While premature ejaculation (PE) has been the focus of much medical research, less is known about other types of ejaculatory disorders. A recent study by a team of U.S. scientists reveals that such disorders are common and, for over two-thirds of men, quite distressing.
The study was the first of its kind to examine the prevalence, severity, and distress of ejaculatory disorders other than PE in a group of community-dwelling men.
The researchers examined data from 988 men who had been screened for a study of testosterone replacement therapy in men with ejaculatory disorders (other than PE) and low testosterone.
The participants had at least one of the following disorders:
• Delayed ejaculation (DE) – taking “too long” to ejaculate
• Anejaculation (AE) – unable to ejaculate at all
• Perceived ejaculate volume reduction (PEVR) – ejaculating a smaller amount of semen than before
• Decreased force of ejaculation (DFE) – ejaculating with reduced force
Validated questionnaires were used to assess sexual function, satisfaction, enjoyment, and distress.
Eighty-one percent of the participants were between the ages of 40 and 70 years. The overall mean age was 52 years. Almost a third were obese and just over three-quarters had eugonadal testosterone levels of at least 10.4 nmol/L.
The most common ejaculatory disorder was PEVR, which affected 88% of the participants. DFE, DE, and AE affected 81%, 62%, and 37% of the men respectively. Eighty-eight percent of the men had more than one of the ejaculatory disorders.
Rates of PEVR and DFE were higher in men over age 60, possibly because of the effects of aging on penile nerve afferents. Age was not associated with DE or AE. Obese men were more likely to have DFE.
Prevalence of all four ejaculatory disorders was higher among black men when compared to white men. “This is a novel finding that needs further exploration in a more generalized population of men,” the authors wrote, noting that culture, partner expectations, and length of relationships could all be influencing factors.
In addition, most of the men with ejaculatory disorders had normal testosterone levels. The researchers explained that ejaculation is a complicated process. Several mini-events need to occur and any problems along the way could lead to ejaculatory disorders, even if a man has normal testosterone.
Sixty-eight percent of the men described their ejaculatory issues as bothersome. Many were dissatisfied with intercourse or didn’t enjoy it.
The authors recommended that healthcare providers ask their patients about ejaculation when evaluating sexual function.
The study was first published online in October in The Journal of Sexual Medicine.
The Journal of Sexual Medicine
Paduch, Darius A., MD/PhD, et al.
“Clinical and Demographic Correlates of Ejaculatory Dysfunctions Other Than Premature Ejaculation: A Prospective, Observational Study”
(Full-text. First published online: October 29, 2015)