The medical literature concerning premature ejaculation is difficult to follow. It is extremely technical but it makes no sense that it should be that way. In this blog post, I’m going to summarize the 4 types of PE so you can try to determine which type you may have. In the near future, I’ll write about treatment options for each PE type.
This article, “An Evidence-Based Uniﬁed Deﬁnition of Lifelong and Acquired Premature Ejaculation: Report of the Second International Society for Sexual Medicine Ad Hoc Committee for the Deﬁnition of Premature Ejaculation“, publish by The International Society for Sexual Medicine (ISSM) Ad Hoc Committee for the Deﬁnition of Premature Ejaculation, is the latest (2014) document to describe premature ejaculation in a way that a doctor can more effectively develop a treatment path.
Lifelong Premature Ejaculation
Most of you guys out there are saying to yourself. That’s me. I’ve had this my entire sexually active life. But I don’t think their definition aligns with the way most guys think of their condition. Here it is:
Lifelong PE is a male sexual dysfunction characterized by the presence of all of these criteria: (i) ejaculation that always or nearly always occurs prior to or within about 1 minute of vaginal penetration; (ii) the inability to delay ejaculation on all or nearly all vaginal penetrations; and (iii) negative personal consequences such as distress, bother, frustration, and/or the avoidance of sexual intimacy.
Why the 1 minute? My research says that most guys with PE have had it their entire adult lives and are above the 1 minute time. And they have plenty of anxiety, distress, etc. because of the condition. Instead, they should call this “Severe Premature Ejaculation”
Acquired Premature Ejaculation
A small percentage of guys with PE acquire the condition later in life. To me, this is the more worrisome case because it may be caused by another health issue: hyperthyroidism, low testosterone, prostate issues, and erectile dysfunction. But why they add a time to this ( less than 3 minutes) makes no sense. Although I do agree with the name “Acquired” because if you do acquire PE later is life, you really should see a doctor.
Variable Premature Ejaculation
This one doesn’t make sense to me. In my personal experience, research and discussion with my readers, you either got it your don’t. Sure, sometimes I can go longer. But that’s the exception not the norm. And when I am able to last longer it’s because used start/stop or squeeze or some behavioral method to get myself to some state where I could last longer. I just didn’t naturally go longer one time vs. the other without some intervention. I think the reason this even exists is for the guy who typically last an average time (6 minutes) but, for whatever reason, occasionally ejaculates early and gets freaked out. I think true variable PE is a really small percentage of guys, and guys that ejaculate early sometimes should fall into the Subject PE category.
Subjective Premature Ejaculation
Subjective PE is the case where you may last less than normal (6 minutes) or even more than normal, but you are very unhappy with your sexual performance. I think that most men on the planet have Subjective Premature Ejaculation. They don’t last as long as they would like and, unfortunately, we put an embarrassing label on it.
My Premature Ejaculation Types
- Severe Premature Ejaculation – You last from 0 -2 minutes. You have a hypersensitive penis. Maybe low serotonin. Try an over-the-counter delay spray. They work for lots of Severe PE guys. Use a lot of sprays. If it doesn’t work, go see a urologist group that has a sexual medicine specialist.
- Regular Premature Ejaculation – You last 2-4 minutes. A delay spray is definitely the way to go. No need for SSRIs and their side effects.
For guys that last 4+ minutes, let’s not call in premature ejaculation. Let’s just say that you want to “last longer in bed”.
IMPORTANT: If you have acquired PE later in your adult life, go see a doctor. You may have a medical issue that you should determine.