PREMATURE EJACULATION - A PSYCHOPHYSIOLOGICAL REVIEW

This review examines the most common male sexual dysfunction, prematur e ejaculation (PE), The prevalence, classification, neurophysiology, n europharmacology, and psychological studies that offer evidence useful for understanding and clinically evaluating PE are reviewed, It is pr oposed that there are two basic kinds of PE: biogenic and psychogenic, Studies reporting pharmacological aspects of ejaculation offer some s uggestions regarding the mechanisms of ejaculation as well as possible pharmacologic aid for some premature ejaculators. The traditional ass umption among sex therapists that PE is almost universally caused by p sychological features, and easily treated with sex therapy behavioral techniques, is drawn into question, Based on the limited available res ults from systematic investigations, behavioral treatments for PE rema in beneficial to only a minority of men three years after treatment en ds, suggesting that this male dysfunction is difficult to treat effect ively. The mediocre results reported in treatment outcome studies may be due, in part, to reports on heterogeneous groups of premature ejacu lators, for whom treatment has been generalized rather than targeted t o the specific type of PE, We propose a biological and psychological e tiology, With more discriminating assessment and more specific diagnos is of PE, and with treatment designed to address the particular type o f PE, long-term outcome should improve for this common sexual dysfunct ion.