Reexamining the Definitions of PE and DE

Area of Science:

• Sexual medicine
• Psychiatry
• Clinical diagnostics

Background:

• Current definitions of premature ejaculation (PE) and delayed ejaculation (DE) by the International Society of Sexual Medicine (ISSM) and the DSM-5 require reevaluation.
• Existing definitions lack sufficient grounding in empirical evidence regarding Intravaginal Ejaculation Latency Time (IELT).

Purpose of the Study:

• To reexamine and propose revised diagnostic criteria for PE and DE.
• To integrate empirical IELT data with clinical assessments of control and distress.

Main Methods:

• Review of existing IELT evidence, ISSM position papers, and critical analyses of ISSM definitions.
• Analysis of quantitative data on IELT ranges in the general male population.

Main Results:

• The majority of men exhibit an IELT ranging from approximately 4 to 10 minutes.
• Deviations from this 4-10 minute IELT range should form the temporal basis for PE and DE diagnosis.
• Diagnosis requires a licensed health-care clinician (HCC) to assess "lack of control" and "distress" alongside temporal factors.

Conclusions:

• Revised diagnostic criteria for PE and DE should be based on a 4-10 minute IELT range.
• "Control" and "distress" are paramount in diagnosis, carrying more weight than latency alone.
• Involving HCCs in evaluating control and distress mitigates the risk of false-positive diagnoses due to loosened latency criteria.