AGE-RELATED CORRELATION BETWEEN ERECTILE DYSFUNCTION AND PREMATURE EJACULATION

Background and objective

To evaluate the relationship between erectile dysfunction (ED) and premature ejaculation (PE) among men aged 40–79 years and to compare age-related differences between men aged 40–59 years and 60–79 years.

Materials and methods

From January 2014 to January 2019, records of 892 men aged 40–79 years were analyzed. We performed correlation analysis using the self-reported intravaginal ejaculation latency time (IELT), premature ejaculatory diagnostic tool (PEDT), Male Sexual Health Questionnaire-ejaculation (MSHQ-EjD), and International Index of Erectile Function5 (IIEF5) questionnaires.

Results

The mean age of the 892 males was 52.8 ± 7.3 years (40–76). All subjects were divided into group 1 (40–59 years old) and group 2 (60–79 years old). The IIEF5 score of group 1 was significantly higher than that of group 2 (18.7 ± 5.5 vs. 17.7 ± 5.7, p = 0.049). Of the total subjects, 71 (8%) had IELT value of less than 1 min. A total of 51 (6.9%) and 20 (13.5%) were in groups 1 and 2, respectively (p = 0.02). The PEDT total score was higher and more subjects were identified as suffering from PE (PEDT ≥ 9) from amongst the ED subjects (IIEF-5 ≤ 21). In both groups 1 and 2, more PE subjects were identified in ED subjects (IIEF-5 ≤ 21) than normal subjects (IIEF-5 > 21) (all p < 0.01). In the total subjects, group 1 and 2, the IIEF-5 and PEDT score showed a weak negative correlation (r = −0.302, r = −0.361, r = −0.248, all p < 0.01). In group 2,the IELT and MSHQ-EjD score also showed a weak positive correlation between the IIEF-5 score (r = 0.166, p = 0.044 and r = 0.164, p = 0.047, respectively).

Conclusion

More subjects defined PE value as less than 1 min on the self-reported IELT in the elderly group ≥60 years than those among the 40–59 years age group; moreover, the lower the IIEF5 total score among subjects ≥ 60 years, the higher the PEDT score and the lower the IELT and MSHQ-EjD scores.

erectile dysfunction; International Index of Erectile Function; premature ejaculation; prema-ture ejaculatory diagnostic tool

1. Montague DK, Jarow J, Broderick GA, et al. AUA erectile dysfunction guideline update panel. AUA guideline on the pharmacologic management of premature ejaculation. J Urol 2004;172:290–4. https://doi.org/10.1097/01.ju.0000132159.61156.ea

2. McMahon CG, Jannini E, Waldinger M, et al. Standard operating procedures in the disorders of orgasmandejaculation. J Sex Med 2013;10:204–29. https://doi.org/10.1111/j.1743-6109.2012.02824.x

3. Serefoglu EC, McMahon CG, Waldinger MD, et al. An evidence-based unified definition of life-long and acquired premature ejaculation: Report of the second International Society for Sexual Medicine Ad Hoc Committee for the Definition of Premature Ejaculation. J Sex Med 2014; 11:1423–41.

4. Althof SE, McMahon CG, Waldinger MD, et al. An update of the International Society of Sexual Medicine’s guidelines for the diagnosis and treatment of premature ejaculation (PE). J Sex Med 2014;11:1392–422. https://doi.org/10.1111/jsm.12504

5. Jannini EA, Maggi M, Lenzi A. Evaluation of premature ejaculation. J Sex Med 2011;4(8 Suppl): 328–34.https://doi.org/10.1111/j.1743-6109.2011. 02289.x

6. Lotti F, Corona G, Rastrelli G, et al. Clinical cor-relates of erectile dysfunction and premature ejac-ulation in men with couple infertility. J Sex Med 2012;9:2698–707.

7. Jeh SU, Yoon S, Choi JH, et al. Metabolic syn-drome is an independent risk factor for acquired premature ejaculation. World J Mens Health 2019;37(2):226–33.

8. Waldinger MD. Ejaculatio praecox, erectio prae-cox, and detumescentia praecox as symptoms of a hypertonic state in lifelong premature ejacu-lation: A new hypothesis. Pharmacol Biochem Behav 2014;121:189–94. https://doi.org/10.1016/j. pbb.2013.12.004

9. Zhu L, Mi Y, You X, Wu S, et al. A meta-analysis of the effects of the 5-hydroxytryptamine transporter gene-linked promoter region polymorphism on sus-ceptibility to lifelong premature ejaculation. PLoS One 2013;8:e54994. https://doi.org/10.1371/journal. pone.0054994

10. Jannini EA, Burri A, Jern P, et al. Genetics of human sexual behavior: Where we are, where we are going. Sex Med Rev 2015;3:65–77. https://doi. org/10.1002/smrj.46

11. Screponi E, Carosa E, Di Stasi SM, et al. Prevalence of chronic prostatitis in men with premature ejac-ulation. Urology 2001;58:198–202. https://doi. org/10.1016/S0090-4295(01)01151-7

12. Jannini EA, Lombardo F, Lenzi A. Correlation between ejaculatory and erectile dysfunction. Int J Androl 2005;2(28 Suppl):40–5.

13. Song WH, Park J, Yoo S, et al. Changes in the prevalence and risk factors of erectile dysfunction during a decade: The Korean Internet Sexuality Survey (KISS), a 10-Year-Interval Web-Based Survey. World J Mens Health 2019;37(2):199–209. https://doi.org/10.5534/wjmh.180054

14. Johannes CB, Araujo AB, Feldman HA, et al. Incidence of erectile dysfunction in men 40 to 69 years old: Longitudinal results from the Massachusetts male aging study. J Urol 2000;163:460–3. https://doi.org/10.1016/S0022-5347(05)67900-1

15. Salonia A, Castagna G, Saccà A, et al. Is erectile dysfunction a reliable proxy of general male health status? The case for the International Index of Erectile Function-Erectile Function domain. J Sex Med 2012;9:2708–15.

16. Besiroglu H, Otunctemur A1, Ozbek E. The rela-tionship between metabolic syndrome, its compo-nents, and erectile dysfunction: A systematic review and a meta-analysis of observational studies. J Sex Med 2015;12(6)1309–18. https://doi.org/10.1111/jsm.12885

17. Buvat J, Maggi M, Gooren L, et al. Endocrine aspects of male sexual dysfunctions. J Sex Med 2010;7:1627–

56. https://doi.org/10.1111/j.1743-6109.2010.01780.x

18. Jackson G, Montorsi P, Adams MA, et al. Cardiovascular aspects of sexual medicine. J Sex Med 2010;7:1608–26. https://doi.org/10.1111/j.1743-6109.2010.01779.x

19. Binmoammar TA, Hassounah S, Alsaad S, et al. The impact of poor glycaemic control on the prev-alence of erectile dysfunction in men with type 2 diabetes mellitus: A systematic review. JRSM Open 2016;7:2054270415622602. https://doi. org/10.1177/2054270415622602

20. Rosen R, Altwein J, Boyle P, et al. Lower urinary tract symptoms and male sexual dysfunction: The multinational survAey of the aging male (MSAM-7). Eur Urol 2003;44:637–49. https://doi.org/10.1016/j. eururo.2003.08.015

21. Laumann EO, Nicolosi A, Glasser DB, et al. GSSAB Investigators’ Group. Sexual problems among women and men aged 40–80 y: Prevalence and correlates identified in the Global Study of Sexual Attitudes and Behaviors. Int J Impot Res 2005;17:39–57.

22. Corona G, Rastrelli G, Limoncin E, et al. Interplay between premature ejaculation and erectile dys-function: A systematic review and meta-analy-sis. J Sex Med 2015;12(12):2291–300. https://doi. org/10.1111/jsm.13041

23. McMahon CG, Lee G, Park JK, et al. Premature ejaculation and erectile dysfunction prevalence and attitudes in the Asia-Pacific region. J Sex Med 2012;9:454–65.

24. Laumann EO, Paik A, Rosen RC. Sexual dysfunc-tion in the United States: Prevalence and predictors. JAMA 1999;281:537–44. https://doi.org/10.1001/jama.281.6.537

25. Porst H, Montorsi F, Rosen RC, et al. The Premature Ejaculation Prevalence and Attitudes (PEPA) sur-vey: Prevalence, comorbidities, and professional help-seeking. Eur Urol 2007;51:816–23. https://doi. org/10.1016/j.eururo.2006.07.004

26. Song WH, Yoo S, Oh S, et al. Ten-year interval changes in the prevalence of self-identified prema-ture ejaculation and premature ejaculation based on an estimated intravaginal ejaculation latency time of <3 minutes in the general population: The Korean Internet Sexuality Survey (KISS) 2016. J Sex Med 2019;16(4):512–21.

27. Lee SW, Lee JH, Sung HH, et al. The prevalence of premature ejaculation and its clinical character-istics in Korean men according to different defini-tions. Int J Impot Res 2013;25(1):12–7. https://doi. org/10.1038/ijir.2012.27

28. Kam SC, Han DH, Lee SW. The diagnostic value of the premature ejaculation diagnostic tool and its association with intravaginal ejaculatory latency time. J Sex Med 2011;8:865–71. https://doi. org/10.1111/j.1743-6109.2010.02151.x

29. Symonds T, Perelman MA, Althof S, et al. Development and validation of a premature ejac-ulation diagnostic tool. Eur Urol 2007;52:565–73. https://doi.org/10.1016/j.eururo.2007.01.028

30. Seo DH, Jeh SU, Choi SM, et al. Diagnosis and treat-ment of premature ejaculation by urologists in South Korea. World J Mens Health2016;34(3):217–23. https://doi.org/10.5534/wjmh.2016.34.3.217