Examining the prevalence of premature ejaculation as a three-dimensional construct of sexual dysfunction-a systematic...

Premature ejaculation is one of the most common types of sexual dysfunction among men. Frequently, a distinction was made between 4 premature ejaculation subtypes-lifelong, acquired, natural-variable, and subjective. Although somewhat outdated but still relevant in terms of etiological considerations, most researchers and clinicians in the past have summarized these subtypes under the terms psychogenic ejaculatory complaint (natural-variable and subjective premature ejaculation) and somatogenic impaired ejaculatory control (lifelong and acquired premature ejaculation). To date, there is no universally accepted subtype-specific therapy to treat premature ejaculation, as the exact etiology and prevalence of the individual premature ejaculation subtypes have not yet been sufficiently researched.

The present systematic review aimed at examining the prevalence of premature ejaculation within the general population, as well as the prevalence of the premature ejaculation subtypes and the influence on prevalence rates of the diagnostic criteria being used.

A total of 79 prevalence studies with 158 prevalence estimates from 33 countries, which were published in English or German, were systematically reviewed and compared. Studies from 1986 to August 2024 were included.

In total, the identified studies included a total sample size of 319 468 participants. The prevalence rate of premature ejaculation (Mw = 14.19%, SD = 15.87%) was strongly dependent on the research definition used. In terms of prevalence, psychogenic ejaculatory complaint appeared to dominate over somatogenic impaired ejaculatory control both within the general population (Mw = 18.22%, SD = 16.10% vs. Mw = 9.97%, SD = 14.06%) and among individuals with premature ejaculation (lifelong premature ejaculation: Mw = 11.67%, SD = 2.70%; acquired premature ejaculation: Mw = 18.96%, SD = 2.20%; natural-variable premature ejaculation: Mw = 43.89%, SD = 10.55%; subjective premature ejaculation: Mw = 24.79%, SD = 5.18%).

The main limitation of this review is the varying sample populations across studies. The heterogeneity of 158 premature ejaculation subtype-specific prevalence surveys from 79 studies prevented meta-analysis. A systematic review was chosen to use mean differences, allowing for continuous results and comparability. This design enabled the examination of several studies to identify population-based trends.

Taking into account the review findings, it can be suggested that, in terms of a need-based treatment, the definition of premature ejaculation should be expanded to include the various forms and subtypes of premature ejaculation.