Introduction

Learning objectives

Understand that premature ejaculation is defined by time, control, and impact, not just by speed.
Differentiate the lifelong form from the acquired form.
Know the general approach to evaluation and treatment.

2

Video lesson

3

Summary

What is it?

Premature ejaculation is a male sexual dysfunction characterized by ejaculation that occurs sooner than desired, with difficulty delaying it and negative consequences for the patient, such as frustration, worry, or difficulty in sexual relationships.

It is not defined by time alone

To understand it, three elements must be considered:

Ejaculatory latency + control over ejaculation + negative impact on the patient.

It can be

Lifelong

Present since the first sexual experiences.

Acquired

It appears after a previous period of ejaculatory function considered normal.

Evaluation

The sexual history is essential.

We should ask:

since when it has occurred;
frequency;
ability to delay ejaculation;
degree of distress;
relationship with the partner;
presence of erectile dysfunction;
other sexual or urologic symptoms.

Treatment

It may include:

education and counseling;
psychosexual strategies;
treatment of associated sexual problems;
topical anesthetics;
certain serotonergic drug treatments.

When erectile dysfunction is also present, it must be properly evaluated and treated.

Key concept

Ejaculating quickly on an occasional basis does not necessarily mean having premature ejaculation. Control, persistence, and impact on quality of life must be considered.

4

PDF

⬇ Download lesson summary

Downloadable PDF pending upload.

5

Practical algorithm

Problems achieving or maintaining an erection → erectile dysfunction.
Persistently too-rapid ejaculation + difficulty controlling it + negative impact → premature ejaculation.
Couple unable to conceive → evaluate both partners; in the man, start with history, examination, and semen analysis.
Scrotal venous dilation, predominantly on the left → consider varicocele.
Compatible symptoms + repeatedly low testosterone → evaluate for possible hypogonadism.
Acquired penile curvature + plaque → consider Peyronie's disease.

Andrology does not study sexual function alone. It integrates erectile and ejaculatory function, reproduction, hormonal function, and diseases of the male genital tract.

6

Clinical case

Content pending upload Progressive clinical case focused on decision-making.

7

Self-assessment

Questions pending upload 5–10 multiple-choice questions on this lesson.

8

References

Links pending upload References to PubMed, DOI, scientific society guidelines and journals.

Premature ejaculation