Operationalizing premature or rapid ejaculation - Statistical Data Included

Journal of Sex Research, Nov, 2001 by Guy Grenier, E. Sandra Byers

Premature or rapid ejaculation (RE) is widely believed to be the most common male sexual dysfunction and has been shown to have a substantial negative impact on men's sexual relationships (Metz, Pryor, Nesvacil, Abuzzahab, & Koznar, 1997; Rowland, Cooper, Slob, & Houtsmuller, 1997). Nonetheless, methodological difficulties in RE research, most notably the inconsistency in operational definitions, have prevented a full understanding of this phenomenon (Grenier & Byers, 1995, 1997). RE research has, for the most part, made the (untested) assumption that the various operational definitions that have been used (e.g., ejaculatory latency, perceived ejaculatory control, number of intravaginal thrusts) all measure the same phenomenon and thus are interchangeable. Further, researchers have largely used these criteria to dichotomize men on the basis of whether they do or do not have RE, creating additional methodological difficulties related to arbitrary and inconsistent cut-off points.

Grenier and Byers (1997) surveyed the ejaculatory behavior of 110 heterosexual college men using the five most commonly employed measures of RE: ejaculatory latency, perceived ejaculatory control, concern over ejaculating more rapidly than desired, satisfaction with ejaculatory control, and the percentage of antiportal ejaculation. In order to determine the extent to which they are related, they assessed these criteria as continuous rather than as dichotomous predictors. They found that the RE criteria were only modestly related, sharing between 2% and 46% (M = 10%) of their variance, challenging the assumption that the various RE criteria are interchangeable. However, these results were based on a sample of university men who were fairly homogeneous in age, sexual experience, and frequency of intercourse. This was unfortunate as each of these variables has been etiologically linked with RE. For example, a number of theorists have suggested that younger, less sexually experienced men ejaculate faster than older, more sexually experienced men (Reinisch & Beasely, 1990; Ruff & St. Lawrence, 1985). However, these associations remain to be empirically demonstrated. Similarly, although a lower frequency of intercourse has been theoretically linked with RE (Gospodinoff, 1989; Williams, 1984), the empirical support for these associations is inconsistent. Spiess, Geer, and O'Donohue (1984) found that greater periods of sexual abstinence were positively correlated with shorter ejaculatory latencies, whereas other researchers have found no such association (Rowland, Strassberg, de Gouveia Brazao, & Slob, 2000; Strassberg, Kelly, Carroll, & Kircher, 1987).

The present study replicated and extended the findings of Grenier and Byers (1997) by investigating the relationships between various RE criteria in a more heterogeneous sample of heterosexual men, using a much larger sample than is typical of RE investigations. We assessed the five RE criteria that are most frequently found in the literature, albeit usually as dichotomous criteria, and that were also assessed by Grenier and Byers (1997): (a) latency to ejaculation after intromission, (b) control over the occurrence of ejaculation, (c) concern about ejaculating too soon, (d) (dis)satisfaction with the ability to select the moment of ejaculation, and (e) the occurrence of antiportal ejaculation. In addition we assessed two other continuous RE criteria which are used less frequently in the RE literature: (f) the percentage of intercourse experiences in which ejaculation occurs sooner or faster than desired, and (g) the percentage of intercourse experience in which specific attempts are made to delay ejaculation and prolong intercourse.

Research on RE has used objective criteria to place men into RE and non-RE groups but has failed to simultaneously query men about their perceptions of their RE status. Consequently, little is known about the aspect(s) of ejaculatory behavior that men use to identify themselves as experiencing a problem or difficulty with RE and/or to seek help for RE. Nor has the impact of having a self-identified RE problem been studied in men who have not sought therapy. Therefore, we also examined (h) men's self-identification as having an RE problem.

The following research questions were addressed in this study:

1. How do estimates of the prevalence of RE based on different dichotomous definitions of RE found in the literature compare to each other?

2. How do these estimates compare to estimates of RE based on having a self-identified RE problem?

3. What is the degree of overlap among the RE criteria when they are used as continuous variables?

4. What are men's perceptions of the impact of RE on their self-esteem, sexual pleasure, sexual relationship quality, overall relationship quality, and avoidance of sexual intercourse.

Although erectile dysfunction (ED) was not a focus of this study, we also examined the prevalence of ED, the overlap between ED and RE, and the impact of ED on men's self-esteem, sexual pleasure, sexual relationship quality, and overall relationship quality.