Evolving concepts in premature ejaculation: Implications for practice

SummaryThe difficulties inherent in identifying a simple definition of premature ejaculation (PE) (premature for some, too quickly for others) should be seen in the light of the fact that although many genetic, neurobiological, pharmacological, psychological, urological and endocrinological factors have been proposed, and may coexist, its aetiology is unknown. Evidence-based aetiologies have found contradictory results and orient clinicians towards a more multifactorial evaluation. In addition, the role of the partner may trigger awareness of this problem among young men, or their frustration may accentuate the problem, and shows that from a clinical perspective the couple's interaction, and the consequences of PE for them must be a strong focus. Nevertheless, a more precise differentiation between the psychological and physiological covariate implicated in ejaculation syndromes can ameliorate the application of integrated treatment approaches, which take account of relational and psychological problems that are involved in the dyadic and/or attenuate the psychological response of men affected by premature ejaculation. It is the understanding of the factors that are implicated in concepts of premature ejaculation that enable a clinical reflection of its evaluation and management.