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Updated: Sep 24, 2025

Treatment Model for Young Patients with Psychogenic Erectile Dysfunction and Resultant Infertility
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Erectile dysfunction and premature ejaculation: a continuum movens supporting couple sexual dysfunction.

G Corona1

  • 1Endocrinology Unit, Medical Department, Azienda Usl, Maggiore-Bellaria Hospital, Largo Nigrisoli, 2, 40133, Bologna, Italy. jocorona@libero.it.

Journal of Endocrinological Investigation
|May 3, 2022
PubMed
Summary
This summary is machine-generated.

Erectile dysfunction (ED) and premature ejaculation (PE) are closely linked, with PE increasing ED risk fourfold. Understanding their bidirectional relationship and associated psychological factors is key for effective diagnosis and treatment.

Keywords:
CoupleErectile dysfunctionPDE5iPremature ejaculationSexual desire

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Area of Science:

  • Urology
  • Sexual Medicine
  • Psychology

Background:

  • The interplay between erectile dysfunction (ED) and premature ejaculation (PE) requires further elucidation.
  • Understanding the specific mechanisms linking ED and PE is crucial for clinical practice.

Purpose of the Study:

  • To review and synthesize existing data on the relationship between PE and ED.
  • To explore the bidirectional nature and underlying factors of the ED-PE association.

Main Methods:

  • A comprehensive narrative review of relevant literature was conducted.
  • A meta-analytic approach was employed to minimize bias and strengthen findings.
  • Evidence was selected to clarify factors contributing to ED and PE.

Main Results:

  • A significant, bidirectional association between PE and ED was confirmed, with PE quadrupling ED risk.
  • Increased risk of ED associated with PE was observed in older patients, those with lower education, and individuals with higher anxiety and depressive symptoms.
  • ED-related PE showed weaker links to organic factors (diabetes, hypertension, dyslipidemia, smoking) and was associated with stable relationships when ED was defined by the International Index of Erectile Function.

Conclusions:

  • ED and PE should be viewed dimensionally, acknowledging their potential overlap and mutual influence.
  • Identifying underlying factors and patient complaints is essential for guiding appropriate diagnostic and therapeutic strategies.
  • A holistic approach considering psychological and relationship factors is vital for managing co-occurring ED and PE.