Assessing premature ejaculation with a combination of objective and subjective measures is “necessary and appropriate,” according to the authors of a recent Journal of Sexual Medicine paper.
Results of the two approaches were comparable in their study.
Premature ejaculation is assessed in several ways. In objective approaches, a stopwatch is used during intercourse to measure the intravaginal ejaculatory latency time (IELT) – the time period between vaginal penetration and ejaculation.
Subjective approaches involve the use of patient-reported outcomes (PROs) such as the Index of Premature Ejaculation and the Premature Ejaculation Profile (PEP). For these tools, participants recall their premature ejaculation experiences over the previous four weeks. However, some experts question the accuracy and consistency of this recall.
Other subjective assessments, such as the Clinical Global Impression of Change (CGIC), are used to monitor progress. With this tool, patients can evaluate their treatment outcomes according to their own expectations and situations.
The current study investigated the assessment responses of men in a clinical trial of cligosiban. All of the participants had lifelong premature ejaculation, defined as an IELT of less than one minute during 75% of sexual encounters and poor ejaculatory control. Men with PE also have “negative personal consequences, such as distress, bother, frustration, and/or the avoidance of sexual intimacy” according to the definition provided by the ISSM. The men were randomly assigned to take cligosiban or a placebo.
The study began with a four-week introductory period, during which 84 participants (or their partners) measured IELT with a stopwatch during each intercourse and recorded the figure in an e-diary. The men also answered two questions about ejaculation control and ejaculation-related distress from the PEP. Following this period, the eight-week drug trial took place. Seventy men finished the study.
Participants completed the full four-item PEP every four weeks. At the conclusion of the study, they filled out the CGIC.
Overall, the researchers found “very high levels of consistency of responses” between the e-diaries and the PEP assessments.
“The results indicate that concerns that men with [premature ejaculation] cannot accurately recall their level of sexual functioning over the previous month are unfounded,” the authors wrote.
“Ejaculation control and ejaculation-related personal distress can be administered in either e-diary or 1-month recall formats with equivalent results,” they added.
They acknowledged that their study did not include men with acquired premature ejaculation (occurring after a period of normal sexual function), men without partners, and men who have sex with men.
Resources
The Journal of Sexual Medicine
Althof, Stanley, PhD, et al.
“Objective and Subjective Measures of Premature Ejaculation: How Closely Do They Correspond and How Well Are the Subjective Measures Recalled?”
(Full-text. Published online: February 20, 2020)
https://www.jsm.jsexmed.org/article/S1743-6095(20)30027-8/fulltext