title: A multinational population survey of intravaginal ejaculation latency time.
abstract: BACKGROUND
  Intravaginal ejaculation latency time (IELT), defined as the time between the start of vaginal intromission and the start of intravaginal ejaculation, is increasingly used in clinical trials to assess the amount of selective serotonin reuptake inhibitor-induced ejaculation delay in men with premature ejaculation. Prospectively, stopwatch assessment of IELTs has superior accuracy compared with retrospective questionnaire and spontaneous reported latency. However, the IELT distribution in the general male population has not been previously assessed.
  
  
  OBJECTIVE
  To determine the stopwatch assessed-IELT distribution in large random male cohorts of different countries.
  
  
  METHODS
  A total of 500 couples were recruited from five countries: the Netherlands, United Kingdom, Spain, Turkey, and the United States. Enrolled men were aged 18 years or older, had a stable heterosexual relationship for at least 6 months, with regular sexual intercourse. The surveyed population were not included or excluded by their ejaculatory status and comorbidities. This survey was performed on a "normal" general population. Sexual events and stopwatch-timed IELTs during a 4-week period were recorded, as well as circumcision status and condom use.
  
  
  METHODS
  The IELT, circumcision status, and condom use.
  
  
  RESULTS
  The distribution of the IELT in all the five countries was positively skewed, with a median IELT of 5.4 minutes (range, 0.55-44.1 minutes). The median IELT decreased significantly with age, from 6.5 minutes in the 18-30 years group, to 4.3 minutes in the group older than 51 years (P<0.0001). The median IELT varied between countries, with the median value for Turkey being the lowest, i.e., 3.7 minutes (0.9-30.4 minutes), which was significantly different from each of the other countries. Comparison of circumcised (N=98) and not-circumcised (N=261) men in countries excluding Turkey resulted in median IELT values of 6.7 minutes (0.7-44.1 minutes) in circumcised compared with 6.0 minutes (0.5-37.4 minutes) in not-circumcised men (not significant). The median IELT value was not affected by condom use.
  
  
  CONCLUSIONS
  The IELT distribution is positively skewed. The overall median value was 5.4 minutes but with differences between countries. For all five countries, median IELT values were independent of condom usage. In countries excluding Turkey, the median IELT values were independent of circumcision status.
authors.affiliation: Department of Psychiatry and Neurosexology, Leyenburg HagaHospital, The Hague, and Department of Psychopharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, the Netherlands. md@waldinger.demon.nl
authors.forename: Marcel D
authors.initials: MD
authors.lastname: Waldinger
authors.forename: Paul
authors.initials: P
authors.lastname: Quinn
authors.forename: Maria
authors.initials: M
authors.lastname: Dilleen
authors.forename: Rajiv
authors.initials: R
authors.lastname: Mundayat
authors.forename: Dave H
authors.initials: DH
authors.lastname: Schweitzer
authors.forename: Mitradev
authors.initials: M
authors.lastname: Boolell
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002944:Circumcision, Male; D003075:Coitus / Q000502:physiology*; D017280:Condoms / Q000706:statistics & numerical data; D003625:Data Collection; D004542:Ejaculation / Q000502:physiology*; D006801:Humans; D038622:Internationality; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011446:Prospective Studies; D013030:Spain; D013997:Time Factors; D014421:Turkey; D006113:United Kingdom; D014481:United States