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Defining What “Ejaculating Prematurely” Means

Premature: Quick, Early, Soon, Rapid. But who says so?

Different doctors have different criteria for defining premature ejaculation, and often their definitions depend on subjective opinions. Also, there is no clear agreement on what is the normal ejaculatory latency (which is the time after penetration but before ejaculation), which doesn’t help much.

What men and women define as a “normal” ejaculatory delay is different from country to country and – perhaps not surprisingly – between women and men even in the same country. But despite these problems, the Global Study of Sexual Attitudes and Behaviors has enough information for us to conclude that rapid ejaculation affects at least 30% of men across all age groups. (I think it’s a lot higher: say 50%. Maybe even 75%. But men just don’t like to talk about it.)

While we don’t know for sure what causes a man to lose control of his ejaculation – or never to develop control in the first place – a lot of modern medical thinking is moving away from the idea of psychosexual causes (i.e. your emotions) towards neurobiological causes (i.e. something in the brain makes you ejaculate quickly). In other words, like erectile dysfunction, PE is becoming more medicalized, which means that doctors are seeing it more as a condition they can cure, rather than a psychosexual issue caused by emotional or relationship factors like anxiety about sex or anger towards a partner.

No surprise there. If it’s a medical problem, they can sell drugs to cure it. Profit, profit, profit. Or am I being too cynical?

Premature Ejaculation Video

Of course, knowing why men are unable to overcome premature ejaculation may help produce more effective therapies. For the moment, however, rapid climax during sex continues to have a major effect on men and their partners, and places a significant burden on many men’s self-image and sexual confidence.

Of course, like I said above, a big problem is the lack of clear diagnostic criteria for normal ejaculation delay. So we think we know whether or not we are premature ejaculators, but in truth we don’t really know how we compare with other men. I mean, if 50% or more of all men suffer from PE, depending on which criteria the researchers used, then isn’t rapid ejaculation NORMAL? However, even if it is normal, prematurity is the most common sexual complaint among men.

And defining normal ejaculatory latency (period between penetration and ejaculation) is difficult because men and women’s ideas of what is normal is not consistent - the perception of the normal period before ejaculation varies widely. For example, in Germany, the perceived average latency time is only 7 minutes, but in the USA it is over 13 minutes. The perceived average for men in the United Kingdom, France, and Italy is around 9 minutes.

Generally, the time between penetration and ejaculation estimated by women is slightly lower than the time estimated by men.

The difficulty of agreeing what is the “normal” ejaculatory latency is reflected in the lack of a universally accepted definition of PE. The best definition is probably that of the DSM-IV diagnostic manual: persistent or recurrent ejaculation with minimal stimulation before, on, or shortly after penetration and before the person wishes it.

As you can see, this definition of premature ejaculation really has three components:

  • a short period before ejaculation
  • a lack of voluntary control over ejaculation
  • a lack of sexual satisfaction for one or both partners

Obviously these are subjective criteria, which do not provide a scientific basis for either the definition of prematurity, or help us conduct research on how to treat it effectively. In fact, in about 45 studies undertaken between 1963 and 2000, only half contained a quantifiable measure of ejaculatory progress such as number of thrusts, or IELT.

And even subjectively assessed criteria, such as a man’s belief that he lacks control over his ejaculation, were reported in less than half.

Of course, most men who are ejaculating quickly know very well they have premature ejaculation, because they generally have so little control in bed. And they cannot overcome this lack of control, nor can they avoid early climax during sexual intercourse. Often they are really unhappy and dissatisfied with their sexual performance, mostly because of this lack of control. Yes, for most men, it is the loss or absence of ejaculatory control that is the key factor in defining prematurity.

The Global Study of Sexual Attitudes and Behaviors (GSSAB) collected data from more than 13,000 men in 29 countries. Overall, approximately one third of all men seem to have difficulty with premature ejaculation. The prevalence of premature ejaculation varies widely, though: in Latin America it was reported as 28.3%, in the Middle East, 12.4%, and in South East Asia 30.5%. These reports were based on men who said PE was a frequent problem which had persisted for a long time. These men appear to have a chronic sexual dysfunction and a much lower quality-of-life because of it. Certainly their sexual confidence and sense of masculinity is diminished. And don’t even talk about sexual fulfillment!

But why would the prevalence of premature ejaculation vary so much from region to region? Several reasons. For example, the level of circumcision in certain regions may be a big factor – circumcision is linked to glans keratinization and desensitization.

Then again, there are religious and cultural influences which may affect the prevalence of premature ejaculation. What is thought of as premature ejaculation may be different among Protestant and Catholic populations. Also, rates of premature ejaculation may appear to be higher in places where sex has a particular cultural significance or where female sexuality is regarded as just as important as male sexuality.

However, in patriarchal societies where women have a lower social position, premature ejaculation is often seen as a sign of virility rather than a problem. (Convenient, eh?)

There may be a suspicion that premature ejaculation is linked to other physical conditions – not in a causative way, but because the pain and discomfort of any condition which affects overall health will affect sexual functioning, both psychologically and physically. In the latter case, the link may actually be no more than the fear of pain striking during sex. Arthritis and gout are excellent examples of conditions which fall into this category. For health resources on gout, in particular a great diet for gout – click here to learn more.

There is conflicting evidence about the association of race and the reported frequency of premature ejaculation. The National Health and Social Life Survey, which was conducted in 1992, looked at over 1,400 men between the ages of 18 and 59 years. The results suggested that premature ejaculation among black, Caucasian, and Hispanic men was 34%, 19%, and 27%, respectively. However, a more recent study suggested the figures were 21%, 16%, and 29% respectively, although this study involved an older population of men aged between forty and eighty years.

Data from the NHLS reveals that the lack of ability to overcome premature ejaculation is not correlated with age. Indeed, the frequency of rapid ejaculation is basically constant throughout the 18 – 59 age group.

However, the GSSAB found that less educated men see to have more prematurity. For example, in the Middle East and Central and South America, men with no college education appeared to be twice as likely to report they had premature ejaculation as men who had received some college education. The only other factor of significance clearly associated with premature ejaculation was infrequent sex, which is hardly surprising.

The above is based very loosely on an article in The Journal Of Sexual Medicine, 2005, Supplement 2: Prevalence of Premature Ejaculation: A Global and Regional Perspective by Francesco Montorsi, MD. Any errors of interpretation are solely the responsibility of this website.