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Wang C, Colonnello E, Sansone A, Zhang H, Jannini EA, Zhang Y. Repeated sexual intercourse as a coping strategy for men with premature ejaculation. J Sex Med 2024; 21:399-407. [PMID: 38563590 DOI: 10.1093/jsxmed/qdae040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 02/15/2024] [Accepted: 03/08/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Patients with premature ejaculation (PE) are often concerned and distressed about their sexual performance. Hence, they may be more willing to exploit their refractory period to employ sexual coping strategies in order to improve their unsatisfactory sexual intercourse compared with patients without PE. AIM The study sought to verify the sexual coping strategies of patients with PE in the daily sexual activities. METHODS We included both patients with PE and individuals without PE and analyzed their sexual behaviors and attitudes by means of detailed interviews and questionnaires. OUTCOMES The main outcomes were perceived intravaginal ejaculatory latency time recording, Premature Ejaculation Diagnostic Tool score, and sexual frequency, attitudes, and behavior log. RESULTS A total of 182 young patients with PE (age 31.2 ± 6.2 years) and 92 individuals without PE (age 30.7 ± 5.1 years) were included in the study. A total of 53.3% of patients with PE vs 17.4% of individuals without PE reported engaging in multiple sexual intercourse sessions within a single day in the past 4 weeks. PE patients who engaged in multiple intercourse sessions displayed better performance during the second attempt but performed poorly compared with individuals without PE. Scores for the first attempt in PE vs second attempt in individuals with PE vs without PE were the following: intravaginal ejaculatory latency time, 2.4 ± 1.6 vs 4.8 ± 5.7 vs 9.9 ± 9.4 (P < .001); Premature Ejaculation Diagnostic Tool, 14.9 ± 3.1 vs 12.7 ± 4.8 vs 5.2 ± 2.5 (P < .001); satisfaction, 2.9 ± 1.0 vs 3.1 ± 0.8 vs 3.7 ± 1.4 (P < .001). A total of 57.1% of patients held a negative attitude toward precoital masturbation, for reasons such as a reduced sexual desire (21.2%), the belief that masturbation is harmful (17.6%), concerns about erectile function (15.7%), fatigue (9.8%), and other mixed reasons (35.3%). CLINICAL IMPLICATIONS Engaging in multiple intercourse sessions within a day is more common among the young PE population, and using precoital masturbation as a coping strategy is not universally applicable among patients with PE. STRENGTHS AND LIMITATIONS This is the first study to explore symptom-coping strategies in patients with PE compared with individuals without PE. However, the conclusions cannot be generalized to the entire male population. CONCLUSION Patients with PE, compared with individuals without PE, are more inclined to engage in multiple sexual intercourse sessions within a single sexual session, likely in an attempt to compensate for their first unsatisfactory sexual encounter. Moreover, the majority of patients with PE here studied hold a negative attitude toward using precoital masturbation as a coping strategy for symptoms.
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Affiliation(s)
- Chunlin Wang
- Department of Infertility and Sexual Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
- Endocrinology and Medical Sexology, Department of Systems Medicine, University of Rome Tor Vergata, Rome 00133, Italy
| | - Elena Colonnello
- Endocrinology and Medical Sexology, Department of Systems Medicine, University of Rome Tor Vergata, Rome 00133, Italy
| | - Andrea Sansone
- Endocrinology and Medical Sexology, Department of Systems Medicine, University of Rome Tor Vergata, Rome 00133, Italy
| | - Hui Zhang
- Endocrinology and Medical Sexology, Department of Systems Medicine, University of Rome Tor Vergata, Rome 00133, Italy
| | - Emmanuele A Jannini
- Endocrinology and Medical Sexology, Department of Systems Medicine, University of Rome Tor Vergata, Rome 00133, Italy
| | - Yan Zhang
- Department of Infertility and Sexual Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
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Li Y, Li X, Wang Z, Chen X, Sescousse G, Santtila P, Dai Y, Zhang B. Altered reward processing in patients with lifelong premature ejaculation. Sci Rep 2023; 13:17539. [PMID: 37845325 PMCID: PMC10579392 DOI: 10.1038/s41598-023-44914-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 10/13/2023] [Indexed: 10/18/2023] Open
Abstract
Given that sexual behavior is usually pleasurable and highly rewarding, it is surprising that there is as yet no known research to empirically assess how premature ejaculation (PE) patients respond to the rewarding aspect of sexual behavior. This study was designed to address this issue by evaluating how these men respond to the anticipation and hedonic experience of sexual rewards in comparison to non-sexual rewards. Thirty lifelong PE patients and thirty healthy controls (HCs) performed the incentive delay task manipulating both erotic and monetary rewards. Compared to HCs, lifelong PE patients exhibited significantly faster RTs to erotic cues than to monetary cues during reward anticipation. Meanwhile, hedonic experience ratings after obtaining the actual reward showed that erotic rewards were rated as more pleasant than monetary rewards only by lifelong PE patients, which was driven by a decreased sensitivity to experienced monetary rewards in lifelong PE patients compared to HCs. These findings indicate the existence of dysfunctional reward processing in lifelong PE patients, which is characterized by increased incentive motivation elicited by sexual cues and reduced hedonic impact of nonsexual rewards. This study may offer an insightful clue regarding how PE is related to the abnormal regulation of the rewarding aspect of sexual behavior.
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Affiliation(s)
- Yansong Li
- Department of Radiology, The Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, China.
- Reward, Competition, and Social Neuroscience Lab, Department of Psychology, School of Social and Behavioral Sciences, Nanjing University, Nanjing, 210023, China.
- Institute for Brain Sciences, Nanjing University, Nanjing, China.
| | - Xiaojun Li
- School of Teacher Education, NanJing XiaoZhuang University, Nanjing, China
| | - Zixiang Wang
- Reward, Competition, and Social Neuroscience Lab, Department of Psychology, School of Social and Behavioral Sciences, Nanjing University, Nanjing, 210023, China
| | - Xi Chen
- Reward, Competition, and Social Neuroscience Lab, Department of Psychology, School of Social and Behavioral Sciences, Nanjing University, Nanjing, 210023, China
| | - Guillaume Sescousse
- Lyon Neuroscience Research Center-INSERM U1028-CNRS UMR5292, PSYR2 Team, University Lyon 1, Lyon, France
| | - Pekka Santtila
- Faculty of Arts and Sciences, New York University (NYU) Shanghai, Shanghai, China
| | - Yutian Dai
- Department of Andrology, The Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, China.
| | - Bing Zhang
- Department of Radiology, The Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, China.
- Institute for Brain Sciences, Nanjing University, Nanjing, China.
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Hamzehgardeshi Z, Sabetghadam S, Pourasghar M, Khani S, Moosazadeh M, Malary M. Prevalence and predictors of sexual distress in married reproductive-age women: A cross-sectional study from Iran. Health Sci Rep 2023; 6:e1513. [PMID: 37655267 PMCID: PMC10468024 DOI: 10.1002/hsr2.1513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 04/12/2023] [Accepted: 08/09/2023] [Indexed: 09/02/2023] Open
Abstract
Background and Aim Although various surveys have been conducted for sexual problems, there is a lack of population-based studies on sexual distress in Iran. Thus, we sought to determine the prevalence and predictive factors of sexual distress in this population. Methods Overall, 1000 married women aged 16-49 years were enrolled in this study using the two-stage cluster sampling method. To identify sexual distress, the female sexual distress scale-revised (FSDS-R) was completed. The predictive factors were assessed using a checklist. Results A total of 318 women (31.8%) suffered from sexual distress. Among socio-demographic factors, satisfaction with marriage (p = 0.001), among personal factors history of infertility and fear of contracting sexually transmitted infections (p < 0.01), and among sexual and interpersonal factors satisfaction with the level of sexual desire (p = 0.01), pain during sexual intercourse (p < 0.01), premature ejaculation disorders in the partner (p < 0.05), and sexual satisfaction (p < 0.001) were significantly associated with sexual distress. Conclusion Clinicians should evaluate sexual distress comprehensively and consider all the related dimensions. The high overall prevalence of sexual distress, with or without an identifiable dysfunction, signals the importance of health professionals being adequately prepared to discuss sexual health concerns.
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Affiliation(s)
- Zeinab Hamzehgardeshi
- Sexual and Reproductive Health Research CenterMazandaran University of Medical SciencesSariIran
- Department of Reproductive Health and MidwiferyMazandaran University of Medical SciencesSariIran
| | - Shadi Sabetghadam
- School of Nursing and MidwiferyGuilan University of Medical SciencesRashtIran
- Reproductive Health Research CenterGuilan University of Medical SciencesRashtIran
| | - Mehdi Pourasghar
- Department of Psychiatry, Psychiatry and Behavioral Sciences Research Center, Addiction InstituteMazandaran University of Medical SciencesSariIran
| | - Soghra Khani
- Sexual and Reproductive Health Research CenterMazandaran University of Medical SciencesSariIran
- Department of Reproductive Health and MidwiferyMazandaran University of Medical SciencesSariIran
- Research Center of DiabetesMazandaran University of Medical SciencesSariIran
| | - Mahmood Moosazadeh
- Gastrointestinal Cancer Research Center, Non‐communicable Diseases InstituteMazandaran University of Medical SciencesSariIran
- Health Sciences Research CenterMazandaran University of Medical SciencesSariIran
| | - Mina Malary
- School of Nursing and MidwiferyShahroud University of Medical SciencesShahroudIran
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Hou G, Gao M, Zheng Y, Hou N, Zhang S, Sun J, Jannini TB, Zhang L, Dun X, Wang F, Jannini EA, Yuan J. Nomogram for stratifying patients with lifelong premature ejaculation before using the PHQ-9: An observational study. Eur J Clin Invest 2022; 52:e13809. [PMID: 35514259 DOI: 10.1111/eci.13809] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 04/24/2022] [Accepted: 05/04/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE A PHQ-9 score ≥ 15, represented as PHQ-9+ , indicates major depressive disorder (MDD). On using PHQ-9, the psychological burden of several patients with lifelong premature ejaculation (LPE) gets aggravated, which may lead to LPE development. We aim to construct a nomogram for predicting the individual risk of PHQ-9+ in patients with LPE and discerning those with low risks, who should avoid the PHQ-9. METHODS The nomogram was constructed by analysing data of 802 patients from Xijing Hospital and Northwest Women's & Children's Hospital. The LASSO and multivariable logistic regressions were used to identify independent predictors of PHQ-9+ , used for developing the nomogram. The discrimination, calibration and clinical usefulness of the nomogram were assessed in the derivation cohort and an independent validation cohort, which was composed of 505 prospectively enrolled patients from Daxing Hospital and Xijing Hospital. RESULTS The duration of PE, IELT, a history of PE exacerbation, IIEF-5 score, urinary frequency and physical pain score were identified as independent predictors. The nomogram showed excellent calibration, discrimination and clinical usefulness in the derivation and validation cohorts, with a predictive accuracy of 0.781 and 0.763, respectively. Based on this nomogram, patients were divided into not recommended, recommended and strongly recommended PHQ-9 filling groups, with PHQ-9+ rates of 3.5%, 9.3% and 30.7%, respectively. CONCLUSION A nomogram to discern LPE patients with low risks of PHQ-9+ was established. This tool can increase the positivity of MDD screening and may improve the therapeutic outcomes of those in the low-risk group.
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Affiliation(s)
- Guangdong Hou
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Ming Gao
- Department of Andrology, Xi'an Daxing Hospital, Shaanxi University of Chinese Medicine, Xi'an, China
| | - Yu Zheng
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China.,Department of Anatomy, Histology and Embryology, Fourth Military Medical University, Xi'an, China.,Medical Innovation Center, Fourth Military Medical University, Xi'an, China
| | - Niuniu Hou
- Department of General Surgery, Eastern Theater Air Force Hospital of PLA, Nanjing, China.,Department of Thyroid, Breast and Vascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Siyan Zhang
- Department of Ultrasound Diagnostics, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Jianhua Sun
- Assisted Reproduction Center, Northwest Women's & Children's Hospital, Xi'an, China
| | - Tommaso B Jannini
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Lei Zhang
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Xinlong Dun
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Fuli Wang
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | | | - Jianlin Yuan
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
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5
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Fiala L, Lenz J, Konecna P, Zajicova M, Cerna J, Sajdlova R. Premature ejaculation and stress. Andrologia 2021; 53:e14093. [PMID: 33932044 DOI: 10.1111/and.14093] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/15/2021] [Accepted: 04/18/2021] [Indexed: 11/29/2022] Open
Abstract
Recent findings indicate that men with premature ejaculation report more frequent sexual problems associated with increased anxiety and interpersonal difficulties. Bearing this in mind, the neuroendocrine changes were examined in men with premature ejaculation and compared to other indicators of stressful experiences to see whether there can be any correlation which could indicate how these factors may contribute to the aetiology of premature ejaculation. Our study comprised 60 male outpatients diagnosed as having secondary premature ejaculation. Clinical examinations were focused on biochemical analysis of cortisol and psychometric scoring using a diagnostic tool for premature ejaculation, traumatic stress and somatoform dissociation. The control group consisted of a 60 healthy men. The results showed significant Spearman correlations of the Premature Ejaculation Diagnostic Tool score with Trauma Symptom Checklist score (R = .86), cortisol level (R = .47) and Somatoform Dissociation Questionnaire score (R = .61). In the control group, the results did not reach statistical significance. Spearman correlations of the Premature Ejaculation Diagnostic Tool score with Trauma symptoms checklist score was (R = .21), cortisol (R = .27) and with Somatoform dissociation questionnaire score (R = .25). These results represent the first reported findings documenting the relationship of traumatic stress indicators with the experience of secondary premature ejaculation and cortisol levels.
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Affiliation(s)
- Ludek Fiala
- 1st Faculty of Medicine, Institute of Sexology, Charles University, Prague, Czech Republic.,Faculty of Medicine, Department of Sexology, Psychiatric Clinic, Charles University, Pilsen, Czech Republic
| | - Jiri Lenz
- Department of Pathology, Znojmo Hospital, Znojmo, Czech Republic.,Faculty of Veterinary Medicine, Department of Anatomy, Histology and Embryology, University of Veterinary and Pharmaceutical Sciences Brno, Brno, Czech Republic
| | - Petra Konecna
- Faculty of Veterinary Medicine, Department of Anatomy, Histology and Embryology, University of Veterinary and Pharmaceutical Sciences Brno, Brno, Czech Republic
| | - Marketa Zajicova
- Faculty of Medicine, Department of Psychology, Charles University, Pilsen, Czech Republic
| | - Jana Cerna
- Faculty of Medicine, Department of Psychology, Charles University, Pilsen, Czech Republic
| | - Rachel Sajdlova
- Faculty of Medicine, Department of Sexology, Psychiatric Clinic, Charles University, Pilsen, Czech Republic
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6
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Li H, Gao P, Gao J, Wu X, Liu G, Dai Y, Jiang H, Zhang X. Risk factors of premature ejaculation and its influence on sexual function of spouse. Basic Clin Androl 2021; 31:5. [PMID: 33596817 PMCID: PMC7890845 DOI: 10.1186/s12610-020-00120-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 12/17/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Premature ejaculation (PE) is a multifactorial problem with a complicated aetiology that has detrimental effects on female partners' sexual function. However, there is a lack of studies on the relationship between the factors related to PE and female sexual dysfunction (FSD) in China. We aimed to identify and explore the relationship between the factors associated with PE and FSD. RESULTS Ultimately, information was collected from 761 couples: 445 couples with PE complaints and 316 couples without PE complaints. The mean ages of the men with and without PE complaints were 36.29 ± 9.87 years and 31.48 ± 10.77 years, respectively. Female partners in the group with PE complaints reported lower total and subdomain female sexual function index (FSFI) scores, and approximately 65% of them were diagnosed with FSD (vs. CONTROL GROUP 31.96%). A PE duration of more than 14 months, a self-estimated intravaginal ejaculation latency time (self-estimated IELT) less than 2 min, a negative attitude towards PE problems, men's introversion, and men's depression were risk factors for FSD in the PE group. CONCLUSIONS PE affects not only the patient himself but also the spouse. Comprehensive analysis reveals a clear relationship and interaction between female sexual function and PE. Moreover, in PE treatment, we should not ignore the occurrence of FSD and its impact and should emphasize the treatment of couples together.
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Affiliation(s)
- Hu Li
- The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Pan Gao
- The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Jingjing Gao
- The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Xu Wu
- The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Guodong Liu
- The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Yutian Dai
- Nanjing Drum Tower Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China.
| | - Hui Jiang
- Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing, 100191, China. .,Department of Andrology, Peking University Third Hospital, Beijing, 100191, China.
| | - Xiansheng Zhang
- The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
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Colonnello E, Ciocca G, Limoncin E, Sansone A, Jannini EA. Redefining a sexual medicine paradigm: subclinical premature ejaculation as a new taxonomic entity. Nat Rev Urol 2021; 18:115-127. [PMID: 33442049 DOI: 10.1038/s41585-020-00417-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2020] [Indexed: 01/29/2023]
Abstract
Premature ejaculation (PE) and poor ejaculatory control are multidimensional sexual symptoms estimated to affect almost one-third of men, severely impairing the overall quality of life of patients and their partners. However, patients who do not completely fulfil the definition criteria for PE rarely receive a diagnosis or adequate treatment, with the risk of subsequent progression from initial, subclinical symptoms to clinically overt PE, frequently with other sexual comorbidities. Thus, the current definitions of PE warrant review, in order to consider and propose a new taxonomy encompassing other unaddressed, crucial clinical aspects of PE. These newly proposed criteria include the recommendation for a primary screening for erectile dysfunction (ED), as PE and ED can be comorbid in up to 50% of patients but have never before been considered as a unified clinical entity. In order to facilitate clinical practice and improve clinical management of men with PE and comorbid conditions, we propose and define the new taxonomic clinical entities of subclinical PE (SPE) and loss of control of erection and ejaculation (LCEE). Application of these diagnoses to men who meet the criteria for SPE and/or LCEE, but not the overt conditions, could improve access to treatment for these patients and reduce progression to the more serious clinical disorder.
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Affiliation(s)
- Elena Colonnello
- Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Giacomo Ciocca
- Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.,Clinical Psychosexology, Department of Dynamic and Clinical Psychology, University of Rome Sapienza, Rome, Italy
| | - Erika Limoncin
- Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Andrea Sansone
- Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Emmanuele A Jannini
- Endocrinology & Medical Sexology (ENDOSEX), Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
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8
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Fiala L, Lenz J. Psychosocial stress, somatoform dissociative symptoms and free testosterone in premature ejaculation. Andrologia 2020; 52:e13828. [DOI: 10.1111/and.13828] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 08/09/2020] [Indexed: 12/19/2022] Open
Affiliation(s)
- Ludek Fiala
- Institute of Sexology First Faculty of Medicine Charles University Prague Czech Republic
- Department of Psychiatry Faculty of Medicine Charles University Pilsen Czech Republic
| | - Jiri Lenz
- Department of Pathology Znojmo Hospital Znojmo Czech Republic
- Department of Anatomy, Histology and Embryology Faculty of Veterinary Medicine University of Veterinary and Pharmaceutical Sciences Brno Brno Czech Republic
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Jern P, Sola IM, Ventus D. Do women's Relationship Satisfaction and Sexual Functioning Vary as a Function of Their Male Partners' Premature Ejaculation Symptoms? JOURNAL OF SEX & MARITAL THERAPY 2020; 46:630-638. [PMID: 32410522 DOI: 10.1080/0092623x.2020.1766612] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The present study investigated how women's sexual functioning and relationship satisfaction are associated with their partner's premature ejaculation (PE) symptoms, and whether prevalence rates of PE differ when women report on their male partners compared to male self-report. The sample comprised of responses from 1,779 Finnish women (mean age 33.3 years) and a control group of 1,024 Finnish men. Women who reported that their male partners had symptoms of PE were less satisfied with their relationships, and reported lower levels of arousal, orgasm, satisfaction, lubrication, and pain, but not desire. Effect sizes of these associations were small. Men and women report similar base rates of PE, suggesting that on a population level prevalence estimates are remarkably similar irrespective of whether men report on PE symptoms themselves, or women report on their partners.
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Affiliation(s)
- Patrick Jern
- Department of Psychology, Åbo Akademi University, Turku, Finland
| | - Ida-Maria Sola
- Department of Psychology, Åbo Akademi University, Turku, Finland
| | - Daniel Ventus
- Department of Psychology, Åbo Akademi University, Turku, Finland
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10
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Stephenson KR. Exploring the Role of Sexual Avoidance in Male Sexual Dysfunction. JOURNAL OF SEX RESEARCH 2020; 57:522-533. [PMID: 31553241 DOI: 10.1080/00224499.2019.1663480] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Theoretical models of male sexual dysfunction highlight the role of sexual avoidance as a maintaining factor. However, little empirical research has directly tested the role of sexual avoidance in samples of men with sexual problems. The goals of the current study were to A) assess the association between sexual avoidance, sexual function, and subjective sexual well-being, and B) explore possible predictors of sexual avoidance, including insecure attachment, activation of negative sexual schemas, and trait experiential avoidance. One hundred and fifty eight men with self-identified impairments in sexual function (low desire, erectile function, and/or premature/delayed ejaculation) completed validated self-report measures in a secure online survey. Sexual avoidance was uniquely predicted by most aspects of sexual function, and was correlated with poorer subjective sexual well-being. Higher levels of attachment avoidance and activation of negative schemas uniquely predicted more frequent sexual avoidance. Alternatively, interaction models suggested that impaired erectile function was less likely to be associated with sexual avoidance for those with high levels of attachment anxiety and for those with high levels of trait experiential avoidance. Theoretical and practical implications are discussed.
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11
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M. S, S. A, Bhat GS. Premature Ejaculation: Do We Need to Address the Issue Differently? JOURNAL OF PSYCHOSEXUAL HEALTH 2019. [DOI: 10.1177/2631831819856740] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Introduction: Premature ejaculation is a complex condition with controversial management modalities. We decided to assess the treatment-seeking behavior of affected couples, which is an indirect indicator of the efficacy of the present management modalities of premature ejaculation. Materials and Methods: Couples, who reported premature ejaculation at our outpatient clinics between January 2015 and December 2016, were enrolled in the study. Patients with acquired causes for premature ejaculation were excluded. Both the partners were administered premature ejaculation diagnostic tool (PEDT) questionnaire separately at the time of initiation of the study and after 1 month. They were asked to report intravaginal ejaculatory latency time (IELT) and their treatment-seeking behavior at these time intervals. The couples were counselled regarding their diagnosis and offered treatment with dapoxetine 30 mg as and when required. Results: A total of 117 couples with an average married life of 5.4 years were enrolled for the study. Among these, 68 had premature ejaculation (PE), 30 had probable PE and 19 had no PE as estimated on PEDT. Post treatment, 55% of couples with PE, 47% of couples with probable PE and 55% of couples without PE wanted to continue treatment seeking despite improvement. Female partners had the desire to seek treatment despite the male partner reporting otherwise. Conclusion: The treatment seeking behavior of the affected couple indicates the inefficacy of the present management modalities of PE. As specialized health care providers, we need to address these concerns to provide a comprehensive solution to their problems.
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Affiliation(s)
- Shivalingaiah M.
- Department of Urology, Institute of Nephro Urology, Bengaluru, Karnataka, India
| | - Anuradha S.
- Department of Urology, Andrology and Sexual Medicine, TSS Shripad Hegde Kadave Institute of Medical Sciences, Sirsi, Karnataka, India
| | - Gajanan S. Bhat
- Department of Urology, Andrology and Sexual Medicine, TSS Shripad Hegde Kadave Institute of Medical Sciences, Sirsi, Karnataka, India
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12
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Liu T, Jia C, Peng YF, Zhong W, Fang X. Correlation between premature ejaculation and psychological disorders in 270 Chinese outpatients. Psychiatry Res 2019; 272:69-72. [PMID: 30579184 DOI: 10.1016/j.psychres.2018.12.038] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 11/01/2018] [Accepted: 12/06/2018] [Indexed: 11/29/2022]
Abstract
Clinical patients with premature ejaculation(PE) often present with poor psychological state. This study investigated whether there is a difference in the psychological state of PE and non-PE in outpatients, and whether there is a correlation between ejaculatory latency and psychological disorders. We studied demographics informations and psychological indicators for PE patients and control group, including the Self-Rating Anxiety Scale(SAS) and Self-Rating Depression Scale(SDS), Pittsburgh Sleep Quality Index (PSQI) and recorded the ejaculatory latency. We analyzed the relationship between PE and psychological disorders by the Pearson correlation and multifactorial logistic regression. There were significant differences in SAS(p < 0.01) and SDS(p < 0.05) scores between the PE and non-PE groups. However, Pearson correlation analysis showed that there was no correlation between ejaculatory latency and SDS. Multifactorial logistic regression analysis showed that anxiety(p < 0.05) and sleep quality(p < 0.05) were closely related to the attack of PE. The incidence of anxiety and depression in PE patients is high, anxiety is a risk factor of PE. Clinicians should pay close attention to the psychological state and sleep quality of patients with PE.
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Affiliation(s)
- Tao Liu
- Department of Sexual Medicine, Affiliated Yijishan Hospital of Wannan Medical College.
| | - Chao Jia
- Department of Sexual Medicine, Affiliated Yijishan Hospital of Wannan Medical College
| | - Yi-Feng Peng
- Department of Sexual Medicine, Affiliated Yijishan Hospital of Wannan Medical College
| | - Wan Zhong
- Department of Sexual Medicine, Affiliated Yijishan Hospital of Wannan Medical College
| | - Xiang Fang
- Department of Sexual Medicine, Affiliated Yijishan Hospital of Wannan Medical College
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Verze P, Arcaniolo D, Imbimbo C, Cai T, Venturino L, Spirito L, Califano G, La Rocca R, Mirone V. General and sex profile of women with partner affected by premature ejaculation: results of a large observational, non-interventional, cross-sectional, epidemiological study (IPER-F). Andrology 2018; 6:714-719. [PMID: 30120814 DOI: 10.1111/andr.12545] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 07/25/2018] [Accepted: 07/25/2018] [Indexed: 11/30/2022]
Affiliation(s)
- P. Verze
- Department of Neurosciences; Sciences of Reproduction and Odontostomatology; Urology Unit; University of Naples “Federico II”; Naples Italy
| | - D. Arcaniolo
- Urology Unit; Department of Woman, Child and General and Specialized Surgery; University of Campania “L. Vanvitelli”; Naples Italy
| | - C. Imbimbo
- Department of Neurosciences; Sciences of Reproduction and Odontostomatology; Urology Unit; University of Naples “Federico II”; Naples Italy
| | - T. Cai
- Department of Urology; Santa Chiara Regional Hospital; Trento Italy
| | - L. Venturino
- Department of Neurosciences; Sciences of Reproduction and Odontostomatology; Urology Unit; University of Naples “Federico II”; Naples Italy
| | - L. Spirito
- Department of Neurosciences; Sciences of Reproduction and Odontostomatology; Urology Unit; University of Naples “Federico II”; Naples Italy
| | - G. Califano
- Department of Neurosciences; Sciences of Reproduction and Odontostomatology; Urology Unit; University of Naples “Federico II”; Naples Italy
| | - R. La Rocca
- Department of Neurosciences; Sciences of Reproduction and Odontostomatology; Urology Unit; University of Naples “Federico II”; Naples Italy
| | - V. Mirone
- Department of Neurosciences; Sciences of Reproduction and Odontostomatology; Urology Unit; University of Naples “Federico II”; Naples Italy
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Acquired premature ejaculation in Parkinson's disease and possible mechanisms. Int J Impot Res 2018; 30:153-157. [PMID: 29855551 DOI: 10.1038/s41443-018-0034-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Revised: 01/16/2018] [Accepted: 04/08/2018] [Indexed: 11/08/2022]
Abstract
Premature ejaculation (PE) has been reported in 40.6-51.5% of men affected by Parkinson's disease (PD), however, this non-motor sexual complaint has not been studied in detail. We describe eight PD patients who asked for a sexological consultation between 2008 and 2014 because of a new-onset of PE. They were diagnosed with acquired PE (APE) according to the DSM-V criteria and the International Society for Sexual Medicine (ISSM) committee. Patients' demographic, medical and sexual related data were retrieved and studied. The average age of onset of PD was 53.3 ± 12.7 years (range 38-77 years) and the sexual problem appeared 4.0 ± 3.1 years later. The mean intravaginal ejaculation latency (IELT) before APE onset was 7.3 (range 2-20) min. Interestingly, the ejaculatory disorder appeared abruptly, characterized by a dramatically shortened IELT in all patients, while in three of the cases ejaculation occurred before vaginal penetration, hampering sexual intercourse. Some patients had 2 additional sexual problems, (four with erectile dysfunctions, five with libido changes: increased desire in four and reduced in one). In this case series of PD patients with APE, the ejaculatory dysfunction developed when patients were on antiparkinsonian medications, suggesting a possible medication effect.
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Verze P, Arcaniolo D, Palmieri A, Cai T, La Rocca R, Franco M, Venturino L, De Sio M, Mirone V. Premature Ejaculation Among Italian Men: Prevalence and Clinical Correlates From an Observational, Non-Interventional, Cross-Sectional, Epidemiological Study (IPER). Sex Med 2018; 6:193-202. [PMID: 29803639 PMCID: PMC6085227 DOI: 10.1016/j.esxm.2018.04.005] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 03/08/2018] [Accepted: 04/10/2018] [Indexed: 12/25/2022] Open
Abstract
Introduction There is a great variability in the prevalence of premature ejaculation (PE) worldwide and only few data are available about the Italian population. Aim To determine the prevalence of PE in the adult male population in Italy. Methods Adult men 18 to 80 years old who were sexually active were randomly sampled from patient lists of general practitioners in Italy and were included in this observational, non-interventional, cross-sectional epidemiologic study from January to July 2015. Main Outcome Measures Subjects were asked to complete general questionnaires on anthropometric data, lifestyle, education, occupation, economic conditions, general health status, comorbidities, and sexual habits: the Premature Ejaculation Diagnostic Tool (PEDT), the 5-item International Index of Erectile Function, and the Sexual Quality of Life Questionnaire–Male. Results 1,104 subjects were recruited. Mean age was 45.6 years. Mean prevalence of PE based on PEDT score (≥11) was 18.5%, and 12.4% self-reported an intravaginal ejaculatory latency time shorter than 1 minute. Prevalence of PE proportionally increased with age. 64.6% of patients presented lifelong PE vs 35.4% of patients who reported acquired PE. Estimated prevalence of coexisting PE and erectile dysfunction was 7.0%. Furthermore, overall quality of sexual life was significantly worse in men with PE (P = .006). Enrolled men reported an overall rate of sexual problems in their partners of approximately 30%. 31.3% of patients with PE did not seek help for their dysfunction. No significant differences were noted between patients with and without PE for body mass index, alcohol consumption, smoking habits, physical activity, education, economic conditions, and marital status. Conclusions PE has a high prevalence in the Italian male population, increases with age, and heavily affects quality of life in patients and their partners. Encouraging data exist concerning the percentage of patients seeking help for their condition. Verze P, Arcaniolo D, Palmieri A, et al. Premature Ejaculation Among Italian Men: Prevalence and Clinical Correlates From an Observational, Non-Interventional, Cross-Sectional, Epidemiological Study (IPER). Sex Med 2018;6:193–202.
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Affiliation(s)
- Paolo Verze
- Department of Neurosciences, Sciences of Reproduction and Odontostomatology, Urology Unit, University of Naples "Federico II," Naples, Italy
| | - Davide Arcaniolo
- Department of Woman, Child and General and Specialized Surgery, Urology Unit, University of Campania "Luigi Vanvitelli," Naples, Italy.
| | - Alessandro Palmieri
- Department of Neurosciences, Sciences of Reproduction and Odontostomatology, Urology Unit, University of Naples "Federico II," Naples, Italy
| | - Tommaso Cai
- Department of Urology, Santa Chiara Hospital, Trento, Italy
| | - Roberto La Rocca
- Department of Neurosciences, Sciences of Reproduction and Odontostomatology, Urology Unit, University of Naples "Federico II," Naples, Italy
| | - Marco Franco
- Department of Neurosciences, Sciences of Reproduction and Odontostomatology, Urology Unit, University of Naples "Federico II," Naples, Italy
| | - Luca Venturino
- Department of Neurosciences, Sciences of Reproduction and Odontostomatology, Urology Unit, University of Naples "Federico II," Naples, Italy
| | - Marco De Sio
- Department of Woman, Child and General and Specialized Surgery, Urology Unit, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Vincenzo Mirone
- Department of Neurosciences, Sciences of Reproduction and Odontostomatology, Urology Unit, University of Naples "Federico II," Naples, Italy
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Teixeira T, Nazima M, Hallak J. Male Sexual Quality Of Life Is Maintained Satisfactorily Throughout Life In The Amazon Rainforest. Sex Med 2018. [PMID: 29523489 PMCID: PMC5960027 DOI: 10.1016/j.esxm.2017.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
INTRODUCTION The Amazon Rainforest is a cradle of biodiversity, where different ethnic groups have specific sexual habits. AIMS To define the average sexual quality of life of Amazonian men 18 to 69 years old, evaluate the influence of aging on their sexual function, and calculate the prevalence of premature ejaculation, delayed ejaculation, and hypoactive sexual desire disorder. METHODS A cross-sectional quantitative probability sample study was performed with a demographically representative population (N = 385), with data collected privately at participants' houses, including men who had been sexually active for a minimum of 6 months. The Male Sexual Quotient (MSQ) was used to measure sexual satisfaction and function. Statistical analysis was performed with SPSS 21.0 using the Kruskal-Wallis test (P < .05), and a multiple linear regression analysis was performed to investigate which factors could predict participants' quality of sexual life. MAIN OUTCOME MEASURES MSQ scores. RESULTS The response rate was 81.69%. The mean age was 36.00 ± 12.95 years, and most men had mixed ethnicity (63.11%), were self-employed (42.07%), had a monthly earned income of US$0 to US$460 (46.75%), and were single (36.10%). The mean MSQ score was 80.39 ± 12.14 (highly satisfied). None of the demographic characteristics showed a statistically significant influence on sexual satisfaction. The difference in quality of sexual life was statistically significant compared with age (P < .01). The domains of desire (P < .01), partner satisfaction (P = .04), and erection quality (P < .01, P = .03, P = .02) were statistically significant. Prevalences of sexual dysfunctions were 36.54% for premature ejaculation, 6.5% for delayed ejaculation, and 11.69% for hypoactive sexual desire disorder. CONCLUSIONS Independent of age, these men have an excellent quality of sexual life. Sexual domains such as desire, partner satisfaction, and erection quality are related to the correlation between sexual quality of life and aging. However, the prevalence of premature ejaculation seems to be slightly higher than in other parts of the world. Teixeira T, Nazima M, Hallak J. Male Sexual Quality Of Life Is Maintained Satisfactorily Throughout Life In The Amazon Rainforest. Sex Med 2018;6:90-96.
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Affiliation(s)
- Thiago Teixeira
- Urology Division, University of Sao Paulo Medical School, Sao Paulo, Brazil; Federal University of Amapa Medical School, Macapa, Brazil.
| | - Maira Nazima
- Federal University of Amapa Medical School, Macapa, Brazil
| | - Jorge Hallak
- Urology Division, University of Sao Paulo Medical School, Sao Paulo, Brazil; Androscience, Science and Innovation Center in Androloy and High-Complex Clinical and Andrology Laboratory, Sao Paulo, Brazil; Institute for Advanced Studies, University of Sao Paulo, Sao Paulo, Brazil
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Event-level impact of Promescent on quality of sexual experience in men with subjective premature ejaculation. Int J Impot Res 2016; 28:216-220. [PMID: 27557610 PMCID: PMC5399162 DOI: 10.1038/ijir.2016.31] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Revised: 05/13/2016] [Accepted: 06/24/2016] [Indexed: 01/23/2023]
Abstract
Promescent is a lidocaine-based ejaculation delaying spray that absorbs into the skin of the penis prior to sexual activity. This article aimed to evaluate the effect of Promescent on the experience of orgasm, ejaculatory latency time and quality of sexual experience (QSE). Additionally, we assessed ease of application of Promescent and the extent to which it enhanced or interrupted the sexual experience. The analytic sample consisted of 91 men with self-reported subjective premature ejaculation who were sent a sample of Promescent and completed a 14-day internet-based prospective daily electronic report. Average ejaculatory latency time was 11.16 min during product use events, compared with 6.81 min during product non-use events. Both members of the couple had an orgasm 65.6% of the time when they used the product, compared with 44.1% when they did not use the product. QSE was significantly improved on product use days (P<0.05). Quality also significantly improved each subsequent time the product was used (P<0.01). The product was reported as easy to use and did not interrupt the sexual experience. Findings suggest that the use of this topical spray significantly improves QSE and perception of partner experience, and that these improve with longer duration of use.
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Maseroli E, Fanni E, Mannucci E, Fambrini M, Jannini EA, Maggi M, Vignozzi L. Which are the male factors associated with female sexual dysfunction (FSD)? Andrology 2016; 4:911-20. [DOI: 10.1111/andr.12224] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 03/18/2016] [Accepted: 04/26/2016] [Indexed: 12/24/2022]
Affiliation(s)
- E. Maseroli
- Sexual Medicine and Andrology Unit; Department of Experimental, Clinical and Biomedical Sciences “Mario Serio”; University of Florence; Florence Italy
| | - E. Fanni
- Sexual Medicine and Andrology Unit; Department of Experimental, Clinical and Biomedical Sciences “Mario Serio”; University of Florence; Florence Italy
| | - E. Mannucci
- Diabetes Agency; Careggi Hospital; Florence Italy
| | - M. Fambrini
- Gynecology and Obstetrics Unit; Department of Experimental, Clinical and Biomedical Sciences “Mario Serio”; University of Florence; Florence Italy
| | - E. A. Jannini
- Department of Systems Medicine; Tor Vergata University of Rome; Rome Italy
| | - M. Maggi
- Sexual Medicine and Andrology Unit; Department of Experimental, Clinical and Biomedical Sciences “Mario Serio”; University of Florence; Florence Italy
- I.N.B.B. - Istituto Nazionale Biostrutture e Biosistemi; Rome Italy
| | - L. Vignozzi
- Sexual Medicine and Andrology Unit; Department of Experimental, Clinical and Biomedical Sciences “Mario Serio”; University of Florence; Florence Italy
- I.N.B.B. - Istituto Nazionale Biostrutture e Biosistemi; Rome Italy
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Limoncin E, Lotti F, Rossi M, Maseroli E, Gravina GL, Ciocca G, Mollaioli D, Di Sante S, Maggi M, Lenzi A, Jannini EA. The impact of premature ejaculation on the subjective perception of orgasmic intensity: validation and standardisation of the ‘Orgasmometer’. Andrology 2016; 4:921-6. [DOI: 10.1111/andr.12220] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 04/07/2016] [Accepted: 04/14/2016] [Indexed: 01/23/2023]
Affiliation(s)
- E. Limoncin
- Department of Biotechnological and Applied Clinical Sciences; University of L'Aquila; L'Aquila Italy
| | - F. Lotti
- Department of Experimental and Clinical Biomedical Sciences; University of Florence; Florence Italy
| | - M. Rossi
- Department of Experimental and Clinical Biomedical Sciences; University of Florence; Florence Italy
| | - E. Maseroli
- Department of Experimental and Clinical Biomedical Sciences; University of Florence; Florence Italy
| | - G. L. Gravina
- Department of Biotechnological and Applied Clinical Sciences; University of L'Aquila; L'Aquila Italy
| | - G. Ciocca
- Department of Biotechnological and Applied Clinical Sciences; University of L'Aquila; L'Aquila Italy
| | - D. Mollaioli
- Department of Biotechnological and Applied Clinical Sciences; University of L'Aquila; L'Aquila Italy
| | - S. Di Sante
- Chair of Endocrinology and Medical Sexology; Department of Systems Medicine; University of Rome Tor Vergata; Rome Italy
| | - M. Maggi
- Department of Experimental and Clinical Biomedical Sciences; University of Florence; Florence Italy
| | - A. Lenzi
- Division of Endocrinology; Sapienza University Rome; Italy
| | - E. A. Jannini
- Chair of Endocrinology and Medical Sexology; Department of Systems Medicine; University of Rome Tor Vergata; Rome Italy
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20
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Cai L, Wen Y, Jiang M, Zeng M, Zhang B. Premature ejaculation results from partners’ mismatch: development and validation of index of intra-vaginal ejaculation latency time. Int J Impot Res 2016; 28:101-5. [DOI: 10.1038/ijir.2016.7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 12/27/2015] [Accepted: 12/09/2015] [Indexed: 01/23/2023]
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Jiann BP, Huang YJ. Assessing satisfaction in men with premature ejaculation after dapoxetine treatment in real-world practice. Int J Clin Pract 2015; 69:1326-33. [PMID: 26194604 DOI: 10.1111/ijcp.12700] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 06/12/2015] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION There are limited data on the treatment satisfaction with dapoxetine in patients with premature ejaculation (PE). AIMS We aimed to evaluate the treatment satisfaction, effectiveness and safety of dapoxetine for PE patients. METHODS Subjects received dapoxetine (30 mg or 60 mg) alone or in combination with a phosphodiesterase type 5 inhibitor, if concurrent with erectile dysfunction for more than 4 weeks in clinical practice. Main outcome measures include Clinical Global Impression of Change (CGIC) and Clinical Global Impression of Satisfaction (CGIS). RESULTS From March 2014 to January 2015, a total of 286 PE patients received dapoxetine treatment in this study, with 137 (47.9%) patients diagnosed with lifelong PE and 149 (52.1%) patients diagnosed with acquired PE. At the final follow-up visit, the mean intravaginal ejaculatory latency time (an increase of 3.4 min) and mean score of Premature Ejaculation Diagnostic Tool (a decrease of -5.0) improved significantly from baseline, and the satisfaction rate and response rate to dapoxetine treatment were 45.0% and 74.6%, respectively. Satisfaction with dapoxetine treatment was highly correlated with treatment response, and might be improved by scheduled follow-up visits and escalation to a higher dose. Subjects with diabetes mellitus (DM) reported a lower treatment response than those without DM. Treatment-emergent adverse event (TEAEs) occurred in 47.7% of patients, but no serious TEAEs were reported. CONCLUSION Our real-world data highlight the effectiveness of dapoxetine and the importance of follow-up visits for the treatment of PE. Half of PE patients were not satisfied with dapoxetine treatment, which reflects an unmet need of present approach or an unrealistic expectation from PE patients.
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Affiliation(s)
- B-P Jiann
- Division of Basic Medical Research, Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Y-J Huang
- Human Clinical Trial and Subject Protection Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Graduate School of Human Sexuality, Shu-Te University, Kaohsiung, Taiwan
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23
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Ketabchi AA. Clomiphene Effects on Idiopathic Premature Ejaculation. Nephrourol Mon 2015; 7:e27281. [PMID: 26543830 PMCID: PMC4630386 DOI: 10.5812/numonthly.27281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 03/12/2015] [Indexed: 11/16/2022] Open
Abstract
Background: Premature ejaculation (PE) is the inability to delay ejaculation, occurring sooner than they or their partner would like during sexual activities. PE is a challenging problem that can affect sexual enjoyment and may harm relationships of couples and affect their quality of life. In idiopathic PE, several helpful techniques and medicines are recommended, but none of them has yielded satisfactory results. Objectives: Our objective in this study was to evaluate the efficacy and safety of clomiphene as a selective estrogen receptor modulator on the treatment of idiopathic PE. Patients and Methods: In a randomized clinical trial, 178 married men with idiopathic PE defined according to the Diagnostic and Statistical Manual of Mental Disorders Third Revised Version (DSM-III-R) who referred to urology clinics over a 10-month period in 2012 were randomized into two groups, namely the study (clomiphene) and control (placebo) groups. They completed self-administered questionnaires that included intravaginal ejaculatory latency time (IELT), erectile dysfunction indexes, quality of life (QOL), sociodemographic characteristics, lifestyle, and medical illness. After 6 months of intervention, all data were compared with the baseline data and between the groups. Results: Within the 10-month study course, 126 patients (70.8%) completed this study. After intervention and comparison of the results between the two groups, IELT, sexual indexes, and QOL improved in the study group, but significant differences were observed only in the IELT and QOL findings. Conclusions: Clomiphene seems to be useful in the pharmacological treatment of PE compared to the placebo.
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Affiliation(s)
- Ali Asghar Ketabchi
- Department of Urology, Bahonar Hospital, Kerman Medical Sciences University, Kerman, IR Iran
- Corresponding author: Ali Asghar Ketabchi, Department of Urology, Bahonar Hospital, Kerman Medical Sciences University, Kerman, IR Iran. Tel: +913-1412131, Fax: +98-3432239188, E-mail:
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Bronner G, Kitrey ND, Uziel N, Eli I, Raviv G, Ramon J, Elran E. Correlation between premature ejaculation and female vaginal penetration difficulties. Int J Impot Res 2015; 27:152-6. [PMID: 25716748 DOI: 10.1038/ijir.2015.3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Revised: 11/29/2014] [Accepted: 01/07/2015] [Indexed: 01/16/2023]
Abstract
Male and female sexual dysfunctions encompass biological, psychological and interpersonal aspects. Premature ejaculation (PE) and female vaginal penetration difficulties (VPD) are problems that may concurrently impair the couple's sexual relationship. We have studied the correlation between PE and VPD in the female partner, in a cross-sectional study of 125 heterosexual couples (male age 35.01±10.63; female age 32.36±10.07). VPD included tampon insertion, gynecological examination, inserting self-finger or partner-finger and penile-vaginal intercourse. Female sexual function index (FSFI) and a validated PE questionnaire were used to measure the female sexual function and PE in their male partners. We found that female partners of men with anteportal ejaculation were found to experience significantly more VPDs, especially with regard to difficulties in penile penetration and tampon use. The intensity of pain in VPD was higher in females whose male partners presented anteportal ejaculation. No significant correlation was found between total male PE score and the total FSFI or separate domains of female sexual function. The results suggest that female VPD and male anteportal ejaculation are interrelated. Such severe couple sexual problems should be addressed in parallel. Further research is required to study the causation of PE and VPD.
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Affiliation(s)
- G Bronner
- Sexual Medicine Center, Department of Urology, Sheba Medical Center, Tel-Hashomer, Israel
| | - N D Kitrey
- Department of Urology, Sheba Medical Center, Tel-Hashomer and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - N Uziel
- Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - I Eli
- Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - G Raviv
- Department of Urology, Sheba Medical Center, Tel-Hashomer and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - J Ramon
- Department of Urology, Sheba Medical Center, Tel-Hashomer and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - E Elran
- Sexual Medicine Center, Department of Urology, Sheba Medical Center, Tel-Hashomer, Israel
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Xia J, Chen T, Chen J, Han Y, Xu Z, Zhou L, Chen Y, Dai Y. The Sympathetic Skin Response Located in the Penis as a Predictor of the Response to Sertraline Treatment in Patients with Primary Premature Ejaculation. J Sex Med 2014; 11:2801-8. [DOI: 10.1111/jsm.12654] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Kaya C, Gunes M, Gokce AM, Kalkan S. Is sexual function in female partners of men with premature ejaculation compromised? JOURNAL OF SEX & MARITAL THERAPY 2014; 41:379-383. [PMID: 24779361 DOI: 10.1080/0092623x.2014.915905] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The authors enrolled 32 female partners of sexually active men with premature ejaculation to investigate their sexual functions. An age-matched sample of the same number women whose partners had no sexual dysfunction was also included. Premature ejaculation was defined for all participants as ejaculation that nearly always occurs before or within 2 min of vaginal penetration. An invitation letter was given to men with premature ejaculation to ask whether their female partners could be contacted about completing a questionnaire to measure female sexual status. On the basis of the Female Sexual Function Index, the average sexual function score was significantly lower in partners of men with premature ejaculation (21.8 ± 7.6) compared with that in healthy controls (25.9 ± 6.6). Female sexual dysfunction was diagnosed in 78% of women who has a male partner with premature ejaculation, while 40% of female partner of healthy men. All of the domain scores of Female Sexual Function Index, except the desire and pain levels, were significantly lower in female partners of men with premature ejaculation group than those of healthy subjects.
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Affiliation(s)
- Cevdet Kaya
- a Department of Urology , Marmara University Medical Faculty , Maltepe, Istanbul , Turkey
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Althof SE, McMahon CG, Waldinger MD, Serefoglu EC, Shindel AW, Adaikan PG, Becher E, Dean J, Giuliano F, Hellstrom WJ, Giraldi A, Glina S, Incrocci L, Jannini E, McCabe M, Parish S, Rowland D, Segraves RT, Sharlip I, Torres LO. An Update of the International Society of Sexual Medicine's Guidelines for the Diagnosis and Treatment of Premature Ejaculation (PE). Sex Med 2014; 2:60-90. [PMID: 25356302 PMCID: PMC4184677 DOI: 10.1002/sm2.28] [Citation(s) in RCA: 145] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
INTRODUCTION In 2009, the International Society for Sexual Medicine (ISSM) convened a select panel of experts to develop an evidence-based set of guidelines for patients suffering from lifelong premature ejaculation (PE). That document reviewed definitions, etiology, impact on the patient and partner, assessment, and pharmacological, psychological, and combined treatments. It concluded by recognizing the continually evolving nature of clinical research and recommended a subsequent guideline review and revision every fourth year. Consistent with that recommendation, the ISSM organized a second multidisciplinary panel of experts in April 2013, which met for 2 days in Bangalore, India. This manuscript updates the previous guidelines and reports on the recommendations of the panel of experts. AIM The aim of this study was to 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 A comprehensive literature review was performed. RESULTS This article contains the report of the second ISSM PE Guidelines Committee. It offers a new unified definition of PE and updates the previous treatment recommendations. 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. We again recommend that these guidelines be reevaluated and updated by the ISSM in 4 years. Althof SE, McMahon CG, Waldinger MD, Serefoglu EC, Shindel AW, Adaikan PG, Becher E, Dean J, Giuliano F, Hellstrom WJG, Giraldi A, Glina S, Incrocci L, Jannini E, McCabe M, Parish S, Rowland D, Segraves RT, Sharlip I, and Torres LO. An update of the International Society of Sexual Medicine's guidelines for the diagnosis and treatment of premature ejaculation (PE). Sex Med 2014;2:60-90.
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Affiliation(s)
- Stanley E Althof
- Department of Psychiatry, Case Western Reserve University School of Medicine West Palm Beach, FL, USA
| | | | - Marcel D Waldinger
- Division of Pharmacology, Department of Pharmaceutical Sciences, Utrecht University Utrecht, The Netherlands
| | - Ege Can Serefoglu
- Department of Urology, Bagcilar Training & Research Hospital Istanbul, Merkez Mah, Turkey
| | - Alan W Shindel
- Department of Urology, University of California at Davis CA, USA
| | - P Ganesan Adaikan
- Department of Obstetrics and Gynecology, National University of Singapore Singapore, Singapore
| | - Edgardo Becher
- Division of Urology, University of Buenos Aires Buenos Aires, Argentina
| | - John Dean
- St. Peter's Sexual Medicine, The London Clinic London, UK
| | - Francois Giuliano
- Neuro-Uro-Andrology, Physical Medicine and Rehabilitation Department, Raymond Poincaré Hospital Garches, France
| | - Wayne Jg Hellstrom
- Department of Urology, Tulane University Health Sciences Center New Orleans, LA, USA
| | - Annamaria Giraldi
- Department of Sexological Research, Psychiatric Center Copenhagen, Rigshospitalet Copenhagen, Denmark
| | - Sidney Glina
- Department of Urology, Instituto H. Ellis Sao Paulo, Brazil
| | - Luca Incrocci
- Erasmus MC-Daniel den Hoed Cancer Center Rotterdam, The Netherlands
| | - Emmanuele Jannini
- School of Sexology, Department of Clinical, Applied and Biotechnological Sciences, University of L'Aquila L'Aquila, Italy
| | - Marita McCabe
- School of Psychology, Deakin University Burwood, Vic., Australia
| | - Sharon Parish
- Albert Einstein College of Medicine, Department of Medicine, Montefiore Medical Center Bronx, NY, USA
| | - David Rowland
- Graduate School, Valparaiso University Valparaiso, IN, USA
| | - R Taylor Segraves
- Department of Psychiatry, Case Western Reserve University School of Medicine Cleveland, OH, USA
| | - Ira Sharlip
- Department of Urology, University of California San Francisco, CA, USA
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Althof SE, McMahon CG, Waldinger MD, Serefoglu EC, Shindel AW, Adaikan PG, Becher E, Dean J, Giuliano F, Hellstrom WJG, Giraldi A, Glina S, Incrocci L, Jannini E, McCabe M, Parish S, Rowland D, Segraves RT, Sharlip I, Torres LO. An update of the International Society of Sexual Medicine's guidelines for the diagnosis and treatment of premature ejaculation (PE). J Sex Med 2014; 11:1392-422. [PMID: 24848686 DOI: 10.1111/jsm.12504] [Citation(s) in RCA: 153] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
INTRODUCTION In 2009, the International Society for Sexual Medicine (ISSM) convened a select panel of experts to develop an evidence-based set of guidelines for patients suffering from lifelong premature ejaculation (PE). That document reviewed definitions, etiology, impact on the patient and partner, assessment, and pharmacological, psychological, and combined treatments. It concluded by recognizing the continually evolving nature of clinical research and recommended a subsequent guideline review and revision every fourth year. Consistent with that recommendation, the ISSM organized a second multidisciplinary panel of experts in April 2013, which met for 2 days in Bangalore, India. This manuscript updates the previous guidelines and reports on the recommendations of the panel of experts. AIM The aim of this study was to 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 A comprehensive literature review was performed. RESULTS This article contains the report of the second ISSM PE Guidelines Committee. It offers a new unified definition of PE and updates the previous treatment recommendations. 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. We again recommend that these guidelines be reevaluated and updated by the ISSM in 4 years.
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Affiliation(s)
- Stanley E Althof
- Department of Psychiatry, Case Western Reserve University School of Medicine, West Palm Beach, FL, USA
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Burri A, Giuliano F, McMahon C, Porst H. Female partner's perception of premature ejaculation and its impact on relationship breakups, relationship quality, and sexual satisfaction. J Sex Med 2014; 11:2243-55. [PMID: 24774717 DOI: 10.1111/jsm.12551] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Women's perceptions of the men's ejaculatory behavior, as well as the impact premature ejaculation (PE) has on the couple's functioning, are important factors that need to be considered. AIM This survey investigated women's perception and importance of ejaculatory function, as well as the specific aspects of PE that cause distress. In addition, the survey further identified the factors with a greater impact on intimacy, relationship, and sexual behavior. METHODS The 1,463 females belonging to a web panel from three different countries (Mexico, Italy, and South Korea), aged 20-50 years, participated in the survey. A combination of validated and self-constructed questionnaires to assess women's perception of PE, relationship satisfaction and quality, and sexual functioning and satisfaction were used. MAIN OUTCOME MEASURES Descriptive statistics in form of proportions and percentages, correlation, and regression analyses. RESULTS A significant correlation between the importance of ejaculatory control and felt distress could be observed (rho = 0.55, P < 0.001). Women reporting less sexual problems considered ejaculatory control more important and reported more PE-related distress (rho = 0.23 and 0.11, respectively; P < 0.001 for both). The male's lack of attention and focus on performance was the most frequently reported reasons for sexual distress (47.6%) followed by "the short time between penetration and ejaculation" (39.9%), and "the lack of ejaculatory control" (24.1%). Almost a quarter of women reported that the man's ejaculatory problem had previously led to relationship breakups (22.8%). Women considering duration to be important were more likely to report breakups. CONCLUSIONS The study highlights the detrimental effects of PE on relationship and sexual satisfaction in the female partner and how it can lead to the termination of the relationship. Most notably, this is the first study to report that an important source of female distress are not only parameters related to performance such as control or duration but rather inappropriate attention focus and the negligence of other forms of sexual activities.
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Affiliation(s)
- Andrea Burri
- Institute of Psychology, University of Zurich, Zurich, Switzerland
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Bailey GC, Trost LW. Current Diagnosis and Management of Premature Ejaculation. CURRENT SEXUAL HEALTH REPORTS 2014. [DOI: 10.1007/s11930-014-0014-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Gao J, Zhang X, Su P, Shi K, Tang D, Hao Z, Zhou J, Liang C. Prevalence and impact of premature ejaculation in outpatients complaining of ejaculating prematurely: using the instruments of intravaginal ejaculatory latency time and patient-reported outcome measures. Int J Impot Res 2014; 26:94-9. [PMID: 24384563 DOI: 10.1038/ijir.2013.42] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2012] [Revised: 06/08/2013] [Accepted: 10/21/2013] [Indexed: 11/09/2022]
Abstract
This study was designed to assess the impact of premature ejaculation (PE) on a large population of men and their female partners using the instruments of intravaginal ejaculatory latency time (IELT) and patient-reported outcome (PRO) measures. A non-interventional, observational and cross-sectional field survey enrolled 2704 men with self-reported PE and their female partners from January 2010 to January 2012. PE was diagnosed by the International Society for Sexual Medicine (ISSM) criterion. IELT and sexual dysfunction were measured using a stopwatch and PRO measures, respectively. The incidence of PE in this study was 19.27%. PE negatively impacted on subjects and their partners, including reduced ejaculatory control and sexual satisfaction, and increased personal distress and interpersonal difficulty (P<0.001 for all). The severity of PE was considered worse by subjects than by their female partners (P<0.001). Reduced ejaculatory control and sexual satisfaction were considered the central themes of PE. Furthermore, a correlation was observed among the outcomes of IELT and PRO measures for subjects and their partners (absolute correlation coefficient ranged from 0.33 to 0.67). This in-depth qualitative study provides valuable insight into the PE status in Chinese men. Further research is needed to confirm and extend these results.
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Affiliation(s)
- J Gao
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - X Zhang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - P Su
- Academy of Public Health of Anhui Medical University, Hefei, China
| | - K Shi
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - D Tang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Z Hao
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - J Zhou
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - C Liang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
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Ciocca G, Limoncin E, Mollaioli D, Gravina GL, Di Sante S, Carosa E, Lenzi A, Jannini EA. Integrating psychotherapy and pharmacotherapy in the treatment of premature ejaculation. Arab J Urol 2013; 11:305-12. [PMID: 26558097 PMCID: PMC4443008 DOI: 10.1016/j.aju.2013.04.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Revised: 04/10/2013] [Accepted: 04/11/2013] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES To describe the different approaches to the treatment of premature ejaculation (PE), with a final focus on integrated treatment, as conventional theories and therapies for PE are based on an organic or psychogenic dichotomy. METHODS We list the principal hypotheses of the causes and therapy of PE on the basis of psychological and medical perspectives, after identifying all relevant studies available on Medline up to 2012. RESULTS The cognitive feedback from PE can lead to a 'performance anxiety', which can combine with other conditions to further impair ejaculatory control. For these reasons, a psychological approach is always useful in treating PE, the most useful of which are sex therapy and behavioural therapy. For pharmacological treatment, reports suggest that dapoxetine (60 mg) significantly improves the control of the ejaculatory reflex, and it thus represents the first-line officially approved pharmacotherapy for PE. CONCLUSIONS A holistic approach which considers the biological, psychological and relational aspects is the advised treatment for PE. Integrated medical and psycho-sexological therapy requires a mutual understanding of and respect for the different disciplines involved in sexology. In this aspect two very important roles are those of the physician and the psychologist.
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Affiliation(s)
- Giacomo Ciocca
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, Rome, Italy
| | - Erika Limoncin
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, Rome, Italy
| | - Daniele Mollaioli
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, Rome, Italy
| | - Giovanni Luca Gravina
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, Rome, Italy
| | - Stefania Di Sante
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, Rome, Italy
| | - Eleonora Carosa
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, Rome, Italy
| | - Andrea Lenzi
- Department of Medical Pathophysiology, University of Rome ‘La Sapienza’, Rome, Italy
| | - Emmanuele A. Jannini
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, Rome, Italy
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Prevalence rate and risk factors of depression in outpatients with premature ejaculation. BIOMED RESEARCH INTERNATIONAL 2013; 2013:317468. [PMID: 23844361 PMCID: PMC3697283 DOI: 10.1155/2013/317468] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/07/2013] [Revised: 06/09/2013] [Accepted: 06/09/2013] [Indexed: 01/23/2023]
Abstract
The purpose of this study is to investigate the prevalence rate and risk factors of depression in outpatients who were diagnosed with PE. Therefore, between September 2009 and September 2011, 1801 outpatients at andrology clinics were enrolled and consented to participate in our survey by completed a verbal questionnaire. It included the following: (1) demographic data (e.g., age, body mass index), (2) PE duration, medical history, and sexual history, (3) self-estimated intravaginal ejaculatory latency times, (4) the Zung Self-rating Depression Scale (SDS), and (5) the National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and (6) the International Index of Erectile Function (IIEF-5). The results showed that a total of 1,206 patients were diagnosed with PE. The prevalence rate of depression in these PE patients was 26.78%. Depression was associated with PE duration, NIH-CPSI score, and IIEF-5 score. Risk factors for depression specifically included PE durations for 13-24, 25-60, or ≥61 months, CPSI scores of 15-30 or ≥31, and IIEF-5 scores <22. These findings suggested that several associated factors (PE duration, CPSI scores, and IIEF-5 scores) were the risk factors of depression in men with PE.
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Serefoglu EC, Saitz TR, Trost L, Hellstrom WJ. Premature ejaculation: do we have effective therapy? Transl Androl Urol 2013; 2:45-53. [PMID: 26816723 PMCID: PMC4708597 DOI: 10.3978/j.issn.2223-4683.2013.01.02] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2012] [Accepted: 01/10/2013] [Indexed: 01/23/2023] Open
Abstract
INTRODUCTION Premature ejaculation (PE) is the most common sexual dysfunction, with the majority of PE patients remaining undiagnosed and undertreated. Despite its prevalence, there is a current paucity of data regarding available treatment options and mechanisms. The objective of the current investigation is to review and summarize pertinent literature on therapeutic options for the treatment of PE, including behavioral/psychologic, oral pharmacotherapy, and surgery. METHODS A pubmed search was conducted on articles reporting data on available treatment options for PE. Articles describing potential mechanisms of action were additionally included for review. Preference was given towards randomized, controlled trials, when available. RESULTS PE remains an underdiagnosed and undertreated disease process, with limited data available regarding potential underlying mechanisms and long-term outcomes of treatment options. Psychological/behavioral therapies, including the stop-start, squeeze, and pelvic floor rehabilitation techniques have demonstrated improvements in short-term series, with decreased efficacy with additional follow-up. Topical therapies, which are commonly utilized result in prolonged intravaginal ejaculatory latency time (IELT) at the expense of potential penile/vaginal Hypothesia. Oral therapies similarly demonstrate improved IELTs with variable side effect profiles and include selective serotonin reuptake inhibitors (daily or on demand), phosphodiesterase-5 inhibitors, alpha-1 adrenergic antagonists, and tramadol. Alternative therapies such as acupuncture have shown benefits in limited studies. Surgery is not commonly performed and is not recommended by available guidelines. CONCLUSIONS PE is a common condition, with limited data available regarding its underlying pathophysiology and treatment. Available therapies include topical, oral, behavioral/psychologic modification, or a combination thereof. Additional research is required to assess the optimal treatment strategies and algorithms as well as to better define the mechanisms for PE and its management.
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New insights on premature ejaculation: a review of definition, classification, prevalence and treatment. Asian J Androl 2012; 14:822-9. [PMID: 23064688 DOI: 10.1038/aja.2012.108] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
There are ongoing debates about the definition, classification and prevalence of premature ejaculation (PE). The first evidence-based definition of PE was limited to heterosexual men with lifelong PE who engage in vaginal intercourse. Unfortunately, many patients with the complaint of PE do not meet these criteria. However, these men can be diagnosed as one of the PE subtypes, namely acquired PE, natural variable PE or premature-like ejaculatory dysfunction. Nevertheless, the validity of these subtypes has not yet been supported by evidence. The absence of a universally accepted PE definition and lack of standards for data acquisition have resulted in prevalence studies that have reported conflicting rates. The very high prevalence of 20%-30% is probably due to the vague terminology used in the definitions at the time when such surveys were conducted. Although many men may complain of PE when questioned for a population-based prevalence study, only a few of them will actively seek treatment for their complaint, even though most of these patients would define symptoms congruent with PE. The complaints of acquired PE patients may be more severe, whereas complaints of patients experiencing premature-like ejaculatory dysfunction seem to be least severe among men with various forms of PE. Although numerous treatment modalities have been proposed for management of PE, only antidepressants and topical anaesthetic creams have currently been proven to be effective. However, as none of the treatment modalities have been approved by the regulatory agencies, further studies must be carried to develop a beneficial treatment strategy for PE.
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