The clinical profile of men with premature ejaculation at presentation has changed over the last fifteen years: picture from a longitudinal study

Abstract

We aimed to assess the clinical characteristics of patients presenting for premature ejaculation (PE) as their primary medical complaint over a 15-year time frame. Data from 257 men seeking first medical help for life-long PE between 2008 and 2022 were analysed. Clinical data and serum hormones were collected in each case. At baseline all patients completed the International Index of Erectile Function (IIEF), the Beck Depression Inventory (BDI), and the Premature Ejaculation Diagnostic Tool (PEDT). Descriptive statistics and linear regression analyses were applied. Median (IQR) age at presentation was 32 (26-37) years, and PEDT, BDI and IIEF-Erectile Function (IIEF-EF) scores were 14 (11-17), 7 (1-11) and 19 (10-26), respectively. Of all, 182 (70.9%) patients reported some degree of erectile dysfunction according to IIEF-EF domain scores. Throughout the 15-year time frame, patient's age at presentation significantly decreased over time (beta -0.4, p < 0.001). In details, patient's age at presentation decreased by 1 year every two years of evaluation. Furthermore, depressive symptoms (beta -0.8, p < 0.001) and the severity of PE at presentation as scored with the PEDT (beta -0.5, p < 0.001) linearly decreased overtime. According to a 5-year group subdivision, age at presentation decreased from 2008-2012 to 2013-2017 (p = 0.04) and further decreased between 2018 and 2022 (p = 0.01). Similarly, baseline BDI scores significantly decreased from 2008-2012 to 2018-2022 (all p < 0.001). PE severity at first assessment was stable between 2008-2012 and 2013-2017 but decreased thereafter (p < 0.01). Patients in a steady couple relationship more frequently asked for medical attention for PE between 2018-2022 compared to 2013-2017 and 2008-2012 (72.0% vs. 43.8% vs. 51.6%, p < 0.001). In conclusion we showed that patients' age has decreased over the last 15 years in men with life-long PE. PE severity and depressive symptoms at presentation showed a significant decline overtime. Men in a steady sexual relationship were more likely to seek medical attention for PE in recent years.