Article

Canadian and American Sex Therapists' Perceptions of Normal and Abnormal Ejaculatory Latencies: How Long Should Intercourse Last?

Authors:
  • Penn State Erie, The Behrend College
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Abstract

Lay public perceptions about how long intercourse should last are discrepant from objective data on ejaculatory latencies. This may be problematic as the subjective interpretation of latency is a factor related to perceived distress with length of intercourse. Quantify the opinion of expert sex therapists as to what are "adequate,"desirable,"too short," and "too long" intravaginal ejaculatory latencies. Method. A random sample of members of the Society for Sex Therapy and Research in the United States and Canada was surveyed. Intravaginal ejaculatory latency, in minutes, for four different conditions: coitus that lasts an amount of time that is "adequate,"desirable,"too short," and "too long." Results. The interquartile range for the sex therapists' opinions regarding an "adequate" length for ejaculatory latency was from 3 to 7 minutes; "desirable" from 7 to 13 minutes; "too short" from 1 to 2 minutes; "too long" from 10 to 30 minutes. Therapists' beliefs about ejaculatory latencies were consistent with objective data on ejaculatory latency and were not affected by therapist demographic characteristics such as sex or experience. These results suggest that the average sex therapist believes that intercourse that lasts 3 to 13 minutes is normative and not prima facie worthy of clinical concern. Dissemination to the public of these results may change lay expectations for intravaginal ejaculatory latency and prevent distress. These results may also be beneficial to couples in treatment for sexual problems by normalizing expectations.

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... Questions regarding perception of normal and abnormal IELT were adopted and modified from a study among sex therapists conducted in the USA and Canada [9]. The respondents were asked to provide information on their demographics (age, sex, occupation, educational level, marital status, etc.) and were to give their opinion on questions about IELT with responses such as "too short, " "adequate, " "desirable, " or "too long. ...
... min. This is longer than what Western sex therapists deem as adequate IELT and borders around what many experienced sex therapists may consider to be too long [9]. The IQR of IELTs perceived by experienced Western sex therapists to be "adequate" ranges from 3 to 7 min. ...
... In the current group of African subjects, married respondents do not only perceive longer time as being "adequate, " "desirable, " "too short, " or "too long" IELTs, but also a significantly higher proportion (about 13, 17, 14 and 7 % more than the single respondents, respectively) have a perceived time which is more than what Western sex therapists recommend [9]. The reasons for these discrepancies are not clearly shown from this study, but may be culturally influenced. ...
Article
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Background: This cross-sectional study aimed at quantifying the perceptions of Ghanaian men and women on how long they thought sex should last, from intromission until ejaculation. Method: A random sample of 568 heterosexual men and women within the Kumasi Metropolis was surveyed from December 2009 to February 2010. The question of primary interest in the present study includes perceived intravaginal ejaculatory latency (IELT), in minutes, for four different conditions: "adequate," "desirable," "too short," and "too long" IELT. Results: The interquartile range for the respondent's judgment of an "adequate" length for IELT was from 7.0 to 20.3 min; "desirable" from 10.0 to 25.0 min; "too short" from 2.0 to 5.0 min; "too long" from 10.5 to 60.0 min. However, the "actual" IELT (i.e. what the respondents are capable of doing) as found in this study was from 6 to 15 min. Ghanaian perceptions about ejaculatory latencies were in part consistent with data from Germany and contrary to data from the USA on ejaculatory latency and were not affected by age or educational level. Conclusion: These results suggest that the average Ghanaian believes that intercourse that lasts 7.0-25.0 min is normal. Dissemination of the present finding to the public may modify their expectations for IELT which will lead to a realistic replica of sexuality and hence help prevent sexual disappointments and dysfunctions. It will also be beneficial to couples who are being treated for sexual problems by normalizing their expectations.
... 47 PE was recorded where a participant reports an IELT less than 2 minutes. 48 These data were the basis for the correlations undertaken. ...
... An IELT less than 2 minutes is considered to be PE. 48 31 participants (3.1%) reported an IELT of 2 minutes or less. Of these participants, 2 men also reported a history of CSA. ...
Article
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Introduction This study explores the impact of childhood sexual assault (CSA) on men's sexual function. There is limited understanding on the impact of CSA perpetrated against boys on later adult male sexual function, as there is a dearth of research on this topic. It was hypothesized that men reporting a history of CSA were more likely to report sexual function issues than men with no history of CSA. Material and methods A cross-sectional survey study of 1,004 Czech men aged between 15 and 85 years (M = 42.8 years; Standard deviation = 17.6 years) have been conducted. The participants anonymously answered a questionnaire on multiple aspects of their life and sexuality. This questionnaire included sought data on history of CSA and self-reported intravaginal ejaculation latency time and the 5-item International Index of Erectile Function. Results 25 men (2.5%) indicated a history of CSA. 71% of the perpetrators where known by the victims, with a minority declaring the crime to authorities (37.5%). Half of those reporting assault also reported sexual function issues in the present or at some time in their life. Significant correlations were recorded between a history of CSA and erectile dysfunction but not significantly with premature ejaculation. Conclusions Men who reported a history of CSA are more likely to report sexual function issues than those who do not. The identified association between CSA and sexual function issues in adult life contributes to the small body of literature on the topic. When taking a sexual history, it is recommended to practitioner to include questions about CSA, considering its correlation with erectile dysfunction. An understanding of the relationship between CSA and adult sexual function helps practitioner to improve his patient's well--being and life satisfaction. Kamnerdsiri WA, Fox C, Weiss P, et al. Impact of Childhood Sexual Assault on Sexual Function in the Czech Male Population. J Sex Med 2020;XX:XXX–XXX.
... A recent survey of Canadian and American sex therapists [1] indicated that they were of the professional opinion that penile-vaginal intercourse duration of as little as 4 minutes (median 20 minutes) was "too long" (p. 1253), and that as little as <2 minutes (median 4.9 minutes) should be judged "adequate" (p. ...
... It appears that the gold standard for reality was the opinions of the sample of sex therapists. Those authors also recommend [1] that clinicians advise patients concerned about short penile-vaginal intercourse duration that 3 minutes can be considered adequate so as to allay their distress. ...
Article
It has been asserted that women's likelihood or consistency of partnered orgasm (her orgasm as a result of sexual activities with a partner) is determined by duration of foreplay, but not by duration of penile-vaginal intercourse. The objective was to examine the extent to which women's likelihood or consistency of partnered orgasm is associated with duration of foreplay, duration of penile-vaginal intercourse, and age. In a representative sample of the Czech population, 2,360 women reported their consistency of orgasm with a partner (from "never" to "almost every time"), and estimates of their typical durations of foreplay and of penile-vaginal intercourse. The association of consistency of partnered orgasm with typical durations of both foreplay and penile-vaginal intercourse. In univariate analyses, consistency of partnered orgasm was more associated with penile-vaginal intercourse duration than with foreplay duration (consistency also correlated negatively with age). In multivariate analysis, foreplay ceased to be a significant correlate of partnered orgasm consistency (the exclusion of respondents reporting a penile-vaginal intercourse duration of 1 minute or less did not alter the results). When both sexual activity categories are examined in tandem on a population level, women's likelihood or consistency of partnered orgasm is associated with penile-vaginal intercourse duration, but not with foreplay duration. In contrast to the assumptions of many sex therapists and educators, more attention should be given to improve the quality and duration of penile-vaginal intercourse rather than foreplay.
... 2. Les souhaits des gens En regard des valeurs rapportées par Waldinger et ses collègues, un sondage mentionné par Montorsi (2005) révèle que ce que les hommes eux-mêmes estiment être une durée normale de pénétration s'établit à 13 minutes en moyenne pour les américains et 9,6 minutes pour les européens. Un sondage réalisé par Corty et Guardiani (2008) auprès de 34 sexologues étasuniens et canadiens expérimentés montre pour sa part que ce qui est jugé « souhaitable » ("desirable"), à savoir 7 à 13 minutes de pénétration, se situe au delà de la norme statistique de 3 à 7 minutes, une durée jugée, elle, « suffisante » ("adequate"). Ceci n'est probablement pas sans lien à l'opinion répandue selon laquelle l'obtention d'un orgasme requiert des stimulations tactiles plus longues chez les femmes que chez les hommes : 5 à 25 minutes en moyenne chez les premières contre 4 à 7 chez les seconds d'après Nagoski (2010). ...
Article
Full-text available
The current trend is to reserve the diagnosis of premature ejaculation (PE) for cases where penetration lasts for about one minute or less. The rationale is that the aetiology is primarily bio-constitutional, and that long-term pharmacological treatment is the only viable option. However, the literature contains little scientific evidence to support this argument. In fact, a good number of individuals who suffer from overly rapid ejaculation present with penetration duration exceeding one minute, and even severe forms of PE have responded favourably to psycho-sexological treatment. Moreover, although certain biological variables are known to influence ejaculation latency time, nothing indicates that they play an exclusive role of psychosocial etiological factors in severe PE. Therefore, it would be ‘premature’ to base a PE diagnosis on a maximum penetration duration of one minute, which should instead be considered a severity gradient. Given that desired criteria for penetration duration often exceed biological norms, it would be inappropriate to propose that only the most severe forms of PE have constitutional origins. In any case, the constitution is relatively flexible, and can respond to adaptive learning. An adaptive learning approach would undoubtedly be more difficult to apply in severe cases, but not impossible. The issue of whether to use pharmacological versus psycho-sexological treatment could be sidestepped by moving beyond the single criterion of ejaculation latency.
... Waldinger et al. [5] found national differences in the mean time from the beginning of vaginal penetration to immediately before ejaculation when they measured T ie (median: 5.4 min) with a stopwatch in 500 married couples from 5 nations. Corty and Guardiani reported that the average sex therapist believes that intercourse lasting from 3 to 13 min is normative and generally not worthy of clinical concern [6]. ...
Article
Purpose Inappropriate intromission time causes sexual problems for couples, and therefore it is important for the couple to set treatment targets. Methods We investigated appropriate intromission times by conducting a questionnaire survey of the interval from initiation of insertion to just before ejaculation in Japanese married couples. A questionnaire survey of 300 married couples was conducted by mail. Results The estimated mean intromission times were 14.5 min (median: 10 min) for male subjects and 13.6 min (median: 10 min) for female subjects. The mean desired intromission time for female subjects was 15.7 min (median: 15 min). Regarding the difference between the actual and desired intromission times, the desired time was longer, the same, and shorter for 43.0%, 38.7%, and 18.3% of all the female subjects. Conclusions It seems that female subjects may consider a wide variety of intravaginal insertion times to be desirable. Accordingly, married couples need to improve communication regarding the desired duration of intromission and other related issues.
... 43 Perhaps, a better definition should include what is considered an adequate maintenance or duration of erection. According to Corty and Guardiani, 44 an adequate duration of erection for satisfactory sexual intercourse is 3-7 min, and a desirable duration of erection should be 7-13 min. If that is true, a shorter routine duration may represent the earlier clue of cardiovascular disease risk. ...
Article
Full-text available
Results are reported from the first two adequate trials of the PDE-5 inhibitor vardenafil using a stopwatch to precisely measure erection duration in men with ED. Two randomized, multicenter, double-blind, placebo-controlled trials were conducted: a crossover 4-week treatment in men with ED (ENDURANCE) and a parallel group, 12-week treatment in men with ED and dyslipidemia (the dyslipidemia study). Stopwatch-assessed duration of erection leading to successful intercourse measured by Sexual Encounter Profile question-3 (SEP-3) was the primary end point in ENDURANCE and one of the secondary end points in the dyslipidemia study. Other efficacy end points included responses to SEP-2, SEP-3 and International Index of Erectile Function-Erectile Function (IIEF-EF) domain scores. Adverse events were recorded. Duration of erection (least squares mean ± s.e.) leading to successful intercourse was statistically superior in men receiving vardenafil versus placebo (12.8 ± 1.0 versus 5.5 ± 1.0 min; p<0.001 in ENDURANCE and 10.0 ± 0.8 versus 3.4 ± 0.8; p<0.001 in the dyslipidemia study), with a difference of 7.4 and 6.6 min, respectively, between treatment groups. Results for SEP-2, SEP-3 and IIEF-EF domain scores were consistent across studies and with stopwatch-assessed measures for duration of erection. Vardenafil was well tolerated. Duration of erection leading to successful intercourse is an important indicator of the efficacy of ED treatment. The stopwatch approach offers an alternative, precise and reproducible measure of efficacy. We propose this approach as a potential new paradigm for assessing the efficacy of ED treatments.
... Comparing men with strong negative correlations to men with strong positive correlations, there was no statistically significant difference in the reported IELT, with means (and SDs), respectively, of 9.54 (7.70) and 13.30 (9.10) minutes. Both of these coital latencies can be considered as normal [18][19][20]. Interestingly, although objectively the men did not differ in IELT, their subjective interpretations of ejaculatory latency did differ. ...
Article
Introduction. Ejaculatory latencies have been studied in coitus and with masturbation, but not with oral or manual stimulation by a partner. Aim. The present study extended research on ejaculatory latency to these outlets, and investigated the effect of perceived pleasure on self-reported ejaculatory latency. Method. A convenience sample of male college students, not selected for sexual dysfunction, completed questionnaires assessing the outcome measures. Main Outcome Measures. Self-report measures of latency to ejaculation in, and perceived pleasure associated with, four different outlets (vaginal intercourse, oral intercourse, manual stimulation by a partner, and masturbation). Results. Ejaculatory latencies in partnered activities were predictive of each other. Masturbatory latencies were predictive of coital latencies but not oral or manual stimulation latencies; all the partnered activities were predictive of each other. There was no difference in time to ejaculation among any of the partnered outlets, although ejaculation occurred more quickly with masturbation than with coitus or manual stimulation. In terms of pleasure associated with the outlets, vaginal and oral intercourse were perceived as equally pleasurable, and both were rated as more pleasurable than manual stimulation or masturbation, which did not differ from each other. Conclusions. These results suggest that rapidity of ejaculation is consistent across outlets for the partnered sexual activities, and that there is little unique—in terms of ejaculatory latency—about vaginal intercourse compared with oral or manual stimulation by a partner. Masturbation, however, does differ from the partnered activities. Although the average correlation, for individuals, between latency and pleasure for the different outlets is near zero, there are subgroups of men who have (i) a negative relation, (ii) a positive relation, or (iii) no relation. Results show that men, for whom greater pleasure is associated with shorter latency, are more likely to be dissatisfied with their intravaginal ejaculatory latencies, regardless of actual latency. Corty EW. Perceived ejaculatory latency and pleasure in different outlets. J Sex Med 2008;5:2694–2702.
... In comparison to the findings of Waldinger and colleagues, a survey conducted by Montorsi (2005) revealed that the respondents estimated normal penetration duration at 13 minutes on average for Americans and 9.6 for Europeans. Elsewhere, Corty and Guardiani (2008) surveyed 34 experienced American and Canadian sexologists and found that what was deemed "desirable" duration, that is, from 7 to 13 minutes of penetration, exceeded the statistical norm of 3 to 7 minutes, which was considered "adequate" duration. This is probably not unconnected to the widespread opinion that achieving an orgasm requires longer tactile stimulation for women than for men: 5 to 15 minutes on average for women versus 4 to 7 minutes for men. ...
Article
The current trend is to reserve the diagnosis of premature ejaculation (PE) for cases where penetration lasts for about one minute or less. The rationale is that the aetiology is primarily bio-constitutional, and that long-term pharmacological treatment is the only viable option. However, the literature contains little scientific evidence to support this argument. In fact, a good number of individuals who suffer from overly rapid ejaculation present with penetration duration exceeding one minute, and even severe forms of PE have responded favourably to psycho-sexological treatment. Moreover, although certain biological variables are known to influence ejaculation latency time, nothing indicates that they play an exclusive role of psychosocial etiological factors in severe PE. Therefore, it would be ‘premature’ to base a PE diagnosis on a maximum penetration duration of one minute, which should instead be considered a severity gradient. Given that desired criteria for penetration duration often exceed biological norms, it would be inappropriate to propose that only the most severe forms of PE have constitutional origins. In any case, the constitution is relatively flexible, and can respond to adaptive learning. An adaptive learning approach would undoubtedly be more difficult to apply in severe cases, but not impossible. The issue of whether to use pharmacological versus psycho-sexological treatment could be sidestepped by moving beyond the single criterion of ejaculation latency.
... This wishful thinking was shared by 58.5% of our nonmedical participants. Corty and Guardiani [22] comparing actual to desired time of intercourse found that both sexes wished intercourse to last more than twice as long as self-reported length (7.86 min for men and 7.03 min for women). Intravaginal ejaculation latency time was estimated in five countries (Holland, UK, Spain, Turkey, and USA). ...
... Previous studies focusing on the experiences of psychosexual therapists are often focused on measurement issues (e.g. ejaculatory latency time, Corty & Guardiani, 2008) or specific populations (e.g. lesbian patients, Hall, 2002) only. ...
Article
Premature ejaculation (PE) is a common sexual dysfunction affecting approximately 20%–30% of men. Despite important issues relating to PE definition, diagnosis, and therapy, there is a paucity of research investigating the experiences of practitioners delivering PE treatment. For the present study, interviews were conducted with eight psychosexual therapists and subjected to interpretative phenomenological analysis. Four master themes emerged from the analysis. These were Romantic Relationships, Vulnerability, Culture, and Diagnosis and Assessment. The Romantic Relationships theme included three sub-themes: Intimacy; Involvement; and Distress. Two sub-themes formed the Vulnerability theme: Self-Esteem; and Anxiety. The Culture theme contained three sub-themes: Religion and Ethnicity; Pornography; and Masculinity. The Diagnosis and Assessment theme included two sub-themes: Referral and Definitions. Findings have important implications for the diagnosis and treatment of PE. Future research should investigate therapist perceptions further, including those factors which impact on engagement with clients and PE treatment success.
... Questions regarding perception of normal and abnormal IELT were adapted and modified from a study among sex therapists conducted in the US and Canada [12]. The respondents were asked for background information (age, sex, occupation, educational level, marital status, etc.) and had questions about IELTs such as "too short," "adequate," "desirable," or "too long." ...
Article
Full-text available
Diabetes mellitus is a chronic disease that can result in various medical, psychological and sexual dysfunctions (SD) if not properly managed. SD in men is a common under-appreciated complication of diabetes. This study assessed the prevalence and determinants of SD among diabetic patients in Tema, Greater Accra Region of Ghana. Sexual functioning was determined in 300 consecutive diabetic men (age range: 18-82 years) visiting the diabetic clinic of Tema General Hospital with the Golombok Rust Inventory of Sexual Satisfaction (GRISS) questionnaire, between November, 2010 and March, 2011. In addition to the socio-demographic characteristics of the participants, the level of glycosylated haemoglobin, fasting blood sugar (FBS) and serum testosterone were assessed. All the men had a steady heterosexual relationship for at least 2 years before enrolment in the study. Out the 300 participants contacted, the response rate was 91.3% after 20 declined participation and 6 incomplete data were excluded All the respondents had at least basic education, 97.4% were married, 65.3% were known hypertensive, 3.3% smoked cigarettes, 27% took alcoholic beverages and 32.8% did some form of exercise. The 69.3% SD rate observed in this study appears to be related to infrequency (79.2%), non-sensuality (74.5%), dissatisfaction with sexual acts (71.9%), non-communication (70.8%) and impotence (67.9%). Other areas of sexual function, including premature ejaculation (56.6%) and avoidance (42.7%) were also substantially affected. However, severe SD was seen in only 4.7% of the studied population. The perceived "adequate", "desirable", "too short" and "too long intra-vaginal ejaculatory latency time (IELT) are 5-10, 5-10, 1-2 and 15-30 minutes respectively. Testosterone correlates negatively with glycated haemoglobin (HBA1c), FBS, perceived desirable, too short IELT, and weight as well as waist circumference. SD rate from this study is high but similar to that reported among self-reported diabetic patients in Kumasi, Ghana and vary according to the condition and age. The determinants of SD from this study are income level, exercise, obesity, higher perception of "desirable" and "too short" IELT.
... In a study conducted by our group (under review), Ghanaians perceived an intravaginal ejaculatory latency of 7-25 min as being normal, with B75% perceiving adequate intravaginal ejaculatory latency time above what sex therapist perceived as being adequate (that is, 3-7 min). Even though what an individual would consider as normal sexual function is determined by their inherent standards and beliefs, which may to a large extent be modified by the type of formal and informal education received from the society 14 including pornographic movies, this may ultimately lead to the purchase of sex-enhancing medication even when such an individual does not actually need it, as observed currently among Ghanaian men (Amidu, personal observation). As expectation is known to be determined by stereotypes and not reality, 15 dissemination of the results of this study Table 4 Pearson product moment correlation coefficient between sexual dysfunction including the seven subscales of the GRISS (N ¼ 255) Previous studies have demonstrated SD in various populations, but the nature of the sexual complaints other than impotence generally remains unexplored. ...
... Contradicting assertions of a sample of North American sex therapists that PVI should be very brief [23], a previous study of Czech women found that PVI duration (but not foreplay duration) was associated with consistency of orgasm with a partner [24]. In addition, women reporting their greatest excitement being from clitoral stimulation had a shorter PVI duration than women experiencing vaginal as well as clitoral excitement. ...
Article
Evidence was recently provided for vaginal orgasm, orgasm triggered purely by penile-vaginal intercourse (PVI), being associated with better psychological functioning. Common sex education and sexual medicine approaches might undermine vaginal orgasm benefits. To examine the extent to which women's vaginal orgasm consistency is associated with (i) being told in childhood or adolescence that the vagina was the important zone for inducing female orgasm; (ii) how well they focus mentally on vaginal sensations during PVI; (iii) greater PVI duration; and (iv) preference for above-average penis length.   In a representative sample of the Czech population, 1,000 women reported their vaginal orgasm consistency (from never to almost every time; only 21.9% never had a vaginal orgasm), estimates of their typical foreplay and PVI durations, what they were told in childhood and adolescence was the important zone for inducing female orgasm, their degree of focus on vaginal sensations during PVI, and whether they were more likely to orgasm with a longer than average penis. The association of vaginal orgasm consistency with the predictors noted above. Vaginal orgasm consistency was associated with all hypothesized correlates. Multivariate analysis indicated the most important predictors were being educated that the vagina is important for female orgasm, being mentally focused on vaginal sensations during PVI, and in some analyses duration of PVI (but not foreplay) and preferring a longer than average penis. Focusing attention on penile-vaginal sensation supports vaginal orgasm and the myriad benefits thereof. Brody S, and Weiss P. Vaginal orgasm is associated with vaginal (not clitoral) sex education, focusing mental attention on vaginal sensations, intercourse duration, and a preference for a longer penis.
... However, we should also recognize the obvious plasticity of the biological condition, which suggests that CBT can be an appropriate and effective intervention for these men also. Finally, in terms of penetration duration, cultural norms and expectations often appear to exceed the biological norms (Amidu, Owiredu, Dapare, & Anuamwine, 2015;Burri, Giuliano, McMahon, & Porst, 2014;Corty & Guardiani, 2008;Miller & Byers, 2004). As a result, legions of "biologically normal" men must learn how to control their excitement in order to prolong penetration beyond their natural limit. ...
Article
Self-treatments have previously shown some efficacy in treating premature ejaculation (PE). It has been hypothesized that adding professional support to cognitive-behaviour bibliotherapy could improve self-treatment outcomes. Therefore, the aim of this study was to compare treatment outcomes for participants with PE who used bibliotherapy alone (pure self-treatment) versus those who used the bibliotherapy with brief support from a health professional (guided self-treatment). Health professionals were not experienced sex therapists, but had attended a short training session in order to equip them to support the self-help process. In total, 135 men reporting difficulties with PE were recruited between February and June 2013. Seventy-one (52.59%) completed the protocol: 37 in the pure self-treatment condition, 34 in the guided self-treatment condition. Thirty-five participants (50%) met criteria for ISSM definition of lifelong PE, 14 (20%) for acquired PE, and 22 (30%) presented other forms of PE complaints. At 4–8 months post-treatment, improvements were found in both groups and in each subtype of PE on self-reported measures of sexual functioning and sexual cognitions. Univariate analyses indicated slightly greater treatment effects in the guided self-treatment group, but multivariate tests failed to identify a significant effect of therapist support. These mixed findings raise questions regarding the amount and quality of therapist input used in this study, and also about a possible ceiling effect of cognitive-behaviour therapy for PE.
... But he didn't ask if the men or their partners considered two minutes mutually satisfying" and "more recent research reports slightly longer times for intercourse". [62] A 2008 survey of Canadian and American sex therapists stated that the average time for intromission was 7 minutes and that 1 to 2 minutes was too short, 3 to 7 minutes was adequate and 7 to 13 minutes desirable, while 10 to 30 minutes was too long [183][184][185]. ...
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... For instance, measuring sexual latency is not straightforward. Most sexual latency studies are based on subjective reports and interviews [15,16,17,18]. However, individuals are seldom concerned about timing during an exhilarating session of love-making and are likely to be biased upwards in their time estimates. ...
Preprint
BACKGROUND Sex is a natural behavior for human being, and human sexual health is one of the principal components of human well-being. Traditional technologies for human sexual behavior (e.g., human sexual length) observation are mainly interview- or stopwatch-based. The data obtained by the traditional solutions would be biased and sample-limited. OBJECTIVE To address the limitations of the traditional sexual behavior data observation methods, a novel cyber-physical system is proposed to capture nationwide natural human sexual behavior data. METHODS A cyber-physical human sexual behavior acquisition system, termed as SeBA, is designed and implemented. The proposed SeBA jointly utilizes the state-of-art information and communication technologies, such as smart sex toys, smart phone, and mobile social network. Smart sex toys enable the objective human sexual behavior collection, while the mobile social network provides the abilities of partnered sex (PS) in cyber-physical manner. The objectives and function settings are discussed, and the overall framework of the system architecture are presented. RESULTS Operation and privacy policies are proposed and the technical solution of the SeBA is given out, followed by the usage process for users. The effectiveness of the SeBA is verified by users’ human sexual behavior data from Jau. 2016 to Jun. 2017. 103,424 solo sex (SS) sexual behaviors were recorded involving 13,047 users, and 61,007 PS sexual behaviors from 7,140 users are observed. The proportions of male and female in SM and PM are fairly consistent with recent statistics on unmarried individuals in China. We also find that only a small portion of individuals have at least one other attributes except gender, e.g., age, height, location, jobs, sex likes, purposes, and interests. CONCLUSIONS To the best of our knowledge, this study is the first study to observe the nationwide objective human sexual behavior data. Although the data were restricted to China, this study can illuminate sexual studies by using huge amount of data from wireless smart sex toys all around the world. It is anticipated that findings from these more objective big data can help deepen our understanding of sexual behavior, as well as improve sexual health and sexual wellness.
... North American sex therapy professionals asserted their opinion that PVI duration of as little as 4 minutes (median 20 minutes) was "too long" (p. 1,253), and that as little as <2 minutes (median 4.9 minutes) should be judged "adequate" [38]. However, a multivariate analysis of the responses of a large representative sample of Czech women revealed that their orgasm likelihood was directly related to PVI duration (mean 16.2 minutes) and unrelated to foreplay duration [39]. ...
Article
Some sex therapists and educators assume that many sexual behaviors provide comparable sexual satisfaction. Evidence is required to determine whether sexual behaviors differ in their associations with both sexual satisfaction and satisfaction with other aspects of life. To test the hypothesis that satisfaction with sex life, life in general, sexual partnership, and mental health correlates directly with frequency of penile-vaginal intercourse (PVI) and inversely with frequency of both masturbation and partnered sexual activity excluding PVI (noncoital sex). A representative sample of 2,810 Swedes reported frequency of PVI, noncoital sex, and masturbation during the past 30 days, and degree of satisfaction with their sex life, life in general, partnership, and mental health. Multivariate analyses (for the sexes separately and combined) considering the different satisfaction parameters as dependent variables, and the different types of sexual activities (and age) as putative predictors. For both sexes, multivariate analyses revealed that PVI frequency was directly associated with all satisfaction measures (part correlation = 0.50 with sexual satisfaction), masturbation frequency was independently inversely associated with almost all satisfaction measures, and noncoital sex frequencies independently inversely associated with some satisfaction measures (and uncorrelated with the rest). Age did not confound the results. The results are consistent with evidence that specifically PVI frequency, rather than other sexual activities, is associated with sexual satisfaction, health, and well-being. Inverse associations between satisfaction and masturbation are not due simply to insufficient PVI.
... Between groups, 80.6% of the medical group disagreed, while 41.5% of the non-medical group disagreed with that statement. The results of the medical group were in agreement with Corty and Guardiani, who reported that vaginal sex lasts from three to thirteen minutes, while Waldinger et al., found that the overall median value for coital duration was5.4 minutes but with differences between countries [27,28]. ...
Article
The Diagnostic and Statistical Manual of Mental Disorders, 4th Ed., text revision (DSM-IV-TR) criteria for premature ejaculation (PE) have been criticized on multiple grounds including that the criteria lack precision, that the requirement of marked distress is inappropriate, and that the specification of etiological subtypes should be deleted. Since these criteria were originally adopted, there has been a tremendous gain in knowledge concerning PE. The goal of this manuscript is to review evidence relevant to diagnostic criteria for PE published since 1990. Medline searches from 1990 forward were conducted using the terms PE, rapid ejaculation, ejaculatory disorder, and intravaginal ejaculatory latency. Early drafts of proposed alterations in diagnostic criteria were submitted to advisors. Expert opinion was based on review of evidence-based medical literature. The literature search indicated possible alterations in diagnostic criteria for PE. It is recommended that the Diagnostic and Statistical Manual committee adopt criteria similar to those adopted by the International Society of Sexual Medicine. It is proposed that lifelong PE in heterosexual men be defined as ejaculation occurring within approximately 1 minute of vaginal penetration on 75% of occasions for at least 6 months. Field trials will be necessary to determine if these criteria can be applied to acquired PE and whether analogous criteria can be applied to ejaculatory latencies in other sexual activities. Serious consideration should be given to changing the name from PE to rapid ejaculation. The subtypes indicating etiology should be eliminated.
Article
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This study was designed to investigate the prevalence and type of sexual dysfunction (SD) in healthy sexually active Ghanaian men of fertile age. Sexual functioning was determined in 300 healthy Ghanaian men with the Golombok Rust Inventory of Sexual Satisfaction (GRISS) questionnaire leaving in Kumasi metropolis, between December 2009 and April 2010. All men had a steady heterosexual relationship for at least 2 years before enrollment in the study. Of the 300 men selected, 255 (85%) completed the survey; the overall prevalence of SD in these subjects was 66%. The most prevalent areas of difficulty were infrequency (70.2%), premature ejaculation (64.7%), dissatisfaction with sexual acts (61.2%), impotency (59.6%), nonsensuality (59.2%), noncommunication (56.9%) and avoidance (49.0%). There were positive correlation between SD, impotence, dissatisfaction and age. The prevalence rate of SD in Ghanaian men is high and related to age.
Article
Complaints of premature ejaculation (PE) and its repercussions are culture-dependent. To report the measured intravaginal ejaculatory latency time (IELT) and the impact of PE in Kermanshah, Iran. From November 1996 through October 2008, 3,458 patients presented to us with self-diagnosed PE. In the first visit, after obtaining a psychosocial and sexual history, PE-specific bother was self-rated by the patients and the patients were advised to measure their IELTs over the next 2-3 weeks. In the second visit, the measured IELTs were reported by the patients. Patients' measured IELT and bother score. Age range was 17-80 years (mean 34.1, standard deviation [SD] 9.1, median 32). Sixty-five percent were married. Primary and secondary PE was reported by 2,105 (60.8%) and 1,353 (39.1%) patients, respectively. Occasional PE was reported by 36 (0.01%). Of those with multiple partners, 6% had partner-specific PE. IELT distribution was positively skewed. Anteportal ejaculation was reported by 97 (2.8%). In 3,458 self-reported PE patients, IELT was 1-15 seconds in 542 (15.7%), 16-30 seconds in 442 (12.8%), 31-60 seconds in 978 (28.3%), > 1 <or= 2 minutes in 551 (15.9%), > 2 <or= 5 minutes in 712 (20.6%), and >5 minutes in 136 (3.9%). IELTs of <or=1 minutes and <or=2 minutes were reported by 59.5% and 75.5%, respectively. Median bother score was 3 of 4. Pearson's correlation between IELT and bother (r = -0.607) was highly negative, with shorter IELTs being correlated with more bother. Six hundred forty-three patients (18.6%) always consumed opium to lengthen their IELTs. All 21 patients who started to use Tramadol as a PE treatment became addicted to it. Of 168 divorced couples due to PE, 23 divorced because the sexually dissatisfied wives became involved in extramarital affairs. Applying the Diagnostic and Statistical Manual of Mental Disorders criteria for PE and a cutoff IELT point of <or=2 minutes, and thus excluding the patients with IELTs of longer than 2 minutes, the patients with occasional PE, and the patients who reported no personal bother, of 3,458 self-reported PE patients, 2,571 (74.3%) had PE. Including the 97 patients with anteportal ejaculation, arithmetic mean IELT in 2,571 patients was 45.87 seconds, SD 36.1, median 40, and range 0-120. Excluding the anteportal ejaculation, arithmetic mean IELT in the remaining 2,474 patients was 47.67 seconds, SD 35.71, median 42, range 1-120, and geometric mean 31.06. PE has a devastating impact. In clinical practice, primary lifelong PE is by far the most common variety of PE. Occasional PE is a very rare cause of presentation. A significant proportion of the patients who consider themselves as premature ejaculators have IELTs of more than 2 minutes; the sexual medicine community should reach a consensus on the clinical diagnostic and therapeutic approach to these patients who consider themselves as premature ejaculators. The most important cause of bother in PE is the briefness of the ejaculatory latency, rather than the lack of control. Second-round ED (pseudoED) was reported for the first time. The worst type of PE, i.e., anteportal ejaculation, is not very rare; thus, geometric mean that excludes anteportal ejaculation is not suitable statistics to report the ejaculatory latency time; instead, median is the best measure of IELT reporting. Cutoffs of 0.5-2.5 percentiles are not suitable means to diagnose PE.
Thesis
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Los tratornos de la sexualidad en general y las disfunciones sexuales en particular forman un conjunto muy amplio y definido dentro de la psicopatología. Su estudio es primordial en la medida que muchos pacientes van a consulta por estas dificultades. A su vez, existe un alto porcentaje de pacientes con otras dificultades psicopatológicas en las que la sexualidad se ve afectada de manera más o menos rotunda. Hay que tener en cuenta que la sexualidad humana es un área de nuestra existencia muy compleja y frágil. La misma une componentes de orden biológico, psicológico y social en continua interacción. Y si bien, en circunstancias favorables es fuente de comunicación, relación y satisfacción profunda, también suele ser causa de problemas cuando su progresión natural se tuerce, hecho que suele dar con relativa frecuencia, dado el gran número de consultas que los profesionales atienden por este motivo. La intervención en los trastornos sexuales es diversa y multidisciplinar (farmacológica, quirúrgica y psicológica), influyendo en su abordaje su etiología (orgánica, psicogénica o mixta) y el enfoque teórico utilizado, ya que cada uno tiene una percepción diferente de los que es una difunción sexual y la forma en que debe abordarse. La presente tesis tiene como objetivo revisar las diferentes terapias psicológicas (psicoanalítica, conductual, cognitivo-conductual, racional-emotiva, humanista y gestáltica) con eficacia demostrada en el tratamiento de las disfunciones sexuales. Sin embargo para mazimizar la potencia de la estrategia terapéutica, se utilizará un enfoque ecléptico e integrar, conciliando de forma pragmática intervenciones y técnicas de distintas corrientes.
Article
Introduction. This study evaluated the prevalence of complaints of premature ejaculation (PE) among a cross-sectional sample of Canadian males and their partners. Aim. It sought to quantify measures of behavior and attitudes as they relate to PE. It evaluated the level of patient knowledge, physician engagement, and patient satisfaction with treatment options for PE, a common sexual complaint. It also explored the patient and partner-reported impacts on quality of life and well-being. Main Outcome Measure. The main outcome measure for the study was the statistical analysis of data on different facets of PE and associated factors from a comprehensive population-based survey conducted in Canada. Methods. A web-based survey was carried out among adults in Canada (phase 1, N = 3,816) followed by a focused telephone interview in phase 2 for those who met the criteria for PE (phase 2, N = 1,636). Men were classified as having PE based on self-report of low or absent control over ejaculation, irrespective of the duration of the ejaculation time, resulting in distress for them or their sexual partner or both, or reporting that they “climaxed too soon.” Results. The prevalence of PE in the survey, diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders-III criteria, ranged from 16% to 24% depending on the definition of PE utilized, and did not vary significantly with age. Ninety percent of those with a determination of PE in this survey had not discussed alternatives to prolong time to ejaculation with a physician, pointing to gaps in patient/physician communication around sexual health. Conclusions. PE is a prevalent sexual problem that poses special challenges to clinicians and causes considerable burden to Canadian men and their partners. There remains a stigma associated with PE, resulting in the existence of significant barriers to obtaining assistance from physicians for this problem. The majority of those interviewed who sought and received treatment have not been satisfied with the results. Brock GB, Bénard F, Casey R, Elliott SL, Gajewski JB, and Lee JC. Prevalence and treatment of premature ejaculation in Canada. J Sex Med 2009;6:2115–2123.
Article
To explore issues that heterosexual women have concerning their sex life and desire toward their male partner, the authors conducted an online survey on actual sex life and sexual quality of life. Survey participants included 5,665 women who were 20 years of age and older who (a) lived in or near Tokyo, (b) had a male sex partner, and (c) intended to have sexual activity. Participants were asked to respond to a wide range of questions regarding their sexual fulfillment and desires. Differences between actual and desired duration of sexual activities (foreplay, intercourse, and afterplay) and number of sexual positions were calculated. The authors performed subgroup analyses regarding pain during sexual intercourse and by degree of partner's unilateral action. In addition, the authors investigated the relation between sexual quality of life and each subgroup. Women who participated in this survey tended to desire a longer duration of foreplay and afterplay than was experienced. The greater the pain during sexual intercourse, the percentage of respondents who desired a shorter duration of intercourse and fewer numbers of sexual positions increased and the sexual quality of life decreased. The degree of partner's unilateral action during sexual activity negatively affected the woman's sexual quality of life. The present study suggests the importance of establishing good communication between sex partners.
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The original goal of this research was to develop an empirically based, conceptual model of optimal sexuality. To that end, semistructured, phenomenologically oriented interviews were conducted with 76 key informants. The three participant groups consisted of men and women over the age of 60 who had been married for over 25 years, self-identified members of sexual minority groups, and sex therapists. Strikingly, the descriptions of optimal sexuality were nearly universally identical among the first two participant groups; that is, across men and women, older married people, and lesbian, gay, bisexual, and transgender (LGBT) or “kinky” participants; however, the sex therapists were conspicuous outliers. Even though five raters in the research team were blind as to the demographic characteristics of the participants, raters consistently and accurately detected the sex therapists’ transcripts and conceptions as undeniably and markedly different. The repercussions of these findings for clinical work are explored. Most notably, assumptions about sexuality (e.g., male–female sexual differences) at the dysfunctional to “normal” ends of the spectrum may not hold true at the high end of the continuum. Sex therapists may benefit from rethinking sexual potential to help in improving clients’ sex lives. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
Article
There are limited data on the treatment satisfaction with dapoxetine in patients with premature ejaculation (PE). We aimed to evaluate the treatment satisfaction, effectiveness and safety of dapoxetine for PE patients. Subjects received dapoxetine (30 mg or 60 mg) alone or in combination with a phosphodiesterase type 5 inhibitor, if concurrent with erectile dysfunction for more than 4 weeks in clinical practice. Main outcome measures include Clinical Global Impression of Change (CGIC) and Clinical Global Impression of Satisfaction (CGIS). From March 2014 to January 2015, a total of 286 PE patients received dapoxetine treatment in this study, with 137 (47.9%) patients diagnosed with lifelong PE and 149 (52.1%) patients diagnosed with acquired PE. At the final follow-up visit, the mean intravaginal ejaculatory latency time (an increase of 3.4 min) and mean score of Premature Ejaculation Diagnostic Tool (a decrease of -5.0) improved significantly from baseline, and the satisfaction rate and response rate to dapoxetine treatment were 45.0% and 74.6%, respectively. Satisfaction with dapoxetine treatment was highly correlated with treatment response, and might be improved by scheduled follow-up visits and escalation to a higher dose. Subjects with diabetes mellitus (DM) reported a lower treatment response than those without DM. Treatment-emergent adverse event (TEAEs) occurred in 47.7% of patients, but no serious TEAEs were reported. Our real-world data highlight the effectiveness of dapoxetine and the importance of follow-up visits for the treatment of PE. Half of PE patients were not satisfied with dapoxetine treatment, which reflects an unmet need of present approach or an unrealistic expectation from PE patients. © 2015 John Wiley & Sons Ltd.
Article
Premature ejaculation (PE), delayed ejaculation (DE), anejaculation (AE) and retrograde ejaculation (RE) are four main ejaculatory disorders (EjDs) observed in clinical practice. Despite their high prevalence, EjDs remain underdiagnosed and undertreated. Primary care physicians should incorporate the discussion of sexual health topics into routine visits to facilitate EjD diagnosis and treatment. Because the causes of EjDs are multifactorial, the management of EjDs is etiology-specific and may require a holistic approach. Dapoxetine, a selective serotonin reuptake inhibitor, is the only drug approved for on-demand treatment of lifelong and acquired PE. In clinical practice, scheduled follow-up visits, risk factor treatment, appropriate dose escalation, adequate sexual attempts, patient education, and partner involvement are critical factors responsible for optimal overall management of PE and dapoxetine treatment outcomes.
Article
Background Sexual health is one of the principal components of human well-being. Traditional methods for observing human sexual behavior typically adopt manual intervention approaches (eg, interviews). However, the data obtained by such traditional approaches suffer from intrinsic bias and limited sample sizes. Objective To address the limitations of traditional human sexual behavior data observation methods, a novel cyberphysical system is proposed to capture natural human sexual behavior data in China at the nationwide level. Methods A cyberphysical human sexual behavior acquisition system (SeBA) was designed and implemented. SeBA jointly utilizes state of the art information and communication technologies such as smart sex toys, smartphones, and mobile social networks. Smart sex toys enable objective collection of data on human sexual behavior, while the mobile social network provides the possibility of partnered sex in a cyberphysical manner. The objectives and function settings are discussed, and the overall framework of the system architecture is presented. Results Operation and privacy policies are proposed and the technical solution of SeBA is described. The effectiveness of SeBA was verified based on analysis of users’ human sexual behavior data collected from January 2016 to June 2017. A total of 103,424 solo sexual behaviors were recorded involving 13,047 users, and 61,007 partnered sexual behaviors from 7,140 users were observed. The proportions of males and females in the solo and partnered sex groups were fairly consistent with recent statistics on unmarried individuals in China. We also found that only a small portion of individuals provided information on at least one other attribute besides the required input of gender, such as age, height, location, job, sex preferences, purposes, and interests. Conclusions To the best of our knowledge, this is the first study to analyze objective human sexual behavior data at the nationwide level. Although the data are restricted to China, this study can provide insight for further research on human sexual behavior based on the huge amount of data available from wireless smart sex toys worldwide. It is anticipated that findings from such objective big data analyses can help deepen our understanding of sexual behavior, as well as improve sexual health and sexual wellness.
Article
Résumé Quoique rarement confronté, le sexologue doit savoir qu’une érection « priapiforme », c’est-à-dire, consciente supérieure à 15 minutes hors tout contexte sexuel, est anormale et devient potentiellement dangereuse après une heure. Jusqu’à preuve du contraire, c’est une urgence thérapeutique en raison du risque de séquelles érectiles (si non traité avant la 24e heure) spécifique au type veineux aigu (95 % des cas). Les trois points-clé du traitement sont de préciser la durée, le mécanisme physiopathologique et l’étiologie. Dans la majorité des cas, la clinique et, si besoin, la gazométrie distinguent le type veineux chronique, subaigu ou aigu (le plus dangereux) du rarissime type artériel. Le traitement est toujours adapté au type artériel ou veineux et à la souffrance hypoxique (rôle de la gazométrie). Pour le type veineux aigu, le traitement médical est quasi toujours efficace avant la 24e heure. La chirurgie n’est indiquée qu’en cas d’échec du traitement médical ou de cas vus après la 24e heure. Le sexologue peut être en 1re ligne en cas de priapisme veineux chronique ou surtout, subaigu provoqué par une injection intracaverneuse de médicaments proérectiles. Après avoir évalué le degré d’urgence, il ne doit pas hésiter à démarrer le traitement médical de 1re ligne avant de l’adresser, si besoin, aux urgences ou à l’urologue. De fait, la meilleure prévention des séquelles érectiles postpriapisme passe par la sensibilisation des professionnels de santé et des sujets à risque concernés à ces dangers ainsi que par le traitement précoce des érections priapiformes.
Article
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Introduction The need for estimates of the extent of sexual function problems in the general population has become more urgent given recent debates surrounding the identification and definition of “sexual dysfunction,” the increased availability of pharmacological interventions, and possible changes in our expectations of what constitutes sexual function and fulfilment.1 We report results from the national survey of sexual attitudes and lifestyles (Natsal 2000). Participants, methods, and results Natsal 2000 was a stratified probability sample survey done between May 1999 and February 2001 of 11 161 men and women aged 16-44 years resident in Britain.2 3 The response rate was 65.4%. A computer assisted self interview asked participants about their sexual lifestyles and attitudes. We asked questions about their experience of sexual problems based on those used in the US national health and social life survey,4 which measured the main dimensions of sexual dysfunction, as defined in ICD-10 (international classification of diseases, 10th revision). We analysed data in STATA accounting for the sample's stratification, clustering, and weighting.2 3 A total of 34.8% of men and 53.8% of women who had at least one heterosexual partner in the previous year reported at least one sexual problem lasting at least one month during this period (table). The most common problems among men were lacking interest in sex, premature orgasm, and anxiety about performance; and among women, inability to experience orgasm and painful intercourse. Persistent sexual problems–lasting at least six months in the previous year–were less prevalent among men (6.2%) than among women (15.6%). The most common persistent problem among men was premature orgasm and among women, lack of interest in sex. View this table:View PopupView InlineSelf reported problems related to sexual function by people who had at least one heterosexual partner in the previous year. Values are prevalences (95% confidence interval) Among people who had sexual problems, 32.5% (95% confidence interval 29.7% to 35.3%) of men and 62.4% (60.4% to 64.3%) of women avoided sex because of their problems. Only 10.5% (8.8% to 12.4%) of men and 21.0% of women (19.3% to 22.7%) with problems in the previous year sought help. People with persistent problems were more likely to have sought help (20.5% (15.8% to 26.3%) of men and 31.9% (28.4% to 35.5%) of women). Among people seeking help, 63.8% (54.6% to 72.1%) of men and 74.3% (70.1% to 78.1%) of women consulted their general practitioner, and 9.2% (5.3% to 15.4%) of men and 4.8% (3.2% to 7.2%) of women sought help at a genitourinary clinic. Comment Problems of sexual function are relatively common, but persistent problems are much less so. Inconsistent definitions make comparing prevalences with other studies difficult. Given the broad spectrum of problems, we have not sought to define clinical “dysfunction” but rather to describe the range of problems of sexual function in the population and to use duration of problems and avoidance of sex as indicators of severity. We asked specifically about problems that lasted more than one month in the previous year; but whether, for example, lacking interest in sex can be considered as “dysfunction” is questionable since it was reported by two fifths of women and one fifth of men. Few people sought help with their problems reflecting how severity varies, and how the need for professional intervention depends on the perceived importance to the patient and the underlying causes. Seeking help also reflects awareness of the availability of advice and treatment; more men present with sexual problems at genitourinary clinics since the licensing of sildenafil.5 People who often seek help consult their general practitioner but given the limited time and resources in this setting, such problems may be accorded low priority. Our data have implications for improving relationship education, counselling, medical education, and doctors' professional development; raising public awareness of the range and location of services available for managing sexual problems; and re-examining the nature of “sexual dysfunction” and how best to tackle it. Editorial by Ogden See also 423) Footnotes Contributors CHM was the lead writer of this paper and did all statistical analyses. KAF, AMJ, KW, and BE were coinvestigators and designed, implemented, and managed the study and prepared the manuscript. SMcM, KN, and WM also prepared the manuscript. CHM is guarantor. Funding Medical Research Council, Department of Health, Scottish Executive, and National Assembly for Wales. Competing interests None declared.References↵Moynihan R. The making of a disease: female sexual dysfunction. BMJ 2003; 326: 45–7.OpenUrlFREE Full Text↵Johnson AM, Mercer CH, Erens B, Copas AJ, McManus S, Wellings K, et al. Sexual behaviour in Britain: partnerships, practices, and HIV risk behaviours. Lancet 2001; 358: 1835–42.OpenUrlCrossRefMedlineWeb of Science↵Erens B, McManus S, Field J, Korovessis C, Johnson AM, Fenton K, et al. National survey of sexual attitudes and lifestyles II: technical report. London: National Centre for Social Research, 2001.↵Laumann EO, Gagnon JH, Michael RT, Michaels S. The social organisation of sexuality: sexual practices in the United States. Chicago: University of Chicago Press, 1994.↵Kell P. The provision of sexual dysfunction services by genitourinary medicine physicians in the UK, 1999. Int J STD AIDS 2001; 12: 395–7.OpenUrlFREE Full Text
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One hundred and fifty-two heterosexual couples reported their actual and ideal duration of foreplay and intercourse, as well as their perceptions of their partners' desired duration of foreplay and intercourse. Further, participants reported the duration of foreplay and intercourse that they felt most men and most women wanted. Ideal length of foreplay did not differ for men and women. However, men reported a significantly longer ideal duration of intercourse than did their partners. The ideal duration of foreplay and intercourse were significantly longer than the actual duration for both genders. The women, but not the men, significantly underestimated their partners' desired duration of foreplay and intercourse. Further, both genders exhibited faulty stereotypes concerning men's but not women's ideal scripts. Men were seen as desiring a significantly shorter duration of foreplay and intercourse than the ideal reported by the men in the study. Both men's and women's perceptions of their partners' ideal duration of foreplay and intercourse were found to be more strongly related to their own sexual stereotypes than to their partners' self-reported sexual desires, suggesting that people rely on sexual stereotypes when estimating their partners' ideal sexual scripts. Men's and women's ideal scripts and men's and women's sexual stereotypes concerning the opposite gender's ideal duration of foreplay were found to uniquely predict the foreplay performance script. For intercourse, men's and women's ideal scripts and men's stereotypes concerning the duration of intercourse that women want uniquely predicated the performance script. We present potential reasons for the discrepancy in individuals' performance and ideal scripts.
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We examined the possible range of content of non-erotic thoughts experienced during typical sexual activities with a partner. Undergraduate men (n = 47) and women (n = 50) were administered a measure of non-erotic thought content, frequency, and anxiety, along with measures of sexual attitude, satisfaction, and functioning. Men were more likely to report performance-related thoughts, and women were more likely to report thoughts about body image. However, men and women were equally likely to report thoughts about the external consequences of the activity (e.g., pregnancy, being caught) and the emotional consequences of the activity (e.g., morality, implications of the activity for the relationship). Women reported that their thoughts occurred more frequently and caused more anxiety. Greater thought frequency and greater anxiety over thoughts were associated with poorer sexual functioning for both men and women. For women, greater frequency of and anxiety evoked by thoughts was associated with lower sexual satisfaction. These data provide modest support for cognitive-behavioral models of sexual dysfunction and indicate the importance of both examining a broad range of non-erotic thought content and taking gender into account when applying these models to understanding and treating sexual difficulties.
Book
In Reply. —Drs Haverkos and Drotman assert in their second paragraph that our conclusion regarding the negligible likelihood of an epidemic spread of HIV in the heterosexual population rests on a simple network model that relies exclusively on our survey findings that 80% of adults reported no or one sexual partner in the past year and the very low percentages of men and women reporting homosexual or bisexual activity during the same period. This is a gross simplification of the argument and its empirical support in chapters 6 and 7 devoted to the characterization of sexual networks in the United States and its implications for the epidemic, and chapter 11's extended discussion of the correlations of sexually transmitted infections (STIs) with numbers of sexual partners and sexual practices.1
Article
Introduction: Intravaginal ejaculation latency time (IELT), defined as the time between the start of vaginal intromission and the start of intravaginal ejaculation, is increasingly used in clinical trials to assess the amount of selective serotonin reuptake inhibitor-induced ejaculation delay in men with premature ejaculation. Prospectively, stopwatch assessment of IELTs has superior accuracy compared with retrospective questionnaire and spontaneous reported latency. However, the IELT distribution in the general male population has not been previously assessed. Aim: To determine the stopwatch assessed-IELT distribution in large random male cohorts of different countries. Methods: A total of 500 couples were recruited from five countries: the Netherlands, United Kingdom, Spain, Turkey, and the United States. Enrolled men were aged 18 years or older, had a stable heterosexual relationship for at least 6 months, with regular sexual intercourse. The surveyed population were not included or excluded by their ejaculatory status and comorbidities. This survey was performed on a "normal" general population. Sexual events and stopwatch-timed IELTs during a 4-week period were recorded, as well as circumcision status and condom use. Main outcome measures: The IELT, circumcision status, and condom use. Results: The distribution of the IELT in all the five countries was positively skewed, with a median IELT of 5.4 minutes (range, 0.55-44.1 minutes). The median IELT decreased significantly with age, from 6.5 minutes in the 18-30 years group, to 4.3 minutes in the group older than 51 years (P<0.0001). The median IELT varied between countries, with the median value for Turkey being the lowest, i.e., 3.7 minutes (0.9-30.4 minutes), which was significantly different from each of the other countries. Comparison of circumcised (N=98) and not-circumcised (N=261) men in countries excluding Turkey resulted in median IELT values of 6.7 minutes (0.7-44.1 minutes) in circumcised compared with 6.0 minutes (0.5-37.4 minutes) in not-circumcised men (not significant). The median IELT value was not affected by condom use. Conclusion: The IELT distribution is positively skewed. The overall median value was 5.4 minutes but with differences between countries. For all five countries, median IELT values were independent of condom usage. In countries excluding Turkey, the median IELT values were independent of circumcision status.
Article
Introduction. Premature ejaculation (PE) is the most common male sexual dysfunction affecting men and their partners. Lack of community-based data describing this condition limits understanding of PE and its outcomes. Aim. To characterize PE in a large population of men with and without PE using patient-reported outcome (PRO) measures elicited from men and their partners. Methods. 4-week, multicenter, observational study of males (≥18 years) and their female partners in monogamous relationships (≥6 months). Screening, baseline, and follow-up visits scheduled at 2-week intervals. Clinicians diagnosed PE utilizing DSM-IV-TR criteria. Intravaginal ejaculatory latency time (IELT), measured by a stopwatch held by the partner, was recorded for each sexual intercourse experience. Subject and partner independently assessed PROs: control over ejaculation and satisfaction with sexual intercourse (0 = very poor to 4 = very good), personal distress and interpersonal difficulty (0 = not at all to 4 = extremely), and severity of PE (0 = none to 3 = severe). Results. Of the total study population (N = 1,587), 207 subjects were diagnosed with PE and 1,380 were assigned to the non-PE group. Median IELT (min) was 1.8 (range, 0–41) for PE and 7.3 (range, 0–53) for non-PE subjects (P < 0.0001). More PE vs. non-PE subjects gave ratings of “very poor” or “poor” for control over ejaculation (72% vs. 5%; P < 0.0001) and satisfaction with sexual intercourse (31% vs. 1%; P < 0.0001). More subjects in the PE vs. non-PE group gave ratings of “quite a bit” or “extremely” for personal distress (64% vs. 4%; P < 0.0001) and interpersonal difficulty (31% vs. 1%; P < 0.0001). Subject and partner assessments showed similar patterns and correlated moderately (0.36–0.57). Conclusions. PE subjects reported significantly shorter IELT. Overlap in IELT distributions was observed between the PE and non-PE groups, indicating the need for additional PRO measures to characterize PE. Shorter IELT was significantly associated with reduced ejaculatory control and sexual satisfaction and increased distress and interpersonal difficulty.
Article
Although psychoanalysis was the first-choice treatment for premature ejaculation (PE) between 1920 and 1960, hardly any reports on its efficacy have been published. Moreover, a scientific debate about its findings has never been fully developed. The recent progress that has been made in the classification of three different PE syndromes creates a new opportunity for psychoanalytic investigations of men with complaints of PE, distinguished by the actual duration of their intravaginal ejaculation latency time (IELT). The term premature-like ejaculatory dysfunction has been introduced to distinguish men with self-perceived PE at normal and long IELT durations from those men with lifelong, acquired and normal variable PE. Psychoanalytic research may contribute to a better understanding of the consequences of objective early ejaculations on the unconscious mental life of men with the four forms of PE. By integrating neurobiological, clinical and epidemiological data of ejaculatory performance, a revival of psychoanalytic research of PE in the four distinct, classified PE groups, will probably contribute to a deeper insight in to the unconscious mental life of men affected by PE.
Article
Consensus on a definition of premature ejaculation has not yet been reached because of debates based on subjective authority opinions and nonstandardized assessment methods to measure ejaculation time and ejaculation control. To provide a definition for lifelong premature ejaculation that is based on epidemiological evidence including the neurobiological and psychological approach. We used the 0.5 and 2.5 percentiles as accepted standards of disease definition in a skewed distribution. We applied these percentiles in a stopwatch-determined intravaginal ejaculation latency time (IELT) distribution of 491 nonselected men from five different countries. The practical consequences of 0.5% and 2.5% cutoff points for disease definition were taken into consideration by reviewing current knowledge of feelings of control and satisfaction in relation to ejaculatory performance of the general male population. Literature arguments to be used in a proposed consensus on a definition of premature ejaculation. The stopwatch-determined IELT distribution is positively skewed. The 0.5 percentile equates to an IELT of 0.9 minute and the 2.5 percentile an IELT of 1.3 minutes. However, there are no available data in the literature on feelings of control or satisfaction in relation to ejaculatory latency time in the general male population. Random male cohort studies are needed to end all speculation on this subject. Exact stopwatch time assessment of IELT in a multinational study led us to propose that all men with an IELT of less than 1 minute (belonging to the 0.5 percentile) have "definite" premature ejaculation, while men with IELTs between 1 and 1.5 minutes (between 0.5 and 2.5 percentile) have "probable" premature ejaculation. Severity of premature ejaculation (nonsymptomatic, mild, moderate, severe) should be defined in terms of associated psychological problems. We define lifelong premature ejaculation as a neurobiological dysfunction with an unacceptable increase of risk to develop sexual and psychological problems anywhere in a lifetime. By defining premature ejaculation from an authority-defined disorder into a dysfunction based on epidemiological evidence it is possible to establish consensus based on epidemiological evidence. Additional epidemiological stopwatch studies are needed for a final decision of IELT values at both percentile cutoff points.
Article
In the Diagnostic and Statistical Manual of Mental Disorders (DSM), a descriptive definition for premature ejaculation (PE) that was based on historical assumptions has been accepted. To formulate a new functional definition of PE in the DSM. A "syndrome" approach instead of a "complaint" approach is applied and evidence-based data from epidemiological and clinical studies are used. A new functional definition of PE should pertain to a cluster of "symptoms" of a distinct "syndrome." A syndrome rather than a descriptive definition should distinguish Lifelong and Acquired PE variants. Evidence-based data also suggest another PE type "Natural Variable PE," which is not a typical syndrome but rather a cluster of inconsistent symptoms of rapid ejaculation. Moreover, in "Natural Variable PE" the occurrence of rapid ejaculation is not based on neurobiological or psychological pathology, but belongs to the normal variability of sexual performance. Its prevalence is probably much higher than that of Lifelong and Acquired PE. We propose three separate operationalized definitions of these three PE types for the pending DSM-V and ICD-11, which include a quantification of the ejaculation time (intravaginal ejaculation latency time), inability of ejaculatory control, and a description of severity of PE in terms of psychological distress. The use of the intravaginal ejaculation latency time into the DSM-V and ICD-11 would mean that statistical evidence becomes accepted as one of the mainstays for establishing an evidence-based definition of the three PE types.
Article
Domains of premature ejaculation (PE) include short intravaginal ejaculatory latency time (IELT), poor perceived control over ejaculation, decreased satisfaction with sexual intercourse, and personal distress and interpersonal difficulty related to ejaculation. How these measures interrelate is unknown. Here, we evaluated the interrelationships between these PE-specific variables, applying cross-sectional data from a large U.S. observational study of men with PE. We analyzed data from men with PE identified in a previously reported observational study. PE was diagnosed by experienced clinicians using the criteria specified in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision. Subjects reported their stopwatch-measured IELT, perceived control over ejaculation, satisfaction with sexual intercourse, personal distress related to ejaculation, and interpersonal difficulty related to ejaculation. Relationships between variables were assessed using bivariate correlations, and the strength and significance of direct or indirect effects between variables were evaluated using a form of regression analysis known as path analysis. Bivariate Pearson correlation coefficients for all relationships were significant at the P <or= 0.05 level, with the exception of IELT and interpersonal difficulty related to ejaculation. When all variables were included in the model, IELT showed a significant direct effect on perceived control over ejaculation but did not show a significant direct effect on ejaculation-related personal distress or satisfaction with sexual intercourse. Perceived control over ejaculation showed a significant direct effect on both ejaculation-related personal distress and satisfaction with sexual intercourse, which each showed direct effects on interpersonal difficulty related to ejaculation. The patient's perception of control over ejaculation is central to understanding how PE is associated with satisfaction with sexual intercourse and ejaculation-related distress. In contrast, the association of IELT with satisfaction with sexual intercourse and distress related to ejaculation is mediated by perceived control over ejaculation.
The new male sexuality
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Thanks for taking this poll
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