Altered reward processing in patients with lifelong premature ejaculation

Abstract

Given that sexual behavior is usually pleasurable and highly rewarding, it is surprising that there is as yet no known research to empirically assess how premature ejaculation (PE) patients respond to the rewarding aspect of sexual behavior. This study was designed to address this issue by evaluating how these men respond to the anticipation and hedonic experience of sexual rewards in comparison to non-sexual rewards. Thirty lifelong PE patients and thirty healthy controls (HCs) performed the incentive delay task manipulating both erotic and monetary rewards. Compared to HCs, lifelong PE patients exhibited significantly faster RTs to erotic cues than to monetary cues during reward anticipation. Meanwhile, hedonic experience ratings after obtaining the actual reward showed that erotic rewards were rated as more pleasant than monetary rewards only by lifelong PE patients, which was driven by a decreased sensitivity to experienced monetary rewards in lifelong PE patients compared to HCs. These findings indicate the existence of dysfunctional reward processing in lifelong PE patients, which is characterized by increased incentive motivation elicited by sexual cues and reduced hedonic impact of nonsexual rewards. This study may offer an insightful clue regarding how PE is related to the abnormal regulation of the rewarding aspect of sexual behavior.

Topological differences of striato‐thalamo‐cortical circuit in functional brain network between premature ejaculation patients with and without depression

“…Likewise, a structural MRI study demonstrated increased structural covariance between the striatum and thalamus, which showed potential higher sensitivity to sexual stimulation in PE patients (Wu et al., 2022). A recent study observing the response of PE patients to both sexual and nonsexual rewards suggested enhanced incentive motivation and hedonic impact of sexual stimuli, which highlighted an allostatic shift in the reward processing pathways of PE patients (Li, Wang, et al., 2023). Based on our findings, the higher functional connectivity and increased global integration of information might again reinforce the abnormalities of PE patients in sensory and emotional processing, controlling sexual inhibition, and reacting to reward‐related information (Wu et al., 2022).…”

High-intensity interval training (HIIT) and slow breathing interventions alleviate premature ejaculation (PE) symptoms

“…PE is characterized by a man's inability to maintain ejaculatory control as desired, resulting in a short intravaginal ejaculation latency time (IELT), such as ejaculating within one minute of penetration ( Althof et al, 2014 ), which in turn leads to sexual distress as well as diminished self-esteem and self-confidence ( Rowland et al, 2007 ; Symonds et al, 2003 ) and heightened levels of anxiety and depression ( Ermeç et al, 2022 ; Porst et al, 2007 ), increased interpersonal difficulties ( Giuliano et al, 2008 ; Patrick et al, 2005 ), and an altered rewarding processing (Y. Li et al, 2023 ). Furthermore, men suffering from PE symptoms have female sexual partners with reduced relationship and sexual satisfaction, elevating the risk of sexual dysfunction ( Jern et al, 2020 ; Zhang et al, 2020 ).…”