Evidence-based definition may aid in diagnosis, treatment, and research.


ORLANDO—For the first time, clinicians have an evidence-based definition of premature ejaculation (PE).

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In October 2007, the International Society for Sexual Medicine (ISSM) gathered 21 leading sexual health experts in Amsterdam, the Nether-lands, to develop an evidence-based definition of PE. The new definition, presented here at the American Urological Association annual meeting, may help urologists better identify and treat men who suffer from PE.


“For something that has such a profound effect on men young and old, there needs to be a definitive measure to diagnose premature ejaculation,” said Ira Sharlip, MD, clinical professor of urology at the University of California in San Francisco and a member of the panel. “The hope is that more people with these symptoms will understand this is an actual health condition and seek treatment. They no longer need to suffer in silence.”


The ISSM has defined PE as “a male sexual dysfunction characterized by ejaculation which always or nearly always occurs prior to or within about one minute of vaginal penetration; and, inability to delay ejaculation on all or nearly all vaginal penetrations; and, negative personal consequences, such as distress, bother, frustration and/or avoidance of sexual intimacy.”


Dr. Sharlip said he hopes the new definition will become an international standard because it is evidence-based, contemporary, and it was developed by medical researchers without any industry influence.


“Previous definitions were not evidence-based,” he said. “They are opinion-based and so they are subjective, and we need an objective definition.”


The panel concluded that the definition could also apply to men with premature ejaculation who engage in sexual activities other than vaginal intercourse, although the definition does not apply to acquired premature ejaculation. This definition does not apply to homosexual activity because there are no data on that.


Anthony Smith, MD, professor of urology at the University of New Mexico in Albuquerque, said this new definition could benefit men, many of whom are afraid to talk about the topic. “I see guys who come in and they don’t know what normal is,” he said. “This definition will be mainly useful for research, but for me it will be helpful to use when talking to patients.”