Premature Ejaculation

Premature ejaculation (PE) is a common complaint, but clinical prevalence rates are strongly dependent on diagnostic criteria and range from 2% to 30% of the general population. Recent definitions employ criteria requiring a recurring ejaculation latency of one minute or less during penetrative intercourse, which is rare in comparison to a subjectively perceived lack of control over the ejaculatory reflex. To date, little is known about the etiology of PE, but there is evidence to suggest that it is partly heritable (with genes accounting for roughly 30% of its variance) and that various endocrine, neurotransmitter-related, psychosocial, and lifestyle factors all play a role. PE is associated with lowered overall well-being and quality of life, problems in intimate relationships, and frequently occurs comorbidly with other sexual problems as well as lifestyle diseases such as type 2 diabetes and metabolic disease. A range of treatment options have been developed for PE, but there is considerable variation in treatment response between individuals. Available evidence suggests that combination therapy, where pharmacotherapy with selective serotonin reuptake inhibitors administered together with psychobehavioral interventions and/or psychoeducation tends to produce the best outcomes.