Differences between ICD-11 MMS and DSM-5 definition of premature ejaculation: a continuation of historical inadequacies and a source of serious misinterpretation by some European Regulatory Agencies (PART 2)

Abstract

Recently, the ICD-11 for Mortality and Morbidity Statistics (ICD-11-MMS, 2018 Version) has been published with a new definition of premature ejaculation (PE), including a third PE subtype. This definition differs from Diagnostic and Statistical Manual of Mental Disorders (DSM-5) definition of PE. We hereby address the similarities and differences between ICD-11-MMS and DSM-5 definition of PE and call attention to the illogical policy of some European (EU) National Regulatory Agencies to remain with a 1-min cut-off point of ejaculation time for Lifelong, Acquired and Subjective PE. The advantage of ICD-11-MMS is the inclusion of a third PE subtype, which is congruent with Subjective PE. A serious disadvantage of DSM-5 is that a 1-min criterion is used for both Lifelong and Acquired PE, and that a third PE subtype is not mentioned. Despite the incomplete DSM-5 definition of PE, some EU regulatory agencies adhere to a definition of PE which relies only on the 1-min ejaculation time cut-off point of DSM-5, and do not recognize the more recent PE definitions of ICD-11-MMS and International Society for Sexual Medicine. There is no scientific evidence for this illogical position. The continued use of a 1-min cut-off point for all subgroups of PE ignores the existence of Acquired PE (Intravaginal Ejaculation Latency Time (IELT) <3 min) and Subjective PE (IELT