Effects Of Male Sexual Dysfunction On Men And Women

In 2005 Donald Patrick and a number of colleagues conducted an observational study into the effects of premature ejaculation on men and their partners. This was published in the Journal of Sexual Medicine, volume 2, issue 3, in May 2005.

Patrick makes the observation that whilst premature ejaculation is the most common male sexual dysfunction, estimates suggest that only a small number of men who regard themselves as having PE actually receive any treatment for this problem.

Considering that up to 50% or more of the male population ejaculate too quickly, by their own admission (the figure offered by Patrick is 20 to 30%, but we believe it to be higher) this is a very significant number of men who are tolerating the condition.

It’s obviously the very personal and intimate nature of PE that causes both men and doctors hesitancy in discussing this subject, and this also probably contributes to men’s lack of awareness of how they might deal with the problem.

As we’ve seen on other pages of this this website, there are several factors which may also affect the understanding and analysis of PE, including the lack of an accepted definition, and the controversy around treatment methodology.

We have also seen how definitions of premature ejaculation are based on factors such as personal distress, difficulty between the partners, the level of sexual satisfaction, the time between penetration and ejaculation, and the lack of control that a man subjectively feels he has over his sexual responses.

The effect on the partners is an area that has been less well studied than the effect on the man concerned.

There is no agreed standard for the time between penetration and climax which could be used as a definition of PE. Indeed, there is no standard which is agreed upon for defining delayed ejaculation either – so premature and delayed or slow ejaculation become simply two aspects of the same problem.

Indeed, studies have used intervals of anything between 1 and 7 minutes as a definition of “premature”.

Previous studies have demonstrated that it’s extremely important to take account of what the man and his partner feel about the experience that they’re having.

Factors that are relevant to both partners in a relationship would include the level of satisfaction that they feel around the man’s control, the level of satisfaction they feel with sexual intercourse, and the perception of their overall situation.

Patrick’s study was designed to characterize men with and without premature ejaculation in a large sample from the community. Of course this revealed nothing about how well men could control premature ejaculation during sex with their partners.

And it revealed nothing about sex with their partners, how satisfied their partners were with orgasm frequency or the nature of their partners orgasms. In particular, whether or not the women were able to enjoy female ejaculation as part of sexual pleasure.

The researchers used both measures that could be observed – the IELT or time between penetration and climax – and subjective measures such as reports by the man and his partner about satisfaction, distress, difficulty and severity of the condition. This was especially true in cases of delayed ejaculation. You can read a treatment protcool for this condition here.

No treatment was offered to any of the people in this study, since the objective was purely around descriptive observation of the men’s condition. The study lasted for four weeks and was conducted at 42 centers in the United States.

The couples who took part were paid approximately $400. They were required to make three visits to the centre where they were interviewed at approximately 2 week intervals.

All of the men involved in the study were more than 18 years of age, in long-term heterosexual relationships and, by their own admission, monogamous. Also, the fact that they were required to have been in a relationship for six months should have avoided any potential effects of a new sexual partner on the man’s IELT and other subjective responses to intercourse.

All the subjects underwent a review of their medical history, collection of relevant personal information, and the assessment by a clinician of their ability to control female ejaculation.

The investigators used the standard DSM IV criteria to determine the effort they had made to overcome the problem.

The definition of PE used was: persistent or recurrent ejaculation occurring with little or no physical stimulation, on or shortly after penetration, and before the man wishes it; causing distress or interpersonal difficulty; and the fact that the PE must not have been due to the direct effects of alcohol or other drugs or any other substance.

Studies Into The Effects Of Rapid Ejaculation

Any subjects who reported decreased libido or any other form of sexual dysfunction, and any men whose partners exhibited those characteristics, were ineligible to take part in the study, as were those men who were taking various medications including SSRIs, medication for erectile dysfunction, and any anesthetic ointment treatment to control premature ejaculation.

On the first visit the man and his partner were given a stopwatch and instructed how to record the time between penetration and climax: the man’s partner was asked to operate the stop watch, starting it when the man penetrated her vagina, and stopping it when he ejaculated or withdrew without any ejaculation.

During the course of the study, the couples were asked not to engage in any new sexual techniques, so that their established sexual behavior and routine would not be affected by novelty.

On the second and third visits to the investigation centre, the man was asked to complete various subjective surveys of his ejaculation control, satisfaction, distress and interpersonal difficulty.

His partner was not expected to take part in the second and third visits, but was given a questionnaire to be completed and returned to the investigators at the end of each period of the survey.

As far as the subjective measures of sexual pleasure and satisfaction were concerned, there were five questions which were rated on a scale of 0 to 4.

The first question concerned control over ejaculation, specifically his ability to prevent premature ejaculation. Both the man and his partner were asked what level of control over ejaculation during sexual intercourse the man had achieved, on a scale of 0 to 4.

The second question concerned satisfaction with intercourse and again both the man and his partner were asked where their satisfaction with sexual intercourse over the past month could be rated on a scale of 0 to 4.

The third question related to the severity of the man’s premature ejaculation, and both the man and his partner were asked independently to assess the severity of the condition on a scale of 0 to 3.

The distress caused by PE was the subject of the fourth question, and the men and their partners were asked how distressed man was by how fast he ejaculated during sexual intercourse.

Again his responses were analyzed on a scale of 0 to 4. And the final question was around interpersonal difficulty. Both the man and his partner were asked to what extent the speed with which the man ejaculated during sexual intercourse caused difficulty in the relationship. The answer was rated on a scale of 0 to 4.

Intra-vaginal ejaculatory latency time – IELT – was defined as the average duration of intercourse taking into account all attempts to have intercourse since the last visit to the survey centre.

Those men who ejaculated before they’d even penetrated their partners were given an IELT of 0 minutes. Using statistical analysis, including t-tests, correlation analysis, and chi-square tests, plus Spearman’s rank correlation coefficient, the subjective and objective scores were analyzed with respect to the differences between men who claimed to have had lifelong premature ejaculation and those who claimed that PE had started later in life.

There were 1587 men and their partners involved in the study, of whom the doctors diagnosed 207 as having premature ejaculation. Therefore, 1380 men who did not meet the criteria laid down in DSM IV were assigned to the group of men who were supposed not to have PE.

The majority of subjects completed the survey, although 13 men in the group with PE did not do so, while 38 men in the group without PE were lost to the study at some point. The average age of men in the study was 35.4 years, and the majority were white men living with their partner.

Obviously men with a long IELT of 30 minutes or more could be said to have delayed ejaculation and might benefit from delayed ejaculation treatment. All therapeutic approaches to ejaculatory difficulties aim to stop premature ejaculation and produce a more normal timescale for lovemaking.