Drivers and Barriers to Treatment-Seeking Behavior in Men With Premature Ejaculation.

Drivers and Barriers to Treatment-Seeking Behavior in Men With Premature Ejaculation, Michael A. Perelman, Departments of Psychiatry, Reproductive Medicine, and Urology; Ridwan Shabsigh, Department of Urology, USA

We uncovered what factors drive certain men to seek treatment for premature ejaculation (PE). A multi-country internet-based survey of 12,134 men was conducted in 2004. The PE Prevalence and Attitudes (PEPA) Study enrolled men aged 18-70 in the United States, Germany, and Italy. Respondents answered questions about general quality of life, relationships, sexual experiences and attitudes, health and medicines, and demographics. Men were categorized as having PE via two survey responses regarding timing of and control over ejaculation and were classified as having sought PE treatment if they reported having talked to a therapist or had taken prescription medication for PE. While men with PE, on average, reported having tried 5 different ways to manage their PE, including focusing on something else, special positions during sex, masturbation, and interrupted stimulation, less than 20% had sought treatment from a healthcare professional. Treatment-seeking behavior was positively correlated with high levels of distress from PE, being comfortable talking with their doctor/health professional, tension with their partner, and reduced frequency of sexual intercourse due to PE, among other factors. Factors associated with not seeking treatment included an acceptance of PE, a disbelief that PE negatively affects a man's relationship with his partner, the absence of a primary care physician, discomfort discussing sexual issues with their physician, a lack of commonly-accepted terms for discussing PE, and having comorbid erectile dysfunction. Understanding what drives men with PE to seek professional help, as well as factors that keep them from entering treatment, are important considerations for patient education. There is a significant need for an effective, discreet, and uncomplicated treatment for PE.