ABSTRACT
Numerous definitions of PE exist, but one of the most commonly accepted is that from the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV), 6 which defines PE as ‘the persistent or recurrent onset of orgasm and ejaculation with minimal sexual stimulation before, on, or shortly after penetration and before the person wishes it ’ . This definition is a subjective one and does not seek to quantify ejaculatory latency. In practice the intravaginal ejaculatory latency time (IELT), measured with a stopwatch, is commonly used as a way of quantifying PE and treatment success, and also as a standardized way of comparing treatments in clinical research. Considerable variation exists as to where the threshold IELT should be set to define PE, although the consensus of opinion seems to be that men with PE tend to have an IELT of 1 – 2 minutes or less. 7-9
However, the impact that PE has on quality of life is significant, 3 with a similar qualitative impact on the sufferer as erectile dysfunction. 10 Consequently, there is now general agreement that although IELT comparisons are valuable, the evaluation of treatments in well-designed clinical trials should include measures of sexual satisfaction (by the man and his partner), and perception of control over ejaculation, in addition to IELT. 8,11
PE is a self-diagnosed condition and most men with the condition do not seek treatment, for reasons of embarrassment, shame, or the belief that no effective treatment exists, but they may try self-help techniques or self-medication: In a large multi-country survey of more than 11,500 men in the USA, Italy, and Germany, fewer than 12 % of men who selfreported PE had sought treatment. 12 In a small survey involving in-depth interviews with 28 men with self-diagnosed PE, 89 % had tried some form of treatment (including behavioral therapies, pharmaceutical agents, over-the-counter remedies, herbal remedies, creams, and condoms), regardless of whether or not they had consulted a healthcare professional. 10 Such a high figure indicates that men experiencing PE are highly motivated to seek a solution or treatment.
