title: Pathophysiology of premature ejaculation.
abstract: BACKGROUND
  Although the characteristics of premature ejaculation (PE) are established, the exact aetiology is largely unknown. Genetic, neurobiological, pharmacological, psychological, urological and endocrine factors have all been proposed. In addition PE and erectile dysfunction are often co-morbid.
  
  
  OBJECTIVE
  This article provides an overview of the proposed biological and psychological aetiologies of PE.
  
  
  METHODS
  Review of the literature.
  
  
  METHODS
  Current data on the pathophysiology of PE.
  
  
  RESULTS
  This review shows that most of the proposed biological and psychological aetiologies of PE are not evidence-based and/or that attempts to confirm them have given conflicting results. There are good data to support roles for genetic and psychological factors, either causal, or secondary to PE for the latter, in lifelong PE. Conversely, more evidence-based data support the responsibility of opioid substance withdrawal, prostatic inflammation or hyperthyroidism in some cases of acquired PE, in addition to a probable role of psychological factors.
  
  
  CONCLUSIONS
  The determinants of PE are certainly complex and multifactorial, while each partner's reaction to the frustration caused by the sexual dysfunction may exacerbate or perpetuate it. It is important to understand, as far as possible, the aetiology in the individual patient to ensure appropriate assessment and treatment. It should be noted that identification of an aetiological factor does not necessarily mean the cause of the PE has been completely explained, and the patient may require a combination of treatment approaches.
authors.affiliation: Centre d'Étude et de Traitement de la Pathologie de l'Appareil Reproducteur et de la Psychosomatique, Lille, France. jacques@buvat.org
authors.forename: Jacques
authors.initials: J
authors.lastname: Buvat
mesh_terms: D004542:Ejaculation / Q000502:physiology*; D007172:Erectile Dysfunction / Q000150:complications / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D008297:Male; D011584:Psychology; D012735:Sexual Dysfunction, Physiological / Q000150:complications / Q000503:physiopathology* / Q000523:psychology; D020018:Sexual Dysfunctions, Psychological / Q000150:complications / Q000503:physiopathology* / Q000523:psychology