The definition of premature ejaculation (PE) remains controversial. Currently, international sexual medicine societies classify PE into four types: lifelong PE, acquired PE, situational PE, and PE-like ejaculatory dysfunction. Lifelong PE refers to ejaculation that consistently occurs within one minute of vaginal penetration, starting from the individual's first sexual encounter. Acquired PE refers to a significant reduction in ejaculation latency, typically occurring within three minutes, after a period of previously normal ejaculatory function. Both forms are characterized by poor control over ejaculation, an inability to delay ejaculation during vaginal penetration, and negative psychological and emotional impacts, such as distress, anxiety, frustration, and/or avoidance of sexual intimacy. The prevalence of lifelong and acquired PE is estimated to be approximately 2–5% and 20–30%, respectively.
The etiology of PE remains unclear, though it is widely considered to be associated with psychological factors such as anxiety, heightened penile sensitivity, and dysregulation of serotonin (5-HT) receptor function. PE may also be influenced by other conditions, including erectile dysfunction (ED), prostatitis, and hyperthyroidism.
The treatment of PE involves addressing its underlying causes. This includes eliminating triggering factors, working closely with a partner, and using sensate focus exercises to overcome misconceptions about sexual behavior, reduce feelings of guilt, and restore natural sexual responses. Using condoms during intercourse or applying lidocaine sprays or ointments to the penis to reduce penile sensitivity may help prolong the ejaculation latency period. In recent years, oral selective serotonin reuptake inhibitors (SSRIs), such as dapoxetine, have been used to treat PE, achieving favorable outcomes.