An Evidence-Based Unified Definition of Lifelong and Acquired Premature Ejaculation: Report of the Second International Society for Sexual Medicine Ad Hoc Committee for the Definition of Premature Ejaculation

Abstract

IntroductionThe International Society for Sexual Medicine (ISSM) Ad Hoc Committee for the Definition of Premature Ejaculation developed the first evidence-based definition for lifelong premature ejaculation (PE) in 2007 and concluded that there were insufficient published objective data at that time to develop a definition for acquired PE.AimThe aim of this article is to review and critique the current literature and develop a contemporary, evidence-based definition for acquired PE and/or a unified definition for both lifelong and acquired PE.MethodsIn April 2013, the ISSM convened a second Ad Hoc Committee for the Definition of Premature Ejaculation in Bangalore, India. The same evidence-based systematic approach to literature search, retrieval, and evaluation used by the original committee was adopted.ResultsThe committee unanimously agreed that men with lifelong and acquired PE appear to share the dimensions of short ejaculatory latency, reduced or absent perceived ejaculatory control, and the presence of negative personal consequences. Men with acquired PE are older, have higher incidences of erectile dysfunction, comorbid disease, and cardiovascular risk factors, and have a longer intravaginal ejaculation latency time (IELT) as compared with men with lifelong PE. A self-estimated or stopwatch IELT of 3 minutes was identified as a valid IELT cut-off for diagnosing acquired PE. On this basis, the committee agreed on a unified definition of both acquired and lifelong PE as a male sexual dysfunction characterized by (i) ejaculation that always or nearly always occurs prior to or within about 1 minute of vaginal penetration from the first sexual experience (lifelong PE) or a clinically significant and bothersome reduction in latency time, often to about 3 minutes or less (acquired PE); (ii) the inability to delay ejaculation on all or nearly all vaginal penetrations; and (iii) negative personal consequences, such as distress, bother, frustration, and/or the avoidance of sexual intimacy.ConclusionThe ISSM unified definition of lifelong and acquired PE represents the first evidence-based definition for these conditions. This definition will enable researchers to design methodologically rigorous studies to improve our understanding of acquired PE. Serefoglu EC, McMahon CG, Waldinger MD, Althof SE, Shindel A, Adaikan G, Becher EF, Dean J, Giuliano F, Hellstrom WJG, Giraldi A, Glina S, Incrocci L, Jannini E, McCabe M, Parish S, Rowland D, Segraves RT, Sharlip I, and Torres LO. An evidence-based unified definition of lifelong and acquired premature ejaculation: Report of the second International Society for Sexual Medicine Ad Hoc Committee for the Definition of Premature Ejaculation. Sex Med 2014;2:41–59.

Psychosexual therapy for delayed ejaculation based on the Sexual Tipping Point model

“…This goal (access, validity, reliability) is fulfilled using a DE definition which differs from the ISSM and DSM-5 guidelines but still incorporates the critical tenets of time, control, and distress (19-22,28). This approach emphasizes the utility of a biopsychosocial-cultural perspective combined with particular attention to the patient’s narrative.…”

“…” Such robust quantitative evidence should become the basis for determining the temporal criterion for defining PE and DE [see (D) in “Notes” section]. Any bilateral deviation from the majority of men’s ~4–10 minutes IELT range would meet the qualification for the temporal criterion, but a licensed HCC must also assess for “lack of control” and “distress” for a man to be diagnosed with a PE or DE disorder (19,20,22,29). …”

Prevalence of premature ejaculation and its impact on the quality of life: Results from a sample of Egyptian patients

“…Premature ejaculation (PE) is a common type of male sexual dysfunctions in which the latency time is significantly reduced to a bothering short duration. In other words, the patient is unable to control ejaculation which always or nearly always happens before or within a minute of vaginal penetration, and this usually trigger several negative personal effects, including frustration, anxiety and/or sexual abstinence (Serefoglu et al, 2014).…”

The epidemiology of premature ejaculation

“…As a standardized evidence-based definition of PE has only recently been established (2), the reported prevalence rates of PE prior to this definition have been difficult to interoperate. As a result, a large range of conflicting prevalence rates have been reported ( Table 1 ).…”