[An update on ejaculation physiology and premature ejaculation definition, prevalence data, and etiology]

Area of Science:

• Neuroscience
• Urology
• Reproductive Medicine

Background:

• Ejaculation is a synchronized two-phase reflex (emission and expulsion) controlled by the spinal cord.
• Afferent signals originate from penile stimulation, modulated by descending brain pathways and neurotransmitters like serotonin and dopamine.

Purpose of the Study:

• To review the neurophysiology of ejaculation.
• To discuss the clinical assessment and definition of premature ejaculation (PE).
• To explore the multifactorial etiology of PE, including genetic and biological factors.

Main Methods:

• Review of neurophysiological mechanisms of ejaculation.
• Analysis of the definition and subtypes of premature ejaculation (PE).
• Discussion of etiological factors contributing to PE.

Main Results:

• Ejaculation is a complex spinal reflex influenced by central neurotransmitters.
• Intravaginal ejaculatory latency time (IELT) is a key clinical measure.
• Premature ejaculation (PE) is multifactorial, involving psychological and biological elements, with proposed subtypes.

Conclusions:

• Understanding the neurobiology of ejaculation is crucial for managing PE.
• PE etiology is complex, with genetic predispositions and associated conditions like prostatitis.
• The new DSM-5 definition of PE emphasizes IELT, aiding clinical assessment.