Premature ejaculation. Two words most men hate hearing. But what time frame constitutes a fast performance?
Three minutes or less, says an international group of specialists, who have agreed on a definition for the disorder more than 100 years after it was first documented.
One of the authors of the report, a Sydney sexual health doctor, Chris McMahon, said vague definitions had left doctors confused and led many men to falsely believe they suffered from the condition.
"If a doctor asks a patient 'do you think you ejaculate too frequently?', a substantial proportion of men will say 'yes'," Dr McMahon, the director of the Australian Centre for Sexual Health, said.
While historical population studies suggested between 25 per cent and 30 per cent of men peaked too soon, more recent data found the proportion of premature ejaculators was much lower.
Only about 2 per cent to 3 per cent of men suffered from the lifelong form of the condition, which presented itself from the first time they had sex. These men typically lasted a minute or less.
Another four per cent to six per cent of men acquired the condition in their lifetime and ejaculated after about three minutes or less.
Dr McMahon said there were three dimensions to the diagnosis, which were published in The Journal of Sexual Medicine, and men needed to have all three.
As well as timing, men had to be unable to control or delay their ejaculation during sex, and these performance issues had to cause negative psychological consequences.
"These men are upset, they're bothered, they're frustrated and they develop a pattern of avoiding sex," he said.
Other men who questioned their performance were either experiencing "variable premature ejaculation", which meant sometimes they were quick and other times not, or had the impression they were premature, known as "subjective premature ejaculation", he said.
"What they need is to be educated, they don't need medication," said Dr McMahon, who consults for several pharmaceutical companies.
He said pornography was also to blame for common misconceptions about sexual function.
"I think in many cases men tend to benchmark their sexual performance against what they see in pornography," he said.
"That reflects the very poor sex education we still see in our teenagers."
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There was still a lot of shame associated with sexual performance and many men sought medical advice years after their symptoms first presented.
"The trigger for many seeking treatment is the failure of a relationship," Dr McMahon said.
He said men, their partners and the broader community needed to be educated that sexual function and performance varied among individuals.
"Often all it takes is for [men] to be educated, to be told that their experiences parallel those of other men in their age group."
For the small percentage of men diagnosed with premature ejaculation, treatment – usually a combination of counselling and medication – available, he said.
