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

Introduction. The 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. Aim. The aim of this article is to review and critique the current literature and develop a contemporary, evidencebased definition for acquired PE and/or a unified definition for both lifelong and acquired PE. Methods. In 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. Results. The 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 © 2014 The Authors. Sexual Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Sexual Medicine. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.Sex Med 2014;2:41-59 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. Conclusion. The 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.

Definitions of Sexual Dysfunctions in Women and Men: A Consensus Statement From the Fourth International Consultation on Sexual Medicine 2015

“…The ISSM definition of PE is a male sexual dysfunction characterized by ejaculation that always or nearly always occurs before or within approximately 1 minute of vaginal penetration from the first sexual experience (lifelong PE) or a clinically significant and bothersome decrease in latency time, often to approximately 3 minutes or less (acquired PE), the inability to delay ejaculation on all or nearly all vaginal penetrations, and negative personal consequences, such as distress, bother, frustration, and/or the avoidance of sexual intimacy. 9 The ISSM definition of PE had an obvious influence on the delineation of the diagnosis of PE in the DSM-5.…”

The impact of premature ejaculation on the subjective perception of orgasmic intensity: validation and standardisation of the ‘Orgasmometer’

“…Lifelong (LL-) and acquired (A-) PE were diagnosed by an andrologist on the basis of the International Society of Sexual Medicine (ISSM) and DSM-5 PE definitions (American Psychiatric Association, 2013;Serefoglu et al, 2014;Rowland & Kolba, 2015), including the subjective evaluation of IELT (Waldinger et al, 1998) and the Premature Ejaculation Diagnostic Tool (PEDT) scores (Symonds et al, 2007). Among the other inclusion criteria, men had to be sexually active and had to have experienced orgasmic pleasure during the six months preceding enrollment.…”

“…On the other hand, many individuals with PE do not easily fit into a single class and a number of PE-subcategories may be individuated (Serefoglu et al, 2014) which do not fall into the diagnostic criteria internationally adopted. Therefore, it is clear that a number of key aspects characterising men with PE may be both unrecognised and understudied (Jannini et al, 2015).…”

“…Some recent studies have highlighted the importance of relational variables for some PErelated aspects, such as PE diagnosis and treatment outcome (Jannini et al, 2002). In fact, interpersonal difficulties related to low sexual satisfaction may be considered a fundamental aspect related to PE, which should be considered in a clinical setting, along with intravaginal ejaculatory latency time (IELT), perceived control over ejaculation and personal distress (Jannini et al, 2002;Rowland et al, 2010;APA, 2013;Serefoglu et al, 2014).…”

“…Premature ejaculation diagnosis is based on the internationally codified diagnostic criteria (American Psychiatric Association, 2013;Serefoglu et al, 2014). On the other hand, many individuals with PE do not easily fit into a single class and a number of PE-subcategories may be individuated (Serefoglu et al, 2014) which do not fall into the diagnostic criteria internationally adopted.…”