Rapid ejaculation: a review of conceptual, etiological, and treatment issues

A man's ability to control the timing of his ejaculation is a key aspect of his and his partner's sexual pleasure. This paper reviews the available clinical and experimental literature on rapid ejaculation (RE) highlighting methodological weaknesses common to research in the area. The numerous operational definitions of RE are reviewed. Inconsistencies among these definitions have led to difficulties in comparing studies. Empirical support for existing theories regarding the etiology of RE are reviewed. None has clear empirical support as being causally related to RE. The success of therapeutic interventions for RE are evaluated. The active ingredient(s) of therapeutic interventions for RE and the mechanisms by which they work have yet to be identified. Further, these treatments are far from universally successful, suggesting a need for additional approaches. A multivariate approach to operationalizing RE based on both ejaculatory latency and perceived control is proposed. This approach would also facilitate the understanding of both etiological and treatment issues.