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Premature ejaculation: experts arrive at a definition

Premature ejaculation is a distressing condition that men usually suffer in silence. Flickr:leahbeequilts, CC BY-NC-ND

Experts in sexual medicine from around the world have, for the first time, defined lifelong and acquired premature ejaculation, paving the way for clear medical recognition and the development of better treatment.

Acquired premature ejaculation is when men who have had normal sexual function during their lifetime experience sex that lasts less than three minutes, while lifelong premature ejaculation is when sex lasts for a minute or less.

This is the first time the conditions have been given uniform classifications.

The new definition for acquired premature ejaculation specifically refers to intravaginal sex between a man and a woman that results in distress, frustration or avoidance of sexual intimacy.

Patrick Jern, post-doctoral researcher of psychology at Abo Akademi University, said premature ejaculation was a common sexual complaint.

“We don’t have a very good understanding of its causes,” he said.

Dr Jern said current diagnostic criteria for lifelong premature ejaculation were quite stringent, meaning a lot of men experiencing problems with their ejaculatory control did not fulfil them.

Lead author of the new guidelines for the diagnosis and treatment of premature ejaculation, emeritus professor Stanley E. Althof, said previous definitions had been mostly based on expert opinion rather than evidence.

This had, in turn, affected research efforts because in designing their studies, researchers in the field had been using different definitions and groups.

“The experimental group for one author might be the control group for another paper. It all became very confusing,” he said.

Professor Althof said having a conservative, evidenced-based definition would allow recognition of the condition by regulatory agencies and development of new therapies.

“With a conservative-evidenced based definition, regulatory agencies will view premature ejaculation as a genuine condition, rather than a lifestyle disorder,” he said.

Dr Michael Lowy, a sexual health physician specialising in premature ejaculation who wasn’t involved in the recommendations, said the condition was very distressing but men usually suffered in silence.

Treatment guidelines include psychotherapy for men alone as well as couples; behavioural techniques that enable men to build up confidence; and online treatment programs. They also include a number of drugs such as oxytocin, topical anesthetics and a common class of antidepressants known as SSRIs, among others.

Dr Lowy said researchers had a lot of experience treating premature ejaculation with selective serotonin reuptake inhibitors (SSRI), which raises serotonin levels and, as a side effect, delays ejaculation.

Due to a lack of research into populations of homosexual and bisexual men, acquired premature ejaculation has not been defined for men who have sex with men.

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