Pathophysiology of lifelong premature ejaculation

Abstract

In 2008, lifelong premature ejaculation (PE) was defined by the ISSM as an ejaculation that occurs within about 1 min, and as an inability to delay ejaculation and with negative personal consequences. The neurophysiology of ejaculation in lifelong PE is intact. However, the core problem in lifelong PE is the timing of ejaculation, which is presumably associated with a dysfunction in the central serotonergic modulation of the spinal ejaculation reflex. This central serotonergic modulation is influenced by genetic polymorphisms of serotonergic neurotransmission and specific serotonergic receptors. As there are four PE subtypes, each with its own clinical characteristics, etiology and pathogenesis, it is assumed that the pathophysiology of lifelong PE is different from the pathophysiology of the other PE subtypes. For a full understanding of the pathophysiology of lifelong PE, there are still many questions that need to be answered by evidence-based human and animal research.