Premature ejaculation: on defining and quantifying a common male sexual dysfunction.
BACKGROUND
Premature ejaculation (PE) and its individual and relationship consequences have been recognized in the literature for centuries. PE is one of the most common male sexual dysfunctions, affecting nearly one in three men worldwide between the ages of 18 and 59 years. Until recently, PE was believed to be a learned behavior predominantly managed with psychosexual therapy; however, the past few decades have seen significant advances in understanding its etiology, diagnosis, and management. There is, as yet, no one universally agreed upon definition of PE.


OBJECTIVE
To review five currently published definitions of 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.


METHODS
Data were utilized from the World Health Organization, the American Psychiatric Association, the European Association of Urology, the Second International Consultation on Sexual Dysfunctions, and the American Urological Association.


RESULTS
The current published definitions of PE have many similarities; however, none of these provide a specific "time to ejaculation," in part because of the absence of normative data on this subject. While investigators agree that men with PE have a shortened intravaginal ejaculatory latency time (IELT; i.e., time from vaginal penetration to ejaculation), there is now a greater appreciation of PE as a multidimensional dysfunction encompassing several components, including time and subjective parameters such as "control,""satisfaction," and "distress."


CONCLUSIONS
There is a recent paradigm shift away from PE as a unidimensional disorder of IELT toward a multidimensional description of PE as a biologic dysfunction with psychosocial components.
Broderick
Gregory A
GA
Department of Urology, Mayo Clinic College of Medicine, Jacksonville, FL 32224, USA. broderick.gregory@mayo.edu
D000328:Adult; D004542:Ejaculation; D007172:Erectile Dysfunction / Q000145:classification / Q000175:diagnosis; D019317:Evidence-Based Medicine; D014943:Global Health; D006801:Humans; D007391:International Cooperation; D008297:Male; D008875:Middle Aged; D010410:Penile Erection; D017410:Practice Guidelines as Topic; D012735:Sexual Dysfunction, Physiological / Q000145:classification* / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D020018:Sexual Dysfunctions, Psychological / Q000145:classification* / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D014481:United States / Q000453:epidemiology