The impact of PE on women and the couple

The impact of PE on women. Sexual health and satisfaction are hugely important to a person's well-being, to their quality of life and also to having a good relationship with their partner. The World Health Organisation (WHO) states that "a satisfying, safe and enjoyable sex life" is a central aspect of human existence.
Research shows that many women, even though they reach climax during sex, do not consider their sex life satisfying. And a persistent dissatisfaction can cause a fall in desire, inadequate arousal and failure to achieve orgasm, turning the virtuous circle into the "vicious" circle of sexual function. Dissatisfaction can occur, for example, if the partner suffers from a sexual dysfunction such as a ejaculatory disorder, in particular, Premature Ejaculation (PE).
When the partner is a man with PE, the woman experiences greater sexual problems. All components of the sexual activity (such as desire, arousal and orgasm) are significantly impaired, with less overall satisfaction, more distress and interpersonal difficulties being experienced.

The impact of PE on the couple. For both men with PE and their partners, a lack of control leads to dissatisfaction, a feeling that something is missing from the relationship, and an impaired sense of intimacy. In other words, premature ejaculation leads to an imbalance in a couple's relationship, creating misunderstanding and discomfort. PE often causes frustration, blames and avoidance behaviours in the couple, but could lead to anger, mortification and resentment. Furthermore, without a heart-to-heart talk, both sides can develop a sense of inadequacy, which can affect their sexual well-being and even the couple's stability. Therefore, PE is a problem that a couple should try to resolve together. Mutual dialogue unites the couple and represents one of the most effective "weapons" for achieving a solution.
Some self-help treatments that men use to manage their PE may actually make the situation worse. For example, focussing attention elsewhere in an attempt to delay ejaculation decreases the sense of intimacy between the couple. Moreover, interrupted stimulation such as ‘stop-start’ techniques affects the woman’s sexual satisfaction. The use of alcohol and recreational drugs to help with PE should be avoided, not only because useless, but also because it links to other clinical risks.

"Age groups" and what women say. Are there any differences in the perception and experience of PE according to the age of the women?  No, there isn’t any solid evidence.
Clinical experience, including listening to women, suggests that:

  • Naive young partners may accept it, at least in the short term, more so if a second or third erection and ejaculation leads to her satisfaction as well. If this compensation mechanism is not in play, in most cases she will rapidly become dissatisfied, frustrated and even angry, with a progressive loss of desire.
  • In loving relationships, at any age, women tend not to raise the issue, to avoid humiliating the partner and may, consciously or unconsciously, shift the relationship towards emotional intimacy, shared life goals, childcare or gratifying hobbies. This may work in the long term only if the woman is not very sexually driven herself, or even dysfunctional, and the partner’s problem may mean avoiding her own sexual limitations, inadequacies or problems. In other cases, women are more proactive and will try to solve the problem. At the beginning, raising the issue and facing the problem, depending on the man’s attitude, will lead to a solution or to a chronic complaint.  
  • Experienced women of any age who enjoy sex do not accept a partner with PE for a long time, unless they enjoy other advantages from the relationship (love, social status, career, money, shelter, protection, children...). In this case, they maintain the relationship but may seek their own personal sexual satisfaction elsewhere, exploring another way with their partner or even elsewhere.
  • Postmenopausal women, not using hormone replacement therapy (HRT), who may suffer from low sexual desire (which affects some 48% of postmenopausal women), low arousal and vaginal dryness, may ultimately welcome Lifelong PE as it reduces “duty time”, where intercourse can be perceived as a marital duty before going to sleep. In case of Acquired PE, in a man with good previous ejaculatory control, a woman’s response may be very different. In loving relationships, Acquired PE usually worries the woman who then urges the partner to seek medical help.


UN. The Right to Reproductive and Sexual Health.


Graziottin A. “Sessualità e fisiopatologia sessuale” in: Zanoio L, Barcellona E, Zacché G. (a cura di), Ginecologia e Ostetricia; Elsevier Masson, Milano 2007; pp:165-196


Graziottin A. Althof S. The Journal of Sexual Medicine 2011; 8 Suppl 4: 304-309.


Patrick DL, Althof SE, Pryor JL, et al. J Sex Med 2005;2(3):358–367.


Giuliano F, Patrick DL, Porst H, et al. Eur Urol 2008;53(5):1048–1057.

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Dr. Ian Eardley

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