Impulse control and its association with ejaculation time in men with premature ejaculation

Background: The relationship between impulse control and premature ejaculation (PE), the most common sexual dysfunction in men, is not yet well understood.

Aim: To assess the association between impulse control issues and the severity of PE in men with a lifelong diagnosis of this condition.

Methods: A cross-sectional observational study was designed to evaluate patients who presented to the clinic with complaints of PE between March 2023 and March 2024. The final study sample comprised 40 men with lifelong PE and 40 healthy control subjects.

Outcomes: Impulse control was evaluated with the UPPS Impulsive Behavior Scale and the Barratt Impulsivity Scale-11 (BIS-11), while depression and anxiety levels were measured using the Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI). The severity of PE was assessed using the Arabic Index of PE (AIPE).

Results: The mean AIPE score was 15.13 ± 3.33 in the PE group and 32.05 ± 2.06 in the control group (P ˂ 0.001). Compared to the control group, the PE group had significantly higher UPSS Impulsive Behavior Scale scores in all subscales (P ˂ 0.001 for planning, urgency, and lack of perseverance; P = 0. 001 for sensation seeking) and total scores (P ˂ 0.001). The BIS-11 scores were also significantly higher in the PE group compared to the control group for all subscales (P ˂ 0.001 for all). The patients in the PE group also had higher levels of anxiety and depression (P ˂ 0.001 for all).

Clinical implications: A clinician's quantitative assessment of ejaculation time and the severity of PE among men presenting to the clinic with complaints of PE may reveal accompanying comorbid conditions more effectively.

Strength and limitations: The current study is a novel investigation that quantitatively evaluates PE in terms of intravaginal ejaculatory latency time and severity, aiming to identify comorbid conditions. As a limitation, the necessity for patients and their partners to measure the time to ejaculation limited the sample size, making it challenging to generalize the findings.

Conclusion: Our findings suggest that impulse control plays a significant role in lifelong PE. It is important for clinicians to assess impulse control and consider therapeutic interventions for men presenting with PE complaints, particularly in those classified as severe.