Clinical and Demographic Correlates of Ejaculatory Dysfunctions Other Than Premature Ejaculation: A Prospective, Observational Study.
BACKGROUND
Ejaculatory dysfunctions other than premature ejaculation are commonly encountered in specialized clinics; however, their characterization in community-dwelling men is lacking.


OBJECTIVE
The aim of this study was to evaluate the prevalence, severity, and associated distress of four ejaculatory dysfunctions: delayed ejaculation (DE), anejaculation (AE), perceived ejaculate volume reduction (PEVR) and/or decreased force of ejaculation (DFE) as a function of demographic and clinical characteristics in men.


METHODS
Observational analysis of 988 subjects presenting with one or more types of ejaculatory dysfunctions other than premature ejaculation who screened for a randomized clinical trial assessing the efficacy of testosterone replacement on ejaculatory dysfunction. Demographic and clinical characteristics were assessed as potential risk factors using regression analysis.


METHODS
The main outcome measures used were ejaculatory dysfunction prevalence and scores (3-item Men's Sexual Health Questionnaire Ejaculatory Dysfunction-Short Form [MSHQ-EjD-SF]), and bother (MSHQ-EjD-SF Bother item) and sexual satisfaction/enjoyment (International Index of Erectile Function Questionnaire Q7, Q8) as a function of subject's age, race, body mass index (BMI) and serum testosterone levels (measured by liquid chromatography tandem mass spectrometry).


RESULTS
Mean (standard deviation [SD]) age of the participants was 52 years (11). Eighty-eight percent of the men experienced more than one type of ejaculatory dysfunction and 68% considered their symptoms to be bothersome. Prevalence of the ejaculatory dysfunctions was substantial across a range of age, race, BMI, and serum testosterone categories. Prevalence of PEVR and DFE were positively associated with age (<40 years vs. 60-70 years: PEVR: odds ratio [OR], 3.05; 95% confidence interval [CI], 1.32-7.06; DFE: OR, 2.78; 95% CI, 1.46-5.28) while DFE was associated with BMI (≥30 kg/m(2) vs. < 25 kg/m(2) : OR, 1.80; 95% CI, 1.062-3.05). All ejaculatory dysfunctions were more prevalent in black men.


CONCLUSIONS
The majority of the participants experienced multiple ejaculatory dysfunctions and found them to be highly bothersome. Ejaculatory dysfunctions were prevalent across a wide range of demographic and clinical characteristics.
Department of Urology, Weill Cornell Medical College, New York, USA.
Darius A
DA
Paduch
Eli Lilly and Co., Indianapolis, USA.
Paula
P
Polzer
Men's Health Boston, Chestnut Hill, USA.
Abraham
A
Morgentaler
Center for Marital and Sexual Health of South Florida, West Palm Beach, USA.
Stanley
S
Althof
Eli Lilly and Co., Indianapolis, USA.
Craig
C
Donatucci
Eli Lilly and Co., Indianapolis, USA.
Xiao
X
Ni
Eli Lilly and Co., Indianapolis, USA.
Ankur B
AB
Patel
Brigham and Women's Hospital, Harvard Medical School, Section on Men's Health, Aging and Metabolism, Boston, USA.
Shezhad
S
Basaria
D000328:Adult; D000367:Age Factors; D000368:Aged; D000728:Androgens / Q000097:blood* / Q000627:therapeutic use; D004542:Ejaculation; D007172:Erectile Dysfunction / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D008297:Male; D054526:Men's Health; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010549:Personal Satisfaction; D015995:Prevalence; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013739:Testosterone / Q000097:blood* / Q000627:therapeutic use
D000728:Androgens; D013739:Testosterone
Delayed Ejaculation; Ejaculation; Ejaculatory Dysfunction; Sexual Dissatisfaction; Testosterone