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. 2025 Jan 13;12(6):qfae086.
doi: 10.1093/sexmed/qfae086. eCollection 2024 Dec.

The value of 5-HT, leptin, and NE in the classification of premature ejaculation

Zhimin Chen  1   2   3 , Xiansheng Zhang  1   2   3
Affiliations

The value of 5-HT, leptin, and NE in the classification of premature ejaculation

Zhimin Chen et al. Sex Med. .

Abstract

Background: While premature ejaculation (PE) can be divided into lifelong PE (LPE), acquired PE, natural variable PE (NPE), and subjective PE (SPE), there is no objective method to classify PE.

Aim: To determine the value of serum serotonin (5-HT), leptin, and norepinephrine (NE) levels in the classification of PE.

Methods: From July 2023 to July 2024, we recruited 150 participants and divided them into 4 groups: LPE (43 cases), NPE (32 cases), SPE (35 cases), and non-PE (40 cases) groups. All participants' baseline data, premature ejaculation diagnostic tool score, and intravaginal ejaculation latency time were investigated. In addition, all participants' serum 5-HT, leptin, and NE levels were measured.

Outcome: Serum 5-HT, NE, and leptin levels were compared among all groups.

Results: Serum 5-HT levels were lower and NE and leptin levels were higher in the LPE group compared to the SPE, NPE, and non-PE groups (P < .05). However, serum 5-HT, leptin, and NE levels were not significantly different among the non-PE, NPE, and SPE groups (P < .05). In addition, serum 5-HT <95.0 ng/mL, NE >543.0 ng/L, and leptin >19.8 ng/mL may be predictive indicators of LPE.

Clinical significance: Based on serum 5-HT, NE, and leptin levels, LPE can be distinguished from SPE and NPE, which provides an objective basis for the treatment of PE.

Strengths and limitations: There is no effective method to classify PE. The main limitation of this study is the limited sample size.

Conclusion: The serum 5-HT, leptin, and NE levels in PE patients may contribute to the classification of PE.

Keywords: leptin; norepinephrine; premature ejaculation; serotonin.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Classification criteria for the 4 types of PE. Abbreviations: ED, erectile dysfunction; IELT, intravaginal ejaculatory latency time; LPE, lifelong PE; NPE, natural variable PE; PE, premature ejaculation; SPE, subjective PE.
Figure 2
Figure 2
The evaluation of serum indicators in the classification of PE. Notes: ROC curves of serum (A) leptin, (B) 5-HT, and (C) NE levels. The sensitivity of diagnosing LPE and the specificity of diagnosing PPE were calculated. Abbreviations: AUC, area under the ROC curve; LPE, lifelong PE; NE, norepinephrine; PE, premature ejaculation; PPE, psychogenic PE; ROC, receiver operating characteristic; 5-HT, serotonin.
See this image and copyright information in PMC

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