Steps to Faster Diagnosis of Men with Premature Ejaculation

With physician and researchers in agreement that PE is one of the most common male sexual dysfunctions, there are still few tools to help accurately diagnose it. One of the reasons that survey tools have not been developed is due to the fact that there are several definitions for the disorder, none of which has gained common acceptance.  The purpose of this multi-part study was to develop a statistically valid and reliable survey tool that could be used among a wide variety of men that would help identify PE.  

The questionnaire was developed in four stages: developing survey questions, initial statistical analysis, patient interviews, and the final statistical analysis. Interviews with two experienced sex therapists ( Althof and Rosen ) in the United States during 2000 yielded 17 items that researchers developed to address the following areas: distress related to PE, perceived control over ejaculation, any limitations that may exist during foreplay, and sexual satisfaction. For the initial analysis, two groups of men were given the 17-item questionnaire. The first group of 147 men had been screened already for a study for PE while the second group of 141 men was considered normal men with no evidence of PE. The third group of 34 men all reported short intravaginal ejaculatory latency time ( IELT ) and had self-reported PE. The men were asked to complete the questionnaire on two different occasions, at least 7-10 days apart.

Using a variety of statistical tools, researchers were able to perform factor analysis on responses provided by all three groups. In other words, researchers wanted to determine if the questionnaire had identifiable factors according to the subjects’ perceptions as they did when researchers developed the questionnaire. They also determined how well the items within the survey correlated to one another. Finally, they ran test results for validity – does the questionnaire appear to measure PE as it was intended to measure it. Also, known-groups validity would determine if the responses for each of the groups were along the lines of those researchers expected – would men who were screened for PE report the same information consistently on the questionnaire, while healthy males would not report PE based on the group where they were placed.

Based on the analysis, seven of the items were excluded from the third stage of analysis. During the third stage, patient interviewed were conducted using 13 men who had IELT of ≤ 2 minutes, a self-report of distress due to PE, and no reported erectile problems. These 13 men were interviewed and asked a variety of questions concerning “What does Premature Ejaculation mean to you?” There were follow-up questions that delved further into the issue concerning how PE affected their self-esteem, sexual satisifaction, overall sexual experience, and the affect on their thinking. An additional 30 men were recruited to determine if the survey questions were understandable. These 30 men were asked to complete the survey while speaking out loud their understanding of the questionnaire items. After 20 men had completed this process, changes were made to the survey items and the final 10 men were asked to complete the process.

In the final stage, 939 men were recruited from two clinical trials for a new treatment of PE. These men had to have reported a history of PE for at least the last 6 months, be in a heterosexual relationship of greater than 6 months, and agree to have sexual intercourse at least 4 times per month with an IELT of ≤ 2 minutes in at least 70% of their attempts.. A third group of 67 men were recruited for test-retest reliability. The same inclusion criteria were used when choosing the men for this portion of the study. This group ended up with 45 evaluable results, meaning that they had both pre and post questionnaires completed and their symptoms of PE did not change during the survey period. These men were 20-60 years old with a mean age of 36.8 years; 75% were in the 20-44 age group. A fourth group of men were recruited from the general population, regardless of their PE status, as long as they were in a stable heterosexual relationship lasting longer than 6 months.

The same statistical analysis performed during stage 2 of the 17-item questionnaire was also used for this fourth stage of the study. Factor analysis yielded high internal factor loadings and validity, as well as reliability were also confirmed. Researchers felt that since there is more to PE than low IELT, the way a patient perceives himself and his sexual experiences needs to be fully validated and measured. The “core features of the overall experience of PE” were measured with this questionnaire. Researchers made the full questionnaire available to the public domain, meaning that physicians may begin using it in screening patients who may report symptoms of PE. It is available in multiple languages, including: Czech, Dutch, English, Finnish, French, German, Hebrew, Hungarian, Italian, Norwegian, Polish, Portuguese, Spanish, and U.S. Spanish.

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