Ejaculation delay: what's normal?
Bandolier 69 and 128 examined treatments for premature ejaculation. The results showed that antidepressants, and particularly SSRIs, were useful treatments for premature ejaculation. SSRIs with specific licenses for premature ejaculation are now tested and may be becoming available, so the issue of what is normal (as opposed to desirable) is going to be asked. A multinational survey  helps.
The study was conducted in five countries, the Netherlands, Spain, Turkey, UK and USA, each with 70 to 130 couples in stable heterosexual relationships of at least six months, giving a total of 491 couples. Participants were instructed on the use of stopwatches and measurement of intravaginal ejaculatory latency time (IELT). This was defined as the time between the start of vaginal intromission and the start of intravaginal ejaculation.
IELT was to be measured over a four-week study period. Information was also collected on age, circumcision and condom use. The mean IELT over the four week period was calculated for each man.
There were 491 men with an age range of 19 to 73 years (mean 40 years). The distribution of age was 31% aged 18-30 years, 46% age 31-50 years, and 23% aged over 50 years. There were 4,000 completed sexual events, with a mean frequency of eight events per couple over four weeks.
Intravaginal ejaculatory latency time varied between 30 seconds to 44 minutes, with a median IELT of 5.4 minutes (Figure 1). Within country differences ranged from 3.7 minutes in Turkey to 7.6 minutes for the UK. The distribution is shown in Figure 1. The distribution in average IELT for individual men was highly skewed. About 14% of men had an average IELT below 200 seconds, and 26% an IELT above 600 seconds. The 0.5 and 2.5 percentiles were calculated at 0.9 and 1.3 minutes, respectively.
Figure 1: Distribution of mean individual four-week intravaginal ejaculatory latency time in 491 men aged 19 to 73 years in five countries
There was no significant difference associated with circumcision, though men from Turkey were excluded as all these men were circumcised. There was no difference related to condom use. Older men had a lower average IELT than younger men (Figure 2).
Figure 2: Median Intravaginal ejaculatory latency time by age
Drug treatments for premature ejaculation are likely to become available in the next few years, and some men with premature ejaculation are probably being treated now. Available treatments include local anaesthetic creams, for which there is limited evidence, and which have a risk of desensitisation for female partners when used without a condom.
Drugs with licenses for premature ejaculation are being researched, and may have a license in some countries before long. This will mean interesting decisions about provision by health services. It is also likely to mean a flood of people approaching their doctors for a new treatment for what will look like a newly treatable condition. Good international data on what is normal rather than desirable provides a basis on which decisions can be made.
- MC Waldinger et al. A multinational population survey on intravaginal ejaculation latency time. Journal of Sexual Medicine 2005 2: 492-497.