of ejaculatory disorders

Comprehensive review of the anatomy and physiology of male ejaculation: Premature ejaculation is not a disease

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