Understanding men's attributions of why they ejaculate before desired: an internet study

Recent developments in the study of men's sexual response have raised significant issues related to the definition and diagnosis of premature ejaculation (PE).

We wanted to understand men's perceived reasons for "ejaculating before they wanted," whether they selected attributions from the same broad category when allowed to endorse multiple reasons, and whether younger and older cohorts differed in their attributions.

A subsample of 376 men who indicated that they "ejaculated before they wanted" was drawn from a larger pool of 1,249 men participating in an online survey on men's sexual health. This subsample responded to a number of items regarding their ejaculatory patterns, including two questions listing 10 possible self-reported attributions/reasons for their quick ejaculation--one item allowed respondents to endorse multiple reasons, the other limited the response to the most important reason.

The primary outcome measure was men's attributions for ejaculating before desired, with choices from 10 possible pretested reasons. In addition, concordance across attributions was determined, that is, if a man responded to one category, was he also likely to select another category?

Men who met the ejaculatory latency criterion for PE were generally no different from those who did not. Overall, when required to select the most important attribution, most men identified a specific issue with "lack of self-efficacy" (lack of control or aroused too quickly). Few respondents identified erection loss, partner issues, or medical/medication concerns as the reason--and these patterns were independent of age. Concordance was high across self-efficacy attributions but low across other attributions.

Most men who complain of ejaculating before desired attribute this response to problems with self-efficacy. Only a small percent of men identified other possible reasons for their quick ejaculation. Such findings have implications for both the diagnostic process and definitional language for PE.