Are the Criteria for the Diagnosis of Premature Ejaculation Applicable to Gay Men or Sexual Activities Other than Penile-Vaginal Intercourse?. Issue 3 (24th April 2022)

• Record Type: Journal Article
• Authors: McNabney, Sean M.; Weseman, Claire E.; Hevesi, Kriszta; Rowland, David L.
• Is Part Of: Sexual medicine. Volume 10:Issue 3(2022)
• Page Start: 1
• Page End: 13
• Publication Date: 2022-04-24
• Subjects: Premature Ejaculation -- Gay -- Homosexual -- Ejaculatory Control -- Distress/Bother -- Diagnostic Criteria; Sexual disorders -- Periodicals; Sexual health -- Periodicals; 616.69005
• DOI: 10.1016/j.esxm.2022.100516
• Languages: English
• ISSNs: 2050-1161

Abstract

Abstract: Introduction: The criteria for premature ejaculation (PE) have generally been limited to the diagnosis of heterosexual men engaging in penile-vaginal intercourse and therefore the applicability of PE diagnostic criteria to gay men and to activities beyond penile-vaginal intercourse has yet to be explored in depth. Aim: To compare the prevalence of PE in gay and straight men and to assess whether PE-related diagnostic measures (ejaculatory control, ejaculation latency [EL], and bother/distress) can be applied with confidence to gay men or to men engaging in sexual activities other than penile-vaginal intercourse. Methods: Gay and straight participants ( n = 3878) were recruited to take an online survey assessing sexual orientation, sexual function/dysfunction (including specific PE-related measures), sexual relationship satisfaction, and various other sexual behaviors during partnered sex or masturbation. Outcomes: Comparison of ejaculatory control, EL, and bother/distress across gay and straight men, as well as across different types of sexual activities. Results: A slightly lower PE prevalence among gay men became undetectable when other predictors of prevalence were included in a multivariate analysis (aOR = 0.87 [95% CI: 0.60–1.22]). Gay men with PE reported longer typical ELs (zU = -3.35, P < .001) and lower distress (zU = 3.68, P < .001) relative to straight men, but longer ELs and lower distress were also associated with anal sex. Clinical Translation: Clinicians can feel confident about using existing criteria for the diagnosis of PE in gay men but should be aware of potentially longer ELs and lower PE-related bother/distress—probably related to the practice of anal sex—compared with straight men. Strengths and Limitations: Although well-powered and international in scope, this study was limited by biases inherent to online surveys, the lack of a sizable sample of bisexual men, and a lack of differentiation between men with acquired vs lifelong PE. Conclusions: Irrespective of sexual orientation, gay and straight men with PE reported shorter ELs, lower satisfaction, and greater bother/distress than functional counterparts. While PE-related diagnostic criteria (ejaculatory control, EL, and bother/distress) are applicable to gay men, accommodation for longer ELs and lower bother/distress in gay men should be considered.