Men with delayed ejaculation report lower sexual satisfaction and more depressive symptoms than those with premature ejaculation: findings from a cross-sectional study.

Abstract

Delayed ejaculation (DE) is among the most challenging male sexual dysfunctions. We aim to explore and compare socio-demographic and clinical characteristics of men with self-reported DE and primary premature ejaculation (PE). Data from 555 consecutive men seeking first medical help for DE or primary PE were retrospectively analyzed. Socio-demographic, clinical, laboratory data, and self-reported symptoms of anxiety and depression were collected. Patients completed International Index of Erectile Function (IIEF) and Beck Depression Inventory (BDI). We excluded men who had undergone pelvic surgery. Descriptive statistics compared clinical and socio-demographic characteristics. Linear regression models tested the association between depressive symptoms and baseline IIEF domain scores among men with DE. Of 555 patients, 479(86.3%) and 76(13.7%) had PE and DE, respectively. Men with DE were significantly older than those with PE [47(34-63.5) vs. 44(33-53), P = 0.01]. Conversely, men with PE depicted a CCI ≥ 1 more frequently compared to those with DE [17(22.4%) vs. 53(11.1%); P = 0.01]. The two groups did not differ regarding relational status, BMI, waist circumference, and hormonal milieu. Men with DE reported more frequently symptoms referable to anxiety and depression (P = 0.001) along with higher median (IQR) baseline BDI scores [8(4.8-14.3) vs. 6(2-10); P = 0.01], lower median IIEF-orgasmic function (OF) [6(5-9) vs. 9(6-10); P = 0.003] and IIEF-sexual desire (SD) [7(5.8-8) vs. 8(6-9); P = 0.001] domain scores compared to men with PE. At linear regression analysis, in men with DE, the higher the BDI score the lower the IIEF-overall satisfaction [β = -1.57, CI(-2.60, -0.53), P = 0.004], and the lower the IIEF-intercourse satisfaction [β = -0.76, CI(-1.29, -0.16), P = 0.01] domain scores. Conversely, no association between BDI and IIEF-OF, -SD, and -erectile function domain scores were found. Of men complaining of ejaculatory disorders, one out of ten reports DE. Patients with DE have higher chances to report clinically significant depression which can significantly impact their overall sexual satisfaction.