The Pathophysiology of Delayed Ejaculation

The 2016 review article by Juza Chen on delayed ejaculation (DE) outlines the condition as a complex and multifactorial male sexual dysfunction affecting 1-4% of men. It involves psychological factors like performance anxiety, relationship issues, and sexual dissatisfaction, as well as biological aspects such as age, race, medical conditions like diabetes, and the impact of certain medications. The review indicates that DE is associated with higher general health issues and lower coital activity. Studies show no correlation between DE and age, but a higher prevalence in black populations. DE can be congenital or acquired through surgeries, medical conditions, or psychosexual changes. Hormonal imbalances and medications for conditions like BPH can also cause DE. Despite the known factors, there is a lack of dedicated research on DE's causes and treatments. Diagnosis requires self-reporting and thorough clinical evaluation, and treatment should involve a holistic approach with multidisciplinary collaboration. The review also notes the high rates of sexual dysfunction among men with alcoholism and diabetes, with significant percentages experiencing DE.