What is the role of biochemistry in the pathophysiology of premature ejaculation (PE)?

Updated: Jan 15, 2019
  • Author: Samuel G Deem, DO; Chief Editor: Edward David Kim, MD, FACS  more...
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Other questions have been raised regarding possible biochemical components of premature ejaculation. Testosterone is thought to play a role in the ejaculatory reflex. Higher free and total testosterone levels have been demonstrated in men with premature ejaculation than in men without premature ejaculation. [9]

Research published in a Chinese andrology journal showed that semen from men with premature ejaculation contained significantly less acid phosphatase and alpha-glucosidase than did the semen of control subjects. [10] The researchers concluded that these biochemical parameters may reflect dysfunction of the prostate and epididymis, possibly contributing to premature ejaculation; however, their conclusions have yet to be supported by subsequent studies.

A study by Corona et al found that many men with premature ejaculation have low serum prolactin levels. [11] However, this same study found that men in the lowest quartile of serum prolactin levels who had premature ejaculation also demonstrated associated metabolic syndrome, erectile dysfunction, and anxiety. Thus, whereas biochemical markers (eg, prolactin) may contribute to premature ejaculation, organic and psychological associations (eg, anxiety) suggest that biochemical parameters play only a partial role. Further research is needed.


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