Diagnosing premature ejaculation: A review

Introduction. Premature ejaculation (PE) is one of the most prevalent male sexual dysfunctions, yet it is frequently misdiagnosed or overlooked as a result of numerous patient and physician barriers. In particular, there is no universally used definition of the condition. There are no validated assessments or laboratory assays which distinguish men with PE from men without PE, and there are no risk factors or definitive correlates identified for this condition. Patients fail to seek medical help because of the stigma and embarrassment over the condition. In addition, patients (and clinicians) often misdiagnose PE as erectile dysfunction (ED). Aim. To review the barriers to diagnosing PE, the factors to consider in diagnosing PE and how to diagnose PE. Methods. The Sexual Medicine Society of North America hosted a State of the Art Conference on Premature Ejaculation on June 24-26, 2005 in collaboration with the University of South Florida. The purpose was to have an open exchange of contemporary research and clinical information on PE. There were 16 invited presenters and discussants; the group focused on several educational objectives. Main Outcome Measure. Data were utilized from the American Urological Association (AUA) Guideline on the Pharmacologic Management of Premature Ejaculation. Results. The AUA recommends the diagnosis of PE be based solely upon sexual history. In addition to a shortened latency time, recent research has identified three key factors associated with-and necessary for-a diagnosis of PE: (i) patient reports of reduced control over ejaculation; (ii) patient (and/or partner) reports of reduced satisfaction with sexual intercourse; and (iii) patient (and/or partner) distress over the condition. Conclusions. The diagnosis of PE is based upon sexual history of a shortened latency time, poor control over ejaculation, low satisfaction with intercourse, and distress regarding the condition.