Interrelationships Among Measures of Premature Ejaculation: The Central Role of Perceived Control

Valparaiso University (USA), Вальпараисо, Indiana, United States
Journal of Sexual Medicine (Impact Factor: 3.15). 06/2007; 4(3):780-8. DOI: 10.1111/j.1743-6109.2007.00464.x
Source: PubMed


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.

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    • "For those who are dissatisfied with their ejaculation time, it may be erroneously classified as premature ejaculation, when their actual ejaculation time is less than their desirable IELT or the IELT that is generally considered as adequate in this population. The significant direct effect of perceived IELT with the level of dissatisfaction with sexual intercourse is in agreement in part with the finding of Patrick et al., [28] who reported that, IELT has a significant direct effect on perceived control over ejaculation, but not a significant direct effect on ejaculation-related personal distress or satisfaction with sexual intercourse [28]. Self-estimated IELT is normally adequate for assessing PE in everyday clinical practice despite the fact that self-estimated and stopwatch-measured IELT are interchangeable and correctly assigned PE status with 80% sensitivity and 80% specificity [29]. "
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    ABSTRACT: 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.
    Full-text · Article · May 2011 · Reproductive Biology and Endocrinology
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    • "correlation coefficients ranging from .01 to .45 in a population-based study (indicators of subjective nature having the strongest correlations between them; Jern et al., 2008). Patrick et al. (2007) explained the surprisingly weak association between ''subjective'' and ''objective'' measures by demonstrating a mediatory effect of a variable measuring perceived ejaculatory control on the association between IELT and PE-related distress. Furthermore, Rowland et al. (2000) noted that the association between IELT and control was variable in different contexts (e.g., depending on the sexual activity and how data are collected). "
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    ABSTRACT: Ecological Momentary Assessment (EMA) was used to investigate associations between, and variations in, ejaculatory control and ejaculation latency time (ELT) over repeated measurements of sexual activities. Differences between measures recorded in partnered or non-partnered settings were also investigated. The sample consisted of 21 male Finns aged 18 years or above, contributing a total of 158 reports of partnered and non-partnered sexual activities over a six-week period. In the context of non-partnered sexual activities, after controlling for within-subjects dependence, ELTs between events were predictive of one another, but ELT did not predict ejaculatory control when measured simultaneously, nor at subsequent events. Also, ejaculatory control could not predict simultaneously measured ELT or ejaculatory control at subsequent events. During partnered sexual activities, both ejaculatory control and ELT could be accurately predicted by observing ejaculatory control at prior events. In this context, ejaculatory control could also reliably predict simultaneously measured ELT. ELT or ejaculatory control during partnered sexual activity could not be predicted by observing ELT at prior events. Between-event correlations were generally low, indicating considerable variation in ejaculatory functioning over time. EMA is a thrifty assessment method for studying variations in ejaculatory function, and is likely suitable for studying sexual dysfunctions in general.
    Full-text · Article · Oct 2010 · The Journal of Sex Research
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    • "One large US, multicenter, observational study demonstrated the validity of several PROs in characterizing sexual dysfunction among men with and without PE, four of which comprise the Premature Ejaculation Profile (PEP) [13]. A path analysis of the subset of data from men diagnosed with PE in that trial found that although perceived control over ejaculation was central to determining PE associations with satisfaction with sexual intercourse and personal distress related to ejaculation, IELT did not have a direct effect on these parameters [14]. Because characteristics of PE may differ culturally [15], we conducted a similarly designed observational study in the European Union to characterize men with and without PE and their female partners using IELT and the PEP, and compared the results obtained with those obtained in the US population. "
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    ABSTRACT: To characterize premature ejaculation (PE) in five European countries using intravaginal ejaculatory latency time (IELT) and the Premature Ejaculation Profile (PEP). This 8-wk, multicenter, observational study enrolled men >or=18 yr of age and their female partners. Clinicians diagnosed PE using the DSM-IV-TR criteria and at least moderate, subject-reported, ejaculation-related personal distress or interpersonal difficulty. The PEP was administered at baseline and weeks 4 and 8. Partners measured IELT; the average stopwatch-measured IELT for each 4-wk period was calculated and compared with the man's screening-estimated IELT. Relationships between individual PEP measures and IELT were assessed with path analysis. PE was diagnosed in 201 of 1115 men. Findings were similar to those in a similarly conducted US study. Mean IELT was lower in the PE versus the non-PE group (3.3 vs. 10.0min, respectively), but substantial overlap was observed. Men with PE and their partners reported significantly worse control over ejaculation, ejaculation-related personal distress, satisfaction with sexual intercourse, and ejaculation-related interpersonal difficulty than men without PE and their partners. Path analysis showed that perceived control over ejaculation had a significant effect on ejaculation-related personal distress and satisfaction with sexual intercourse; IELT had an effect on control over ejaculation, no direct effect on satisfaction with sexual intercourse, and a small direct effect on ejaculation-related personal distress. No major cultural differences existed between EU and US men with and without PE and their female partners. These results emphasize the importance of the PEP measures, especially perceived control over ejaculation, in characterizing PE.
    Full-text · Article · May 2008 · European Urology
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