Contemporary consensus and emerging directions in premature and delayed ejaculation: recommendations from the 5th International Consultation on Sexual Medicine
Abstract
INTRODUCTION: Disorders of ejaculation, including premature ejaculation (PE) and delayed ejaculation (DE), are common conditions with a substantial impact on men's quality of life and their relationships. This review synthesizes the latest findings on their etiology, epidemiology, evaluation, and management. This study aims to present evidence-based recommendations for the definition, classification, and treatment of PE and DE, developed under the guidance of the Fifth International Consultation on Sexual Medicine.
METHODS: A multidisciplinary panel conducted a narrative review of global literature and utilized a modified Delphi method to develop consensus recommendations. Evidence was graded using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system.
RESULTS: Premature ejaculation is the most frequently reported male sexual complaint, classified into lifelong, acquired, variable, and subjective subtypes. Evidence-based management includes medical therapies such as selective serotonin reuptake inhibitors, topical anesthetics, and psychotherapeutic approaches. Although less common, DE remains under-researched, with limited pharmacological and behavioral treatment options. Definitions for both disorders have evolved to incorporate timing, distress, and control criteria.
CONCLUSION: Understanding the pathophysiology and adopting individualized approaches to managing PE and DE can improve patient outcomes. Further research is needed to enhance…
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