Diagnosis

Premature Ejaculation

Diagnosis of premature ejaculation

The main complaint of men is not being able to control the timing of orgasm associated with low intercourse time. Often, men relate a whole series of negative personal and interpersonal consequences that arise as a consequence of the inability to defer orgasm.

In the clinical history it is essential to explore the three axes that define premature ejaculation: low coitus time, lack of control over the moment of orgasm and negative interpersonal consequences.

To define these parameters and as a measure of the problem - which will help us later to evaluate the treatment - we recommend using the parameters IELT (Intravaginal Coital Latency Time) and PEDT (Premature Ejaculation Diagnostic Tool). In addition, it is advisable to use a questionnaire to assess erectile function, such as the SHIM or the EHS. In this way we can also rule out that erectile dysfunction is the cause of the problem.

Since many men have an impact not only on their intercourse time but also on their sexuality, it is useful to use IIEF question 12, "How is your level of sexual desire?" to determine if premature ejaculation is having an impact on the amount of intercourse.

In men over 40 years of age it is highly recommended to use the IPSS (International Prostate Symptoms Score), a validated questionnaire that measures the presence and severity of urinary symptoms, to rule out that the cause of the problem is urinary. If there is suspicion of secondary premature ejaculation, it is advisable to extend the study with a blood test (blood count, biochemistry, PSA and free PSA, thyroid profile, urinalysis and urine culture).

The strategy outlined above allows us to define the presence of premature ejaculation, its severity, its cause and its consequences on the sexual sphere.

If, in addition to premature ejaculation, the patient has difficulty achieving or maintaining an erection, the physician may order blood tests to check your male hormone (testosterone) levels and other tests.