Premature Ejaculation - Diagnosing

Introduction

What are the key factors in diagnosing PE?

Although there are no specific diagnosis or treatment guidelines for PE, the diagnosis of PE is based mainly on a detailed sexual history that establishes:

1. The patients' perception of his control over ejaculation. Is it poor, fair or good?
2. The time frame within which he ejaculates. Less than a minute? More than 2 minutes?
• The majority of men who self-identify themselves as having PE will ejaculate in less than 2 minutes.
• The majority of men who self-identify as NOT having PE will ejaculate in longer than 2 minutes.
• PE is considered to be the occurrence of ejaculation prior to the wishes of both sexual partners, (which can vary widely from couple to couple); no clear time cut-offs have been set as to the appropriate duration for sexual contact before reaching orgasm, although the FDA in its assessment of drugs for PE uses 2 minutes as the guideline. Patient self-report time to ejaculation (known as ejaculatory latency time) has been shown to be surprisingly accurate.
3. That the short ejaculatory latency time is a source of distress for him or for his partner.
4. That the short ejaculatory latency time is interfering with the satisfaction of sexual relations for him or the couple.
5. If this condition has been life-long or if it has occurred more recently. Life-long PE is known as primary PE and recently acquired PE is known as secondary PE. If the onset of the problem is more recent, are there precipitating factors?
6. Frequency of PE. An occasional instance of PE might not be cause for concern, but if the problem happens more than 50% of the time, a pattern usually exists for which treatment may be appropiate.

While a physical examination is often conducted (involving an abdominal and genital examination and possibly a prostate examination) it generally aids little in the diagnosis of PE.

PE or ED ?

How do I know if I have ED or PE?

ED is a man's inability to attain or sustain an erection for the duration of sexual intercourse. Whereas PE is when a man and/or his partner perceives that he reaches orgasm and ejaculates too quickly and with little control.

In other words, PE is ejaculation before a man and his partner wants it to happen. There are men however who develop PE as a result of poor erection sustaining capability. In this situation, they condition themselves to reach orgasm/ejaculation quicker so they can do so before they lose their erection. The treatment of this begins by treating the erection problem first. With treatment many men can resolve the PE problem. Differentiating between the two conditions is a very important step for patients and physicians. An experienced physician should be able to define the real problem relatively easily.