Female Partner's Perception of Premature Ejaculation and Its Impact on Relationship Breakups, Relationship Quality, and Sexual Satisfaction
Andrea Burri, PhD; François Giuliano, MD; Chris McMahon, MD; and Hartmut Porst, MD
ONLINE: April 29, 2014 – The Journal of Sexual Medicine
Definitions of premature ejaculation (PE) have varied in the past, but in 2008, experts appointed by the International Society for Sexual Medicine agreed that three factors are involved: timing, a sense that the man does not have control over ejaculation, and distress for the couple.
Many studies have focused on men’s experiences with PE and found that the condition negatively affects quality of life and relationships with partners.
Women’s perceptions of PE have not been widely researched. Recent studies have had mixed results. Most have found that the female partners of men with PE tend to feel more sexual distress and dissatisfaction. But other research shows that while PE affects women’s sexual satisfaction, it does not affect relationships and personal functioning.
Current research has not been able to explain whether distress is caused specifically by the PE itself or by its impact on the man, who might be more focused on his PE than on his partner’s satisfaction. Also, research has not addressed how PE might impact a woman’s sexual functioning. Examining these issues more closely could help clinicians better understand the physical, psychological, and interpersonal aspects of PE for couples.
The researchers aimed to answer the following questions:
• What is the woman's perception of PE?
• How important is ejaculatory performance for the woman?
• Which aspects of PE are most distressing to the woman?
• How much does PE impact on intimacy, relationship quality, and satisfaction?
• What impact does PE have on the woman's sexual satisfaction and functioning?
• How much does a woman's own sexual functioning influence her perception of PE?
Methods and Materials
Women between the ages of 20 and 50 were screened for the study. The final sample included 1,463 women: 502 from Italy, 508 from South Korea, and 453 from Mexico. These countries were selected to reflect cultural differences among the participants.
To be included, a woman needed to be sexually active, having at least half of her sexual experiences with a man. She also needed to be with a man who had PE. PE status was determined through information provided by the participant
The survey included questions that were designed for this particular study as well as questions taken form validated, standardized assessment tools.
In addition to collecting sociodemographic data, the researchers evaluated the following:
• PE status of the male partner
• Women’s perceptions of PE
• Women’s sexual functioning and distress (using two versions of the Female Sexual Function Index short form – one to assess functioning and distress with PE partners and one for lifelong function/distress)
• Orgasmic ability
• Sexual distress (Female Sexual Distress Scale)
• Sexual attitudes and functioning
• Relationship satisfaction and quality (Relationship Assessment Scale)
The women were divided into four groups:
• Women whose partners ejaculated before they wished it to happen (PEW)
• Women whose partners had been clinically diagnosed with PE (CD)
• Women whose partners had an intravaginal ejaculation latency time (IELT) of less than two minutes (IELT)
• Women whose partners repetitively expressed wanting to have more ejaculatory control (PEM)
The mean age of the participants was 34.3. The average relationship duration was 85.9 months.
Most of the women (63.1%) were in the PEM group. The PEW group was the second-largest category, with 53.7%. Just over 9% of the women were in the CD group and about a quarter were in the IELT group.
Women’s Perception and Importance of PE
About 40% of the women said that ejaculatory control was “extremely or very important.” Almost a fifth of these women felt distressed by their partner’s lack of control.
Control was most important for the IELT group and least important for the PEW group. Distress over control was greater for the IELT group and less for the PEW group.
The reasons for the women’s distress included the following:
• Lack of attention to her other sexual needs (47.6%)
• Short time between penetration and ejaculation (39.9%)
• Lack of ejaculatory control (24.1%)
• Partner distress (20.3%)
• Other (16.2%)
Women’s Sexual Functioning and Views on Sexuality
Almost 78% of the women reported having a sexual problem, with low libido and sexual dissatisfaction being the most common ones. Of the women who had sexual problems, 78.6% said the problems occurred during their relationship with a man who had PE. Just over 64% said the problems began when they started their relationship with the PE man. Almost 36% said the problems started before this relationship.
When asked “what constitutes good sex for you,” 69.2% of the women answered that versatility and creativity were most important. Almost half said duration was important. The women’s ideal penetration time was a mean of 23.2 minutes. When asked why, about 60% said the time period allowed them to reach orgasm and 60% said that this time frame created more intimacy.
Women were more likely to report sexual problems if they valued versatility or felt that their partner focused more on his PE issues than on their sexual needs.
Almost 3% of the women were not able to reach orgasm at all. About 7% could not achieve orgasm during intercourse and 4.4% could not do so during sexual activities with their current partner. Women who had orgasm difficulties tended to value sexual versatility.
Impact of PE on Relationship Breakups, Relationship Satisfaction, and Sexual Satisfaction
For almost a quarter of the women, a man’s PE had caused a relationship breakup.
This situation was most likely for women in the PEM group and least likely for women in the PEW group. It was also more likely among women who said ejaculatory control was important, those who were more distressed, and those who had sexual problems themselves.
About 40% of the women said they had been “extremely” or “much” more satisfied in prior relationships with men who did not have PE. About 20% said PE was “a major problem” but another 20% said that it was “not a problem at all.”
The authors noted that this was the first study to report women’s distress when their PE partners were more concerned about their own situation than the women’s sexual needs.
Relationship Dissatisfaction and Separation
It appeared that women were more willing to accept shorter intercourse durations and that this issue did not always lead to dissatisfaction or a breakup. A man’s concern with PE and his own performance – and ignoring a woman’s needs – was a stronger factor leading to a breakup.
However, the way a woman handles a man’s PE, her own sexual functioning, and her attitudes about sex can also be involved. “Sexual problems clearly are a couple’s problem and disruptions of dyadic processes and well-being not only affects both parties but can also be precipitated and aggravated by both of them,” the authors explained.
Importance of Ejaculatory Control and Reasons for Distress
A man’s preoccupation with his own PE and lack of focus on a woman’s needs is again discussed in the context of PE definitions. The authors point out that PE definitions have largely concentrated on “objective and physiologic” factors, but in this study, these factors are not as concerning for female partners. This finding “highlights the necessity for psychosexual education and sexological approaches where PE sufferers equally learn about the partner’s specific needs and wishes and how to appropriately address them.”
Women’s Sexuality and Impact of PE on Their Sexual Satisfaction
Women’s own sexual functioning and preferences, such as their ability to reach orgasm and the best ways for them to do so, need to be considered as well. Some women preferred a longer intercourse duration because they were more likely to have an orgasm and feel an intimate connection with their partner. For other women, sexual creativity was more important than intercourse duration.
The authors stated, “It seems that there are ‘subgroups’ of women and that the amount of PE-related distress depends not only on how important they consider ejaculatory control but also on their own sexual functioning and her individual importance of sexuality and what they consider good and fulfilling sexuality.”
They noted that the average preferred intercourse of duration of 23 minutes was not consistent with previous research and needed to be interpreted cautiously. It’s possible that the women were basing their preferences on what they believed to be the preference of their partners.
Past research has shown that sexual function is worse in women with PE partners when compared to women whose partners do not have PE. This study showed that about two-thirds of women had started having sexual problems while in a relationship with a PE man. However, sexual problems were also common in women who preferred sexual versatility and those who felt their partner was more focused on his PE than her needs. It appeared that the effects of PE on women were “more drastic” for those who wanted more variety in their sexual activities.
The authors acknowledged the following limitations:
• The assessment of men’s PE was based on the women’s perspectives, not on formal diagnoses.
• They were unable to find a causal relationship among their variables.
• There may have been some biases.
• Only 10% of the women were anorgasmic, which is not consistent with past research.
• Bisexual women were included and their sexual attitudes might be different.
In accordance with previous research, this study found a link between a man’s PE and relationship dissatisfaction in a female partner. Such dissatisfaction causes some women to end the relationship. However, women’s perceptions of PE in relation to their own sexuality varies greatly.
The authors suggested that clinicians consider the perspectives of female partners when treating men with PE.