Clinical Outcomes of a New Self-Help Booklet for Premature Ejaculation

Abstract

Introduction. Premature ejaculation (PE) is quite common. Although effective treatments do exist, only a few affected people consult a practitioner in order to overcome their problem. At the same time, studies have shown that reading didactical documents about their PE problem (bibliotherapy) can be useful to men. Aim. The aim of this study was to improve the bibliotherapy approach using up‐to‐date knowledge and techniques. The expected benefits were the following: (i) an effective manual shorter than previous ones; (ii) easier to assimilate therapeutic principles; and (iii) a method thereby made accessible to a broad population most of whom usually do not consult for this type of sexual problem. Method. A short bibliotherapy titled The Practical Guide of PE[in French] was tested among PE subjects who were diagnosed with PE according to Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision criteria. Assessments were made at baseline (N = 421), at 4–8 months (N = 120), and at 10–14 months (N = 79) after they read The Practical Guide. A control group of 66 subjects was left on a waiting list and was assessed 2 months after baseline. Main Outcome Measures. The main outcome measures are self‐reported ejaculatory latency time, feeling of control upon ejaculation, sexual satisfaction, distress related to PE, anxiety experienced during sexual intercourse, and sexual cognitions (Sexual Irrationality Questionnaire). Results. Significant improvements were found for all the self‐reported parameters, both at 4–8 and at 10–14 months after the bibliotherapy. The improvements were associated with an adjustment of sexual cognitions. The response to treatment seemed better for those subjects with moderate PE. Although the severity criteria used in this study did not precisely meet the International Society for Sexual Medicine criteria for lifelong PE, they were likely related. The response did not seem to be affected by variables such as age, education, or personality. Conclusion. Its cost/benefit ratio makes The Practical Guide a valuable therapeutic tool. Kempeneers P, Andrianne R, Bauwens S, Georis I, Pairoux J‐F, and Blairy S. Clinical outcomes of a new self‐help booklet for premature ejaculation. J Sex Med 2012;9:2417–2428.

The premature ejaculation ‘disorder’: Questioning the criterion of one minute of penetration

“…Yet at least three clinical trials appear to have refuted this proposal. Thus, De Carufel and Trudel (2006), De Sutter et al (2002), and Kempeneers et al (2012) found that subjects affected by particularly short ejaculation latency may also respond favourably to sexual behavioural therapy. It is true they showed less improvement in comparison to PE subjects with penetration duration exceeding one minute (Kempeneers et al, 2012), but there were improvements nonetheless.…”

“…Thus, De Carufel and Trudel (2006), De Sutter et al (2002), and Kempeneers et al (2012) found that subjects affected by particularly short ejaculation latency may also respond favourably to sexual behavioural therapy. It is true they showed less improvement in comparison to PE subjects with penetration duration exceeding one minute (Kempeneers et al, 2012), but there were improvements nonetheless. Similar findings were obtained for medication treatments (Waldinger, 2007), such that at the end of the day, latencies shorter than one minute represent a severity gradient of the disorder that limits, not to say eradicates, the effectiveness of any treatment whatsoever.…”

Le « trouble » de l’éjaculation précoce : le critère d’une minute maximum de pénétration en question

“…Au moins trois essais cliniques semblent pourtant démentir le propos. De Carufel et Trudel (2006), De Sutter et al (2002) et Kempeneers et al (2012) ont en effet trouvé que des sujets affectés d'une latence éjaculatoire particulièrement courte pouvaient également répondre favorablement à un traitement sexo-comportemental. Les améliorations sont, il est vrai chez eux de moindre ampleur qu'elles ne le sont chez les sujets EP signalant a priori des durées de pénétration supé-rieures à une minute (Kempeneers et al, 2012), mais elles n'en sont pas moins présentes.…”

“…De Carufel et Trudel (2006), De Sutter et al (2002) et Kempeneers et al (2012) ont en effet trouvé que des sujets affectés d'une latence éjaculatoire particulièrement courte pouvaient également répondre favorablement à un traitement sexo-comportemental. Les améliorations sont, il est vrai chez eux de moindre ampleur qu'elles ne le sont chez les sujets EP signalant a priori des durées de pénétration supé-rieures à une minute (Kempeneers et al, 2012), mais elles n'en sont pas moins présentes. Du reste un constat similaire vaut également pour les traitements médicamenteux (Waldinger, 2007) de sorte qu'il apparaît au bout du compte que les latences inférieures à une minute reflètent un gradient de sévérité de l'affection, lequel limite, sans pour autant l'anéantir, l'efficacité des traitements quels qu'ils soient.…”

“…Le développement d'instruments efficaces d'auto-traitement devrait opportunément rendre plus accessible l'option sexothérapeutique en première ligne (De Sutter et al, 2002 ;Kempeneers et al, 2012 ;Kempeneers et al, in press). Par ailleurs, du moment qu'il s'agisse d'un usage éclairé et puisque le but est de soulager une souffrance, il serait dommage de s'interdire de recourir aux médicaments en cas d'inefficacité ou d'impossibilité d'un traitement psycho-sexologique, même lorsqu'on a affaire à des temps de pénétration réputés statistiquement normaux.…”