Psychobiological Correlates of Delayed Ejaculation in Male Patients With Sexual Dysfunctions

Abstract

The pathogenesis of delayed ejaculation (DE) is rather unknown, though the contribution of various psychological, marital, hormonal, and neurological factors has been advocated. In this study we systematically investigated the relative relevance of the aforementioned factors in 1632 men who were seeking medical help for sexual dysfunction. The severity of DE was classified according to Kaplan criteria. Mild and moderate forms of DE (MMDE) recognized different risk factors than the most severe ones (anejaculation or severe DE [ASDE]). ASDE was essentially coupled with the presence of neurological diseases or with the use of serotoninergic drugs. Serotoninergic drugs also significantly increase (by at least 10-fold) the risk for MMDE, which, however, was also coupled with other relational factors (eg, partner's impaired climax, patient's hypoactive sexual desire [HSD]) or intrapsychic factors (eg, stress at work). At multiple regression analysis, some organic pathological conditions (such as psychiatric disorders and hypogonadism) were also associated with MMDE. In particular, hypogonadism retained significance for DE even after adjustment for HSD (adjusted odds ratio 5 2.08 [1.11-3.89]; P , .05), suggesting other effects of testosterone deficiency on the ejaculatory reflex besides reduced libido. In conclusion, the present study demonstrates that multiple psychobiological determinants are associated with DE, a still obscure condition that substantially impairs psychosexual equilibrium of the couple.

Sexual Dysfunctions as Self-Reported by Diabetic- Type-2 Men: An Andrology Clinic-Based Study in Alexandria, Egypt

“…Even in general population, remarkably scarce studies investigated this problem. So, Corona et al [42] reported it among 62 of 1632 (3.8%) men while Rowland et al [43] claimed it to be present in 2% among 1400 men.…”

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

“…In contrast, few data were available about delayed ejaculation (DE) and its relational correlates. The main pathogenic mechanism of DE is probably an uncoupling between genital and subjective arousal (Rowland, 2005), which can be exacerbated by partner's impaired orgasm ability (Corona et al, 2006b), creating a vicious cycle. While some women enjoy the extended intercourse, others may experience pain, question their own attractiveness, or suspect the partner's infidelity (Perelman, 2013).…”

The Infertile Male-3: Endocrinological Evaluation

“…Ejaculatory time, coital frequency, and timing should be investigated (Krausz and Forti 2000;Nieschlag et al 2010;Grumbach and Styne 2003). Both thyroidal hormones and testosterone levels have been observed to be associated with ejaculatory dysfunction (Corona et al 2004b(Corona et al , 2006a(Corona et al , 2008Carani et al 2005;Cihan et al 2009). In particular, hyperthyroidism has been associated to premature ejaculation while hypothyroidism has been related to delayed ejaculation (Corona et al 2004b(Corona et al , 2006aCarani et al 2005;Cihan et al 2009).…”

“…Both thyroidal hormones and testosterone levels have been observed to be associated with ejaculatory dysfunction (Corona et al 2004b(Corona et al , 2006a(Corona et al , 2008Carani et al 2005;Cihan et al 2009). In particular, hyperthyroidism has been associated to premature ejaculation while hypothyroidism has been related to delayed ejaculation (Corona et al 2004b(Corona et al , 2006aCarani et al 2005;Cihan et al 2009). In addition, specific treatment of those thyroidal dysfunctions are associated to the reduction of the prevalence of the relative ejaculatory dysfunction Carani et al 2005;Cihan et al 2009).…”

“…In addition, specific treatment of those thyroidal dysfunctions are associated to the reduction of the prevalence of the relative ejaculatory dysfunction Carani et al 2005;Cihan et al 2009). Furthermore, high testosterone levels seem to play a facilitatory role in the control of ejaculatory reflex while hypogonadism is associated with an overall lower propensity to ejaculate (Corona et al 2006a(Corona et al , 2008. Finally, it has been reported that subjects with low prolactin levels (e.g., in the lower quartile of the normal range) show a higher risk of premature ejaculation (Corona et al 2009a) while subjects with high prolactin levels in the normal range (i.e., excluding subjects with pathological hyperprolactinaemia) more often report ejaculatory latency .…”