186 Premature Ejaculation (302.75)
DSM-IV-TR criteria
- A. Persistent or recurrent ejaculation with minimal sexual stimulation before, on, or shortly after penetration and before the person wishes it. The clinician must take into account factors that affect duration of the excitement phase, such as age, novelty of the sexual partner or situation, and recent frequency of sexual activity.
- B. The disturbance causes marked distress or interpersonal difficulty.
- C. The premature ejaculation is not due exclusively to the direct effects of a substance (e.g., withdrawal from opioids).
- Specify type:
- Lifelong Type
- Acquired Type
- Specify type:
- Generalized Type
- Situational Type
- Specify:
- Due to Psychological Factors
- Due to Combined Factors
Associated Features
- Premature Ejaculation can be categorized as one of two types – Primary PE and Secondary PE. Primary PE refers to the type that has been present in an individual since becoming sexually functional. Secondary PE refers to the type that is acquired later in life in individuals who have had normal levels of sexual function. Both forms of PE are categorized as psychological conditions, as physiological factors such as organic diseases and brain lesions cannot be implicated.
- Individuals suffering from Premature Ejaculation display symptoms included but not limited to abdominal pain, involuntary movements of the eyes, accentuated fall in systolic pressure, and urinary problems.
Child vs. adult presentation
Premature ejaculation can happen at any point during a man’s life but is more common in young men aged 18-30. It may also occur in conjunction with secondary impotence in men aged 45-65.
Gender and cultural differences in presentation
- Premature Ejaculation is limited to the male sex, though its effects can pose problems for both sexes..
- Research shows that only men suffer from this disorder and it is common. Although all races can have premature ejaculation, there is some evidence that it occurs more in African Americans than in Hispanic and white men. In an analysis by Laumann et al (1999), they found that premature ejaculation occurred more among African American men (34%) and white men (29%) than in Hispanic men (27%).
- Rates are relatively uniform around the world except in the Middle East, where the rate is approximately 12.4%
Epidemiology
- This disorder affects 25%-40% of men in the U.S.
- According to the NHSLS, PE affects approximately 30% of men aged 18 to 59, making it the most prevalent male sexual dysfunction.
Etiology
There is no clear cause for premature ejaculation. It is believed that some psychological factors such as anxiety, guilt, or depression may be causing premature ejaculation. It may also be caused by medical conditions, such as hormonal problems, history of injuries, or side effect from certain medications. It has been suggested that PE may have conferred males an evolutionary advantage; males who were able to ejaculate faster would have been able, poten