Barriers to Treatment and Finding Acceptable Treatment Optionsby PEhomepage.com Editorial Team
While premature ejaculation (PE) remains one of the most common male sexual dysfunctions, researchers agree that men need to be willing to discuss the problem openly and then accept help in getting treatment. Part of the reason why PE remains “hidden” in society is the lack of a standard definition for it. Several definitions exist, centering around three primary criteria: low intravaginal ejaculatory latency time (IELT), little control over ejaculation, and reported low sexual satisfaction both on the part of the male, but the female partner as well.
An examination of research concerning length of IELT reveals that it varies widely by country, with men from several counties providing estimates of what a “normal” IELT would be. A study using the Multi Country Concept evaluation and assessment of PE found that men from the
United States indicated normal IELT time was 13.6 minutes while men from
France noted 9.3 minutes and men from
Germany listing 6.9 minutes. Women also rated a normal IELT, usually in line with the time that men from their corresponding countries indicating. One notable difference was found in women from the
United States; they reported a normal time of 11.2 minutes.
Another study used a large cross-section of data from a national population pool in United States supported previous results that approximately 30% of men felt they had “fair” to “very poor” control over their ejaculations. This study rated responses from 2,056 surveys with 1,158 of the men responding fitting the criteria for the study (men who were at least 21 years of age, sexually active, and in a monogamous heterosexual relationship). Of the men who qualified for the study’s inclusion, 32.5% of them reported that they often ejaculated before they wished. Of this group, 16.3% of were bothered either “very much” or “somewhat.” Researchers classified this group as having “probable PE.” When examining sexual satisfaction rates for this group, researchers discovered that 40% of men rated satisfaction as “good,” while approximately 30% rated “very good.” Researchers feel that men in this population group have become acclimated to their condition over time, adjusting their sexual satisfaction to fit their condition.
There can be serious barriers to diagnosing a patient with PE. Men often hinder the diagnosis process by trying to compensate for PE in other ways, such as masturbation prior to sexual intercourse, distraction, multiple condoms to decrease penile sensitivity, and even “harder and faster thrusting to try to satisfy their partner.” These techniques may show short-term results, but often fail or they may not produce results at all. It is interesting to note that general practitioners, as opposed to specialists, often report being uncomfortable discussing sexual dysfunctions and prefer to give patients written literature as opposed to discussing the situation in person. A large portion of the population feel that the condition is both not treatable as a medical condition and that it is purely psychological in nature, often limiting treatment options prior to exploring them fully.
Researchers feel that three facets of the burden or dilemma of PE for patients exist as emotional, health, and relationship. Concerning emotional burdens, there is significant shame and embarrassment since men feel unable to satisfy their sexual partners. In addition, anxiety and depression are present in men presenting with PE. Information from the Global Study of Sexual Attitudes and Behaviors reveals that Latin American men with PE are 2.9 times more likely to be diagnosed with depression. Relationship concerns can present with equal obviousness. These concerns include lack of trust in the relationship, feelings of sexual inadequacy, and lack of understanding on the part of the female partner. Some studies suggest that women who are unable to reach orgasm (or who take longer periods of time to reach orgasm) may contribute to problems related to PE, although more research into female dysfunctions and their effect on PE is still being examined.
Finally, patients who view Premature Ejaculation as strictly a psychological condition often limit themselves in terms of treatment options. Medical intervention is available. Erectile Dysfunction (ED) is a contributing factor in approximately 30% of PE cases. Researchers have also noted a correlation with “generally poor health.” There are some men who feel that the condition is more closely related to “quality of life” than with medical concerns. To demonstrate this, the Global Study of Sexual Attitudes and Behaviors found higher divorce rates for men with PE accompanied by lower levels of education.
Source: Sotomayor, Mariano, M.D. “The Burden of Primary Ejaculation: The Patient’s Perspective.”
The Journal of Sexual Medicine, 2005, Supplement 2, p. 110.
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