What should be the focus of history in suspected acquired premature ejaculation (PE)?

Updated: Jan 15, 2019
  • Author: Samuel G Deem, DO; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

In addition to a general medical history, the history should include details about the following:

  • Previous relationships – Were there earlier relationships in which premature ejaculation was not a problem? Were there earlier relationships in which transient episodes of premature ejaculation occurred?

  • Current relationship – Was premature ejaculation always a problem, or did it start after an initial time frame when coitus was satisfactory to both partners?

  • Nonsexual aspects of the current relationship – Do the partners get along on most issues, or is conflict present? Who is dominant in the relationship, or is the relationship generally equal?

  • Involvement of the sexual partner – If the patient’s female sexual partner did not accompany him to the clinic, why not? If she regards the problem as his alone, rather than theirs, this may be an important clue

  • Impotence problems – If the patient has erectile dysfunction, did it begin after the premature ejaculation or before? If the patient does not have erectile dysfunction, what is the general timing for the male (ie, the typical time from commencement of intromission to climax)?

  • Capacity for coitus – Can actual coitus be achieved, or does the premature ejaculation prevent it entirely?

  • Sexual context – Is the patient experiencing premature ejaculation with self-stimulation (ie, masturbation), with nonintercourse stimulation by the partner, or just with coitus?

  • Sexual response of partner – What is the time required for the female partner to reach climax? Can she reach climax with intercourse, or does she require direct clitoral stimulation (oral or manual)?


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