The definition and prevalence of premature ejaculation (frequency of premature ejaculation)

What Is Premature Ejaculation?

[ Home ] [ More definitions of PE ] [ Subjective rapid ejaculation definitions ] [ More on the definition of quick ejaculation ]

Based very loosely on an article in The Journal Of Sexual Medicine, 2005, Supplement 2: Prevalence of Premature Ejaculation: A Global and Regional Perspective by Francesco Montorsi, MD. Any errors of interpretation are solely the responsibility of this website.

How widespread is premature ejaculation (PE)? One problem is that we don't really know because there is no accepted definition of premature ejaculation. 

At the moment, different doctors have different criteria for diagnosing the condition, and the definitions that are available depend to a large extent on subjective measurement or opinion. Also, there is no clear agreement on what is a normal ejaculatory latency (time after penetration but before ejaculation). This has hampered research into premature ejaculation.

What men and women think of as "normal" ejaculatory latency is different from country to country and - perhaps not surprisingly - between women and men even in the same country. But despite these problems of definition, the Global Study of Sexual Attitudes and Behaviors has enough information for us to conclude that premature ejaculation affects about 30% of men across all age groups.

And exactly what causes premature ejaculation? Like erectile dysfunction, premature ejaculation is becoming more medicalized, which means that doctors are seeing it more as a condition they can cure than a psychosexual issue caused by emotional issues like anxiety. While we don't know for sure what causes premature ejaculation, current thinking is moving away from psychosexual ideas towards neurobiological bases. Of course, knowing what causes premature ejaculation will certainly help produce more effective therapies, but for the moment it remains a fairly major problem for men and a significant burden on psychological well-being.

Up till now, the prevalence of premature ejaculation has been little understood, but recent research has offered a clearer picture and shows there are regional differences in the frequency of premature ejaculation among men. Of course, a big problem is that the lack of clear diagnostic criteria for normal ejaculation has hampered attempts to measure the prevalence of premature ejaculation: values between 25% and 60% are reached, depending on which criteria the researchers used. One thing we do know is that  that premature ejaculation is the most common sexual complaint among men.

Defining normal ejaculatory latency (period between penetration and ejaculation) is difficult.

Men and women's ideas of what is normal is not consistent -  the perception of the normal period before ejaculation varies widely - between 7 and 14 minutes, with significant geographical variation. For example, in Germany, the perceived average latency time is only 7 minutes, but in the US it is over 13 minutes. The perceived average for men in the United Kingdom, France, and Italy is around 9 minutes.

Generally, the time before ejaculation as estimated by women was  similar to the time estimated by men, though slightly lower in most cases. The difficulty of agreeing what is the "normal" ejaculatory latency is reflected in the lack of a universally accepted definition of premature ejaculation. The best definition is probably that of the DSM-IV diagnostic manual: persistent or recurrent ejaculation with minimal stimulation before, on, or shortly after penetration and before the person wishes it.

As you can see, this definition of premature ejaculation encompasses three components:

• a short period before ejaculation

• a lack of voluntary control over ejaculation

• a lack of sexual satisfaction for one or both partners

Obviously these are subjective criteria, which do not provide a rigorous basis for either the definition of PE, or useful research on how to treat it effectively. In fact, in about 45 studies undertaken between 1963 and 2000, only half contained a quantifiable measure of ejaculatory progress such as number of thrusts, while subjectively assessed criteria, such as a man's perceived lack of control, were reported in less than half. Of course, most men who seek help know full well they have premature ejaculation, perhaps partly because they are so dissatisfied with their sexual performance, and partly because rapid ejaculation is so widely known to be a problem among men.

One recent study showed the prevalence of ejaculatory dysfunction among Argentinean men was around 28% (based upon the self-reporting of the study participants). This matches the results of the Global Study of Sexual Attitudes and Behaviors (GSSAB), which collected data from more than 13,000 men in 29 countries. Overall, approximately one third of all men seem to have difficulty with premature ejaculation. The prevalence of premature ejaculation varies widely, though: in Latin America it was reported as 28.3%, in the Middle East, 12.4%, and in South East Asia 30.5%. These reports were based on men who said PE was a frequent problem which had persisted for a long time. These men appear to have a chronic complaint associated with significantly lowered quality-of-life or sex.

But why would the prevalence of premature ejaculation vary so much from region to region? Several reasons. For example, the level of circumcision in certain regions may be a big factor - circumcision is linked to glans keratinization and desensitization. Then again, there are religious and cultural influences which may affect the prevalence of premature ejaculation. What is thought of as premature ejaculation may be different among Protestant and Catholic populations. Also, rates of premature ejaculation may appear to be higher in places where sex has special cultural significance or where female sexuality is regarded as equal to male sexuality. However, in patriarchal societies where women have a lower social position, premature ejaculation may actually be seen as a sign of virility rather than a problem.

There is conflicting evidence about the association of race and the reported frequency of premature ejaculation. The National Health and Social Life Survey, which was conducted in 1992, looked at over 1,400 men between the ages of 18 and 59 years. The results suggested that premature ejaculation among black, Caucasian, and Hispanic men was 34%, 19%, and 27%, respectively. However, a more recent study suggested the figures were 21%, 16%, and 29%  respectively, although this study involved an older population of men aged between forty and eighty years.

Data from the NWLS reveals that the prevalence of premature ejaculation is not correlated with age. Indeed, the prevalence of PE is basically constant throughout the 18 - 59 age group. Overall, the GSSAB found few firm correlations for the prevalence of PE. One which did appear was the finding that education level is negatively associated with PE. For instance, in the Middle East and Central and South America, men with no college education appeared to be twice as likely to report they had premature ejaculation as men who had received some college education. The only other factor of significance clearly associated with premature ejaculation was infrequent sex, which is hardly surprising.

Continued here - causes of premature ejaculation

Other pages on this website about the treatment of premature ejaculation The effective treatment of premature ejaculation

Treatments for PE which do not require drugs Effect of premature ejaculation on couples