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Type of PE
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Criteria
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primary
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never normal (PE from earliest coital experience)
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secondary
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previously normal
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Conditions that may cause secondary premature ejaculation:
(1) medication-related
(2) alcohol or drug abuse related
(3) spinal cord injury or consequence of pelvic trauma
(4) inflammatory condition of male genital tract (urethra, prostate, etc) with loss of ejaculatory control
(5) psychological (associated with anxiety, depression or obsessive-compulsive behavior)
(6) conditioning or learned response (associated with a protracted period when it was deemed necessary to achieve a rapid ejaculation)
(7) prolonged period of decreased sexual frequency
Sometimes no cause is found (idiopathic). These can be difficult to treat. Continued followup may be able to identify a cause that was not initially evident.
Factors that impact the timing of ejaculation (contributory factors):
(1) general decline in the patient's level of sexual interest (with PE as an associated finding)
(2) lack of sexual interest in partner (which may be the cause for trying to achieve rapid ejaculation in #6 above)
