Abstract
Professional standards committees have generally applied the diagnostic criteria for premature ejaculation only to situations involving (presumed) heterosexual men having penile–vaginal intercourse. This paper reviews the existing evidence supporting expansion of the criteria for use among non-straight men engaging in sexual activities that do not include vaginal intercourse. In brief, estimated ejaculation latencies appear similar across men identifying with different sexual orientations, and various partnered sexual activities (oral, vaginal, and manual) tend to be well correlated. In contrast, masturbation latency patterns are different between men with and without premature ejaculation, and ejaculatory control and bother/distress may be less critical to gay men than straight men during partnered sex. Finally, it should be noted that existing patient report outcomes (PROs) require modification for use with non-straight men.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 8 print issues and online access
$259.00 per year
only $32.38 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
McMahon CG, Althof SE, Waldinger MD, Porst H, Dean J, Sharlip ID, et al. An evidence-based definition of lifelong premature ejaculation: report of the International Society for Sexual Medicine (ISSM) ad hoc committee for the definition of premature ejaculation. J Sex Med. 2008;5:1590–606.
American Urological Association. Disorders of ejaculation: an AUA /SMSNA guideline. Baltimore, Maryland, USA: American Urological Association; 2020. https://www.auanet.org/guidelines/disororders-of-ejaculation.
American Psychiatric Association. The diagnostic and statistical manual of mental disorders (DSM-V). 5th ed. Washington, DC: American Psychiatric Association; 2013.
International Classification of Diseases 11th Revision (ICD-11). Definition of male early ejaculation. Geneva, Switzerland: ICD-11; 2018. https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f361151087.
Peixoto M, Nobre P. Prevalence of sexual problems and associated distress among lesbian and heterosexual women. J Sex Marital Ther. 2015;41:427–39. https://doi.org/10.1080/0092623X.2014.918066.
Jern P, Santtila P, Johansson A, Alanko K, Salo B, Sandnabba NK. Is there an association between same-sex sexual experience and ejaculatory dysfunction? J Sex Marital Ther. 2010;36:303–12. https://doi.org/10.1080/0092623X.2010.488102.
Breyer BN, Smith JF, Eisenberg ML, Ando KA, Rowen TS, Shindel AW. The impact of sexual orientation on sexuality and sexual practices in North American medical students. J Sex Med. 2010;7:2391–400. https://doi.org/10.1111/j.1743-6109.2010.01794.x.
Lau JT, Kim JH, Tsui HY. Prevalence and factors of sexual problems in Chinese males and females having sex with the same-sex partner in Hong Kong: a population-based study. Int J Impot Res. 2006;18:130–40. https://doi.org/10.1038/sj.ijir.3901368.
Bancroft J, Carnes L, Janssen E, Goodrich D, Long JS. Erectile and ejaculatory problems in gay and heterosexual men. Arch Sex Behav. 2005;34:285–97. https://doi.org/10.1007/s10508-005-3117-7.
Barbonetti A, D’Andrea S, Cavallo F, Martorella A, Francavilla S, Francavilla F. Erectile dysfunction and premature ejaculation in homosexual and heterosexual men: a systematic review and meta-analysis of comparative studies. J Sex Med. 2019;16:624–32. https://doi.org/10.1016/j.jsxm.2019.02.014.
Cote-Leger P, Rowland DL. Estimations of typical, ideal, premature ejaculation, and actual latencies by men and female sexual partners of men during partnered sex. J Sex Med. 2020;17:1448–56.
Cote-Leger P, Rowland DL. Diagnostic criteria for premature ejaculation: Clarifying the role of “ejaculatory-control” and “bother/distress”. Sexes. 2020;1:72–86.
Rowland DL, Sullivan SL, Hevesi K, Hevesi B. Orgasmic latency and related parameters in women during partnered and masturbatory sex. J Sex Med. 2018;15:1463–71. https://doi.org/10.1016/j.jsxm.2018.08.003.
Rowland DL, Kolba TN. Understanding orgasmic difficulty in women. J Sex Med. 2016;13:1246–54. https://doi.org/10.1016/j.jsxm.2016.05.014.
Grulich A, de Visser R, Badcock P, Smith A, Heywood W, Richters J, et al. Homosexual experience and recent homosexual encounters: the Second Australian Study of Health and Relationships. Sex Health. 2014;11:439–50.
McDonagh LK, Nielsen EJ, McDermott DT, Davies N, Morrison TG. “I want to feel like a full man”: Conceptualizing gay, bisexual, and heterosexual men’s sexual difficulties. J Sex Res. 2018;55:783–801. https://doi.org/10.1080/00224499.2017.1410519.
Vanden Broucke H, Everaert K, Peersman W, Claes H, Vanderschueren D, Van Kampen M. Ejaculation latency times and their relationship to penile sensitivity in men with normal sexual function. J Urol. 2007;177:237–40. https://doi.org/10.1016/j.juro.2006.08.071.
Corty E. Perceived ejaculatory latency and pleasure in different outlets. J Sex Med. 2008;5:2694–702. https://doi.org/10.1111/j.1743-6109.2008.00939.x.
Jern P, Gunst A, Sandqvist F, Sandnabba NK, Santtila P. Using Ecological Momentary Assessment to investigate associations between ejaculatory latency and control in partnered and non-partnered sexual activities. J Sex Res. 2011;48:316–24. https://doi.org/10.1080/00224499.2010.518293.
Strassberg DS, Kelly MP, Carroll C, Kircher JC. The psychophysiological nature of premature ejaculation. Arch Sex Behav. 1987;16:327–36. https://doi.org/10.1007/BF01542142.
Rowland DL, Strassberg DS, de Gouveia Brazao CA, Slob AK. Ejaculatory latency and control in men with premature ejaculation: an analysis across sexual activities using multiple sources of information. J Psychosom Res. 2000;48:69–77. https://doi.org/10.1016/s0022-3999(99)00078-1.
Horvath Z, Smith BH, Sal D, Hevesi K, Rowland DL. Body image, orgasmic response, and sexual relationship satisfaction: understanding relationships and establishing typologies based on body image satisfaction. Sex Med. 2020;8:740–51. https://doi.org/10.1016/j.esxm.2020.06.008.
Pascoal PM, Narciso Ide S, Pereira NM. What is sexual satisfaction? Thematic analysis of lay people’s definitions. J Sex Res. 2014;51:22–30. https://doi.org/10.1080/00224499.2013.815149.
Rowland DL, Hamilton B, Bacys K, Hevesi K. Sexual response differs during partnered sex and masturbation in men with and without sexual dysfunction: implications for treatment. J Sex Med. 2021. In press.
Donatucci C. Etiology of ejaculation and pathophysiology of premature ejaculation. J Sex Med. 2006;3 Suppl 4:303–8.
Waldinger M. The pathophysiology of lifelong premature ejaculation. Transl Androl Urol. 2016;5:424–33.
Rosen RC, Althof S. Impact of premature ejaculation: the psychological, quality of life, and sexual relationship consequences. J Sex Med. 2008;5:1296–307.
Patrick DL, Giuliano F, Ho KF, Gagnon DD, McNulty P, Rothman M. The premature ejaculation profile: validation of self-reported outcome measures for research and practice. BJU Int. 2009;103:358–64.
Jern P, Piha J, Santtila P. Validation of three early ejaculation diagnostic tools: a composite measure is accurate and more adequate for diagnosis by updated diagnostic criteria. PLoS ONE. 2013;8:e77676. https://doi.org/10.1371/journal.pone.0077676.
Symonds T, Perelman M, Althof S, Giuliano F, Martin M, May K, et al. Development and validation of a premature ejaculation diagnostic tool. Eur Urol. 2007;52:565–73.
McDonagh L, Bishop CJ, Brockman M, Morrison T. A systematic review of sexual dysfunction measures for gay men: how do current measures measure up?. J Homosex. 2014;61:781–816. https://doi.org/10.1080/00918369.2014.870452.
Author information
Authors and Affiliations
Contributions
Conceptualization: DR, literature search: DR, CR, writing: DR, editing: DR, CR, and formatting: CR.
Corresponding author
Ethics declarations
Competing interests
The authors declare no competing interests.
Additional information
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Rowland, D.L., Roberson, C.B. Do the diagnostic criteria for premature ejaculation apply to non-straight men and to sexual activities other than penile–vaginal intercourse?. Int J Impot Res 34, 730–732 (2022). https://doi.org/10.1038/s41443-021-00467-y
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/s41443-021-00467-y