Defining and treating premature ejaculation

The common denominators in “rapid ejaculation” and “premature ejaculation” are used interchangeably, they include: 1) ejaculatory latency, 2) voluntary control, and 3) presence of marked distress or interpersonal disturbance. According to the IDC – 10, ejaculation must occur “within 15 seconds of the beginning of intercourse”. Premature ejaculation is defined as;

Persistent or recurrent ejaculation with minimal sexual stimulation before, on, or shortly after penetration and before the person wishes it.
The disturbance causes marked distress or interpersonal difficulty.
The premature ejaculation is not due exclusively to the direct effects of a substance.

After determining that the patient meets the diagnostic criteria for premature ejaculation, the clinical provider is required to make three additional assessments: whether the dysfunction is lifelong or acquired, whether it is of a generalized or specific type, and whether it is due to psychological factors, biological factors, or both.

The specifier of lifelong versus acquired in the assessment may turn out to be a predictor of who will benefit from pharmacological treatment over the long term.

Acquired premature ejaculation specifier requires the clinician to explore issues that generated the new symptom, which may reflect some recent psychosocial stressors or could be the consequence of medication, illness, or a surgery. An example of a psychosocial stressor could be a male who acquired rapid ejaculation resulting from an erectile failure. Some males have developed performance anxiety around their ability to maintain erection and might often hurry intercourse, thinking they may have limited time to “complete the act.”