A lifespan perspective on lifelong premature ejaculation: unresolved issues and new insights.

Background: Despite the numerous studies dealing with lifelong premature ejaculation (LPE), significant issues remain unresolved, including the age of onset relative to sexual debut, its constancy or variation over the lifespan, how it is affected by foreplay, and whether it is altered by different types of partnered sexual activities and/or masturbation. Aim: To describe lifespan changes in PE symptomology in men with LPE.

Method: Using a retrospective-current analysis, from an online sample of 409 men with PE, 160 identified as specifically having LPE. Data regarding PE symptomology-including lack of ejaculatory control, foreplay time and estimated ejaculation latencies (ELs) at sexual debut and currently, and other sexual characteristics-were collected to better describe and understand PE lifespan patterns in this group of men.

Outcomes: Foreplay and EL comparisons between sexual debut and the present time, as well as EL comparisons across different types of sexual activities, including masturbation.

Results: Men with LPE showed strong consistency in foreplay duration and ELs ever since their sexual debut. 77% indicated no change in their PE, 18.6% reported worsening of their PE, and 2% indicated improvement since sexual debut, with only the frequency of partnered sex showing any association with the above patterns. LPE men showed some variation in ELs across different types of partnered sexual activities, and also in comparison with masturbation.

Clinical implications: Men with LPE show remarkable consistency in their short ELs with the passage of time and across different sexual activities; however, variation in EL does appear to be mildly-moderately linked to different kinds of sexual stimulation in some LPE men.

Strengths and limitations: This study is the first of its kind to adopt a retrospective-current strategy to explore lifespan changes in PE symptomology in men with LPE. Limitations may include reliance on recall of events surrounding men's sexual debut, as well as the use of social media to recruit respondents, which likely results in age, education, and socioeconomic status bias.

Conclusion: Men with LPE show typically normal foreplay duration, along with estimated ELs of 1-2 min, both of which are consistent over their lifespan. Mild to moderate variation in ELs was associated with specific types of sexual activity, including masturbation.