Problems with Definitions Lead to Diagnosis Difficultiesby PEhomepage.com Editorial Team
Stanely E. Althof examined approximately 20 years of research for premature ejaculation (PE) to discover that prevalence rates vary widely depending on the study and the mechanisms used to diagnose PE. These rates range from 20% to 30%. Large scale population based studies do not exist for PE, making any estimates for the prevalence of the condition difficult to be properly assessed.
In studies examining culture and ethnicity, some studies have found variations. For example, a study of 1,340 men age 40 and older revealed that white men who reported that PE was a problem “always/almost always” or “usually” was 16% in the previous 3 months. Yet, black men using those same criteria noted 21% prevalence of PE. Even still, Hispanic men reported 29% incidence of PE. Age, however, is still an interesting area of study. Some researchers believe that the younger the male, the more likely they are to experience problems related to PE. Other studies, however, have found stable rates of PE regardless of age. Longitudinal studies, says Althof, are needed to determine if PE increases, decreases, or stays the same during the aging process.
Althof contends that one of the primary barriers to accurately assessing PE is the lack of a single definition. Unlike erectile dysfunction (ED), which has a generally accepted definition, PE has several varying definitions, depending on the viewpoint used to diagnose it. Most of the definitions in the scientific community agree that the disorder combines lack of ejaculation control, distress in the patient and his partner, as well as low sexual satisfaction. Aside from those commonalities, it has been difficult to assess “normal” functioning, since even individual patients disagree over how long intravaginal ejaculation latency time (IELT) should be. (NOTE: IELT is measured from the time of vaginal penetration to the time of ejaculation.)
When determining when to include individuals in a study, there are variations in the inclusion criteria - some studies have used IELT≤ 1 minute, while other studies used IELT ≤ 2 minutes. Yet, in studies using these cut-off times, there are men who do not report low sexual satisfaction or distress, although the majority of men do report lack of control over ejaculation. Althof notes, “Ultimately the definition of PE/RE [rapid ejaculation] is subjective, based on individual perceptions over control over ejaculation, satisfaction with sexual intercourse and associated distress.”
Diagnosis of PE is problematic since many physicians and counselors do not routinely screen for it. The American Urological Association (AUA) issued guidelines for PE assessment that includes a full sexual history. The type of information needed for the sexual history assessment is often too cumbersome for the physician to complete during a routine office visit. These guidelines include information about frequency of sexual activity, frequency of PE and time PE has existed, and the impact PE has on sexual activity and the partner, as well as how PE affects the patient’s quality of life. Simpler screening tools are needed to aid physicians in making the diagnosis quicker and easier. Some of these screening tools are in progress. These include
two ten-item questionnaires and a 36-item questionnaire. These tools could be more beneficial to physicians and counselors as a short screening method to determine if their patient/client has difficulties with Premature Ejaculation and enable the person to gain access to treatment faster.
Source: Althof, Stanley E. “Prevalence, Characteristics and Implications of Premature Ejaculation/Rapid Ejaculation.”
The Journal of Urology, (175), March 2004, p. 842-848.
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