Premature Ejaculation (PE) is a medical condition, which can be caused by various factors. It was described for the first time as a clinical syndrome in 1943 by Bernard Shapiro, who made an initial distinction between Type A and Type B, later classified as Lifelong (primary) and Acquired (secondary).
The International Society for Sexual Medicine (ISSM) has defined Lifelong 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 the inability to delay ejaculation on all or nearly all vaginal penetrations, and negative personal consequences, such as distress, bother, frustration and/or the avoidance of sexual intimacy.
The ejaculatory reflex is controlled and governed by the Central Nervous System (CNS). It involves numerous neurotransmitters with serotonin as the key neurotransmitter, which has an inhibitory effect on ejaculation and male sexual activity. See more about normal male sexual response
The etiology of PE. PE apparently depends on several different factors. Psychological and physical factors may be associated in the same individual. In PE, as in most sexual dysfunctions, certain psychological factors observed in men and their partners result from the emotional reaction and the frustration caused by PE itself. Thus, they may contribute to exacerbate and perpetuate the problem, leading to a vicious circle.
Grafh: The PE vicious circle
Lifelong PE (about 65% of men reporting PE) is a chronic condition, that is suggested to be associated, in some cases, with special features in the serotonin receptor and transporter system resulting in reduced concentrations of serotonin, a neurotransmitter that plays a key role in ejaculation. See more about Lifelong PE
Acquired PE begins at a certain time of life after a period of normal ejaculation control and can be a symptom of other diseases such as prostate diseases, erectile dysfunction or hyperthyroidism to name some of them. Other factors causing or contributing to acquired PE may be social, psychological or interpersonal. See more about Aquired PE
References
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EAU Guidelines on ED and PE 2012.
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McMahon CG et al. J Sex Med 2008;5:1590–1606.
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Waldinger MD. Premature Ejaculation Definition and Drug Treatment. Drugs 2007;67 (4):547-568.