Short, easily stimulated ejaculation that occurs always or nearly always before or within about 1 minute of vaginal penetration or other relevant sexual stimulation or a clinically significant and bothersome reduction in latency time, often to about 3 minutes or less
The American Urological Association (AUA) utilizes a more permissive cut-off of within 2 minutes of vaginal penetration since about 20% men with suspected PE ejaculate for >1 minute
Either present from the first sexual experience or following a new bothersome change in ejaculatory latency
Involuntarily controlled or there is inability to delay ejacuation
Causes negative personal consequences eg distress, bother, embarrassment, frustration, avoidance of sexualintimacy and interpersonal difficulty
Must be present for 6 months and experienced in almost all or all occasions
The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5) classifies PE depending on when ejaculation occurs
Mild: Before or within 15 seconds of penetration
Moderate: 15-30 seconds after penetration
Severe: 30-60 seconds after penetration
Dịch tễ học
Affects about <5% of men; with up to 30% of men in community surveys
Most common male sexual dysfunction with prevalence not affected by age
Sinh lý bệnh
Unknown exact etiology with few data to support the following suggested biological and psychological hypotheses including:
Anxiety
Penile hypersensitivity
Serotonin or 5-hydroxytryptamine (5-HT) receptor dysfunction receptor dysfunction
Erection and ejaculation are triggered by the integration of tacticle (eg genital sensation) and non-tactile (eg audio and visual inputs) stimuli in the brain
Studies have shown that lesions in the galaninergic neurons within the central spinal cord is associated with ejaculatory failure
Galaninergic neurons may be responsible for the integration of central and peripheral stimuli and triggering ejaculatory reflex
Alteration in the bladder neck and prostate functions (eg surgery, radiation) also alters ejaculation
Yếu tố nguy cơ
Risk factors include:
Genetic influences (lifelong PE)
Prostatic inflammation and chronic bacterial prostatitis (acquired PE)
Hormonal aberrations (eg low prolactin levels, high testosterone levels) or thyroid hormone disorders
Poor overall health status (including lack of physical activity) and obesity
Psychological factors that may precipitate PE are historical
factors (eg sexual abuse, attitude towards sex in the home), individual
psychological factors (eg body image, depression, performance anxiety)
or relationship factors (eg intimacy, anger)
