US researchers have suggested revised definition of premature ejaculation in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders.
The current fourth edition criteria for premature ejaculation (PE) have been criticized on multiple grounds including that the criteria lack precision, that the requirement of marked distress is inappropriate, and that the specification of etiological subtypes should be deleted. Since these criteria were originally adopted, there has been a tremendous gain in knowledge concerning PE, noted researchers led by Robert Taylor Segraves, MD, PhD, Department of Psychiatry, Metrohealth Medical Center Cleveland, Ohio.
AdvertisementSetting out to review evidence relevant to diagnostic criteria for PE published since 1990, they searched Medline, the National Library of Medicine's premier bibliographic database using the terms PE, rapid ejaculation, ejaculatory disorder, and intravaginal ejaculatory latency.
In their conclusions, published in the Journal of Sexual Medicine, they said, "t is recommended that the Diagnostic and Statistical Manual committee adopt criteria similar to those adopted by the International Society of Sexual Medicine. It is proposed that lifelong PE in heterosexual men be defined as ejaculation occurring within approximately 1 minute of vaginal penetration on 75% of occasions for at least 6 months. Field trials will be necessary to determine if these criteria can be applied to acquired PE and whether analogous criteria can be applied to ejaculatory latencies in other sexual activities. Serious consideration should be given to changing the name from PE to rapid ejaculation. The subtypes indicating etiology should be eliminated."
New research techniques have begun to shed light on some of the physiologic parameters of rapid ejaculation (RE), like hypersensitivity of the ejaculation reflex and of the sensory receptors on the penis. We know that the particular levels and combinations of neurotransmitters like adrenalin and serotonin in different people will play into the equation as well. These can be a function of genetics, learned behaviour, hormone levels, not to mention levels of caffeine and alcohol, Barry Richards, a Canadian expert points out.
Also RE can be secondary to a medical cause, like prostatitis, if it develops later in life. This should prompt men to see a doctor. Sometimes RE develops in conjunction with erectile dysfunction (ED). This too should prompt a visit to a physician so that any underlying medical conditions, like diabetes or vascular disease (to name just a few), can be uncovered or ruled out.
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