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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.
How widespread is premature ejaculation (PE)? One
problem is that we don't really know because there is no accepted
definition of premature ejaculation. At the moment, different
doctors have different criteria for diagnosing the condition, and the
definitions that are available depend to a large extent on subjective
measurement or opinion. Also, there is no clear agreement on what
is a normal ejaculatory latency (time after penetration but before
ejaculation). This has hampered research into premature ejaculation.
What men and women think of as "normal" ejaculatory latency
is different from country to country and - perhaps not surprisingly -
between women and men even in the same country. But despite these
problems of definition, the Global
Study of Sexual Attitudes and Behaviors has enough information for us to
conclude that premature ejaculation affects about 30% of men across all age groups.
And what causes it? Like erectile dysfunction,
premature ejaculation is becoming more medicalized, which means that
doctors are seeing it more as a condition they can cure than a
psychosexual issue caused by emotional issues like anxiety. While we
don't know for sure what causes premature ejaculation, current thinking
is moving away from psychosexual ideas towards
neurobiological bases. Of course, knowing what causes premature
ejaculation will
certainly help produce more effective therapies, but for the moment it
remains a fairly major problem for men and a significant burden on psychological
well-being.
Up till now, the prevalence of
premature ejaculation has been little understood, but recent research has
offered a clearer picture and shows there are regional differences in
the frequency of premature ejaculation among men. Of course, a big
problem is that the lack of clear diagnostic criteria for normal
ejaculation has hampered attempts to measure the prevalence of premature ejaculation:
values between 25% and 60% are reached, depending on which
criteria the researchers used. One thing we do know is that that premature ejaculation is the most
common sexual complaint among men.
Defining normal
ejaculatory latency (period between penetration and ejaculation) is difficult.
Men and women's ideas of what is normal is not consistent - the perception of
the normal period before ejaculation varies widely - between 7 and 14
minutes, with significant geographical variation. For example, in
Germany,
the perceived average latency time is only 7 minutes,
but in the US it is over 13 minutes. The perceived
average for men in the United Kingdom, France, and Italy is
around 9 minutes.
Generally, the time before ejaculation as estimated by women was
similar to the time estimated by men, though slightly lower in most
cases.
The difficulty of agreeing what is the "normal" ejaculatory latency
is reflected in the lack of a universally accepted definition of
premature ejaculation. 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 encompasses 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 rigorous basis
for either the definition of PE, or useful 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, while subjectively
assessed criteria, such as a man's perceived lack of control, were reported
in less than half. Of course, most men who seek help know full well they
have premature ejaculation, perhaps partly because they are so
dissatisfied with their sexual performance, and partly because rapid
ejaculation is so widely known to be a problem among men.
One recent study showed the prevalence of
ejaculatory
dysfunction among Argentinean men was around 28% (based upon the
self-reporting of the study participants). This matches the results of
the Global Study of Sex ual Attitudes and Behaviors
(GSSAB), which 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 complaint associated with
significantly lowered quality-of-life or sex.
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 special
cultural significance or where female sexuality is regarded as equal to
male sexuality. However, in
patriarchal societies where women have a lower social position, premature ejaculation may
actually be seen as a sign of virility rather than a problem.
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.
Continued here - premature ejaculation prevalence
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