Perception of normal and treatment level ejaculatory latency times in men with premature ejaculation

Abstract Background Although the normal intravaginal ejaculation latency time (NIELT) as subjectively perceived by patients with premature ejaculation (PE) and expected IELT (EIELT), which represents the individual’s expectations of what treatment for PE would achieve, are critically influential in the treatment of patients with PE, there is a significant dearth of exploratory research on NIELT and EIELT among patients with PE. Aim To explore the NIELT and EIELT of patients with PE, understand why patients with PE perceive such a long IELT as normal, and identify factors associated with EIELT. Methods We recruited both patients with PE and control subjects, and analyzed the parameters related to IELT using detailed interviews and questionnaires. Outcomes Parameters related to IELT. Results A total of 592 individuals (mean age 29.6 ± 6.2) were included in the study, comprising 466 patients with PE (mean age 28.3 ± 5.4) and 126 non-PE individuals (mean age 34.6 ± 6.5). The actual perceived intravaginal ejaculation latency time (PIELT), referring to the patient’s self-assessed IELT at baseline, as well as NIELT, and EIELT of patients with PE, were 1.0 (1.0 − 2.0), 14.0 (10.0 − 15.0), and 15.0 (10.0 − 20.0), respectively. The control group’s PIELT and EIELT were 15.0 (10.0 − 20.0) and 20.0 (15.0 − 24.3), respectively, showing statistical differences compared with the PIELT and EIELT in the PE group. In the PE group and the control group, 31.5% and 57.9% of individuals, respectively, have an EIELT greater than the average actual normal ejaculatory latency time of 15.0 minutes. Among patients with PE, 51.3% expressed a NIELT >10 minutes, identical to the EIELT in a higher percentage (59.4%). The control group’s EIELT is 5 minutes longer than the PE group’s EIELT. Multivariable linear regression analysis showed that age, marital status, education level, BMI, satisfaction evaluation of PIELT, PEDT score, and IIEF-6 score were not associated with EIELT; only NIELT (beta = 0.817, P < 0.001) and PIELT (beta = 0.056, P = 0.044) were related to EIELT. Clinical implications Sexual health care providers should be aware that patients with PE have excessively high expectations for IELT. Strengths and limitation The first study explores why patients with clinically diagnosed PE perceive long IELT as normal and examines factors associated with EIELT. Further validation is needed in different cultural contexts. Conclusion Patients with PE often have excessively high expectations regarding IELT, primarily due to their insufficient understanding of IELT.