Assessing personality traits and attitudes might help clinicians better understand and treat men with premature ejaculation (PE), suggests new research in the Journal of Sexual Medicine. 

In general terms, premature ejaculation occurs when a man ejaculates before he wishes to. The International Society for Sexual Medicine (ISSM) defines PE with three criteria:

• Ejaculation always or nearly always occurs prior to or within one minute of vaginal penetration from a man’s first sexual experience (lifelong PE). Or, there is a clinically significant and bothersome reduction in latency time, often about 3 minutes or less (acquired PE).
• The inability to delay ejaculation occurs on all or nearly all vaginal penetrations.
• The situation has negative personal consequences, such as distress, bother, frustration, and/or the avoidance of sexual intimacy.

For this study, the authors considered four types of PE:

• Lifelong PE – occurring consistently throughout a man’s life
• Acquired PE – occurring consistently after a period of normal ejaculation
• Variable PE – occurring inconsistently
• Subjective PE – occurring as a “subjective perception.” The man believes he has PE, but his time between penetration and ejaculation is in the normal range.

Personality and attitudes have not been widely studied in the context of PE, the authors said. However, in their experience, both concepts can affect a patient’s experience with PE.

“In our clinical work, we found that personality characteristics are an important influencing factor of PE and the attitude toward PE can be used as a true reflection of the patient’s own needs during the treatment of PE,” they wrote.

They interviewed 350 heterosexual men with PE who were seen at their practice in China between December 2018 and December 2019. All of the men had been in monogamous relationships with their female partners for at least six months. Their mean age was 41 years.

A control group of 252 men without PE also participated.

Researchers used the Index of Premature Ejaculation (IPE) to assess ejaculatory function, control, and distress.

In addition, they used the Temperament and Character Inventory-Revised (TCI) tool to assess personality. The TCI addresses four aspects of temperament [novelty-seeking, harm avoidance, reward dependence, and persistence] as well as three aspects of character [self-directedness, cooperativeness, and self-transcendence.(Self-transcendence was defined as a “state of unified consciousness” in which “the boundary between the individual’s self and the surrounding environment becomes very blurred, and the individual becomes part of the whole.)]

Attitudes about PE were explored through questions on reasons for seeking help, influencing factors, and the role of partners in treatment.

Among men with PE, the acquired form was most common, affecting 45% of the men. Lifelong PE, variable PE, and subjective PE were reported by 18%, 14%, and 23% of the men, respectively.

Temperament and Character

TCI scores revealed the following:

• Compared to the men without PE, men with PE had lower scores in the novelty-seeking and self-transcendence domains and higher scores on harm avoidance
• Men with variable PE had the highest harm avoidance and lowest novelty-seeking scores.
• Men with lifelong PE had the lowest self-transcendence scores.

Attitudes Toward PE 

• Most of the men sought treatment for PE because of their own dissatisfaction or the combined dissatisfaction for them and their partner.
• Just over half said that their inability to control ejaculation was the factor with the “greatest influence.”
• About 58% rated their partner’s role in treatment decisions as “very important.” Only 8% said it was “not very important.”

The authors concluded that men with PE “tended to react with indifference or rejection to novelty, tended to feel unsatisfied, cannot effectively adapt to changes in the surrounding environment, and tended to avoid situations involving risk.”

Clinicians should consider these characteristics when treating men with PE, they added.

They recommended more research, especially in men from other areas of the world.

Resources

• The Journal of Sexual Medicine - “Temperament-Character Traits and Attitudes Toward Premature Ejaculation in 4 Types of Premature Ejaculation”
  Gao, Pan, MM, et al.
  (Full-text. Published: December 15, 2020)
  https://www.jsm.jsexmed.org/article/S1743-6095(20)31044-4/fulltext