Treatment of premature ejaculation

Masturbation Prevalence, Frequency, Reasons, and Associations with Partnered Sex in the Midst of the COVID-19 Pandemic: Findings from a U.S. Nationally Representative Survey

Despite well-documented individual, relational, and health benefits, masturbation has been stigmatized and is understudied compared to partnered sex. In a US nationally representative survey of adults, we aimed to: (1) assess the prevalence and frequency of participants' prior-year masturbation, (2) describe reasons people give for not masturbating, (3) describe reasons people give for masturbating, and (4) examine the association between masturbation frequency and actual/desired partnered sex frequency in the prior year. Significantly more men than women reported lifetime masturbation, past month masturbation, and greater masturbation frequency. The most frequently endorsed reasons for masturbating related to pleasure, feeling "horny," stress relief, and relaxation. The most frequently endorsed reasons for not masturbating were lack of interest, being in a committed relationship, conflict with morals or values, or being against one's religion. Among women, those who desired partnered sex much more often and a little more often were 3.89 times (95% CI: 2.98, 5.08) and 2.07 times (95% CI: 1.63, 2.62), respectively, more likely to report higher frequencies of past-year masturbation than those who desired no change in their partnered sex frequency. Among men, those who desired partnered sex much more often and a little more often were 4.40 times (95% CI: 3.41, 5.68) and 2.37 times (95% CI: 1.84, 3.06), respectively, more likely to report higher frequencies of past-year masturbation activity than those who reported that they desired no change in their current partnered sex frequency. Findings provide contemporary U.S. population-level data on patterns of adult masturbation.

Initiators and Barriers to Discussion and Treatment of Premature Ejaculation Among Men and Their Partners in Asia Pacific - Results From a Web-based Survey

Introduction

Premature ejaculation (PE) is one of the most prevalent yet under-reported sexual disorders. Differing sociocultural norms across the Asia-Pacific region provide unique challenges in PE management.

Methods

This web-based study collected data from 5,038 men and women across 11 countries in the Asia-Pacific region. Respondents were recruited from an existing database.

Main Outcome Measures

The initiators and barriers for PE discussions and for seeking professional management following self-treatment, as well as their choices and expectations of healthcare professionals (HCPs).

Results

More than two-thirds of respondents have discussed PE with their partners, and men are more likely to initiate the discussion. Top drivers were for both partners to attain sexual satisfaction and greater fulfillment in the relationship. Emotional insecurity was the top barrier for men as they did not want to feel hurt or inadequate. Before consulting an HCP, more than two-thirds of men self-treated their PE for at least 20 months. The primary reason for stopping self-treatment and seeking medical management was a lack of improvement in sexual satisfaction. The ideal attributes that men seek in their HCP included trust and being knowledgeable about PE management.

Conclusion

Attitudes and barriers to PE and its treatment in the Asia-Pacific region are poorly understood. Many men are reluctant to seek professional advice and therefore resort to self-treatment for extended periods. HCPs can play a key role to empower PE sufferers and partners to understand the prevalence, medical relevance, treatability, and negative impacts of PE on sexual and overall relationships. Greater awareness of the diverse cultural and social norms, education of both partners and HCPs, and the involvement of HCPs through a patient-centric approach are all pivotal in managing PE optimally across the Asia-Pacific region.

Is premature ejaculation an impulse control disorder?

Premature ejaculation (PE) is defined as persistent or recurrent ejaculation with minimal sexual stimulation that occurs before the participant wishes to ejaculate and is associated with marked distress or interpersonal difficulty. Impulse control disorders (ICDs) are grouped as a heterogeneous cluster of disorders linked by a "failure to resist" impulses to engage in harmful, disturbing or distressing behaviours. I hypothesise that premature ejaculation is an impulse control disorder. ICDs share features with PE aspects of impaired control, rapid responses to stimuli and hypersensitivity. These disorders often occur with subjective and social distress for patients. In addition to these features, the neurotransmitter systems have been similarly implicated in ICDs and PE. The same treatment options further support a relationship between ICDs and PE. The behaviours likely exist on a spectrum.

Premature ejaculation: definition and prevalence

Premature ejaculation (PE) is likely the most common sexual dysfunction in men, with a worldwide prevalence of approximately 30%. To date, the lack of a universally acknowledged definition of PE has complicated the examination and analysis of PE in clinical and research-related settings. The impact of PE on men and their partners also needs to be clearly defined. Clearly, a better understanding of the epidemiology of this disorder, especially with regard to prevalence and risk factors, is necessary. The prevalence of PE appears to vary across socio-cultural and geographic populations. The elucidation of the etiology of PE and risk factors associated with PE has been difficult. However, several risk factors for PE exist that have strong support in the literature. Clearly, an improved and universal definition and understanding of PE and its epidemiology will improve the clinical management of PE and the success of future epidemiologic studies and clinical trials.