Premature ejaculation (PE) is not always the easiest condition to talk about. While it’s extremely common – around 30% of men are affected to some degree, and it’s the most prevalent sexual disorder in men under 40 – it’s probably not something you’ll be discussing round the watercooler the next morning.
Perhaps less obviously, it’s also a difficult condition to define. Sex is different for everyone, and there are no hard and fast rules (pun intended) about when orgasm should arrive.
“The truth is that the time between penetration and ejaculation varies not only from man to man, but from one time to the next for the same man.”The Kinsey Institute
What is premature ejaculation?
In simple terms, PE occurs when a man orgasms soon after the start of sex, or even before sex begins. While this happens to most guys every once in a while, it may be a source of distress if it happens all the time.
Experts divide PE into two main categories: primary (lifelong) and secondary (acquired). Those with primary PE have dealt with the problem since puberty, whereas those with secondary PE have developed it at a later stage in their lives.
Contrary to popular belief, it’s rare that a man can go all night. As a ballpark figure, the average man lasts around five and a half minutes once sex gets underway, and what constitutes ‘normal’ is a wide range. The average also varies depending on how old you are, and where you are in the world.
However, men with PE tend to fall on the speedier end of the spectrum. In one 1998 study, 110 men with lifelong PE timed themselves during sex. Eighty percent of them lasted less than 30 seconds, and only 10% lasted more than a minute. The researchers suggested that PE might be defined as lasting less than a minute, more than 90% of the time.
Finding a definition
Over the years, there have been many attempts to develop a reliable definition of PE. They tend to refer to two factors: how long a man usually lasts, and how he feels about it. (After all, if PE isn’t a problem for you, it’s hard to argue that it’s a problem.)
Most allude to the ‘intravaginal ejaculation latency time’, or IELT. If you’re having sex with a woman, this is the time between vaginal penetration and orgasm. Unfortunately, research on PE among gay men is quite limited, and the definition doesn’t cover other things you might do in bed, such as oral sex. This highlights just how tricky it can be to establish a definition that works for everyone.
Many of the early definitions were vague, referring to ‘short ejaculation time’ or perceived lack of control. This lack of clarity wasn’t helpful to researchers, and even less to men seeking a diagnosis.
The ISSM definition
In 2007, the International Society of Sexual Medicine (ISSM) attempted to settle the question for once and for all, by developing the first evidence-based definition of lifelong PE. Their current definition, developed in 2013, includes acquired PE too. Its criteria are as follows:
- An IELT less than a minute (lifelong PE) or a reduction to less than three minutes (acquired PE)
- The inability to delay ejaculation
- Negative personal consequences, such as frustration or avoiding sex.
The definition is worded in a way that intentionally gives doctors some wiggle room. For instance, if you tend to last around two minutes, and always have done, you could still be diagnosed with lifelong PE.
Even here, the definition of PE is open to question. While measuring the IELT is all well and good, you probably don’t take a stopwatch into bed with you, and your partner is unlikely to keep score of whether you lasted three minutes or two minutes and 59 seconds. Clearly, that the exact time to orgasm isn’t the be-all and end-all.
There is also some dispute about whether men with PE truly have less ‘control’ than other guys. In fact, some studies have suggested that IELT and control are relatively independent factors, meaning you might orgasm before you want to, even if you last a while.
On top of that, many men who are worried about PE don’t necessarily meet the definition. For instance, you might struggle with symptoms of PE some of the time, and ejaculate normally the rest of the time. This is known as ‘variable PE’, and some researchers believe it counts as a subtype in its own right.
The Premature Ejaculation Profile
Another way of assessing PE is via the Premature Ejaculation Profile (PEP). This is a questionnaire covering four areas:
- perceived control over ejaculation
- personal distress related to ejaculation
- interpersonal difficulty related to ejaculation
- satisfaction with sexual intercourse.
Although it only measures the subjective aspects of the problem, there is a strong correlation between lower PEP scores and faster ejaculation times.
While the PEP is not meant as a diagnostic tool, it does cover the most important part of PE – namely how you feel about it. After all, if you’re ejaculating before you want to, and it’s damaging your sex life, that’s a problem whether or not you fit the diagnostic criteria. For many guys, PE is associated with an immense amount of frustration, along with concerns (often unfounded) about letting their partner down. It’s worth getting help on that basis alone, whatever the other specifics.
Don’t sweat it
As should be clear by now, there isn’t yet a perfect definition of PE. According to researchers writing in 2016: “PE is a complex condition, which still remains incompletely characterised despite advances in our understanding over the last decade. As a consequence, the ability to define and classify the condition has been difficult.”
The good news is that PE is fairly easy to treat, be that through behavioural strategies or medication. If you’re worried, make sure to seek medical help – and know that you’re far from the only one in this position. You can start your consultation here to see if you’re eligible for Priligy, a prescription-only medicine for PE that has been shown to make sex last twice as long.