Research and Methodology

Research on lifelong delayed ejaculation is scarce. Most of the literature consists of hypotheses that have not been investigated according to methodological well-designed studies. Several factors may have contributed to this state of affairs. Delayed ejaculation is a relatively rare condition. Both in the general population and in the clinical practice, the prevalence of delayed ejaculation is rather low (84). Furthermore, delayed ejaculation is known as a disorder that is relatively difficult to treat (92). Although controlled studies do not exist, clinical experience suggests that the outcome is rather poor (92). A major problem in the research of lifelong delayed ejaculation is the absence of an empirically derived operational definition of delayed ejaculation.

The DSM-IV criteria are arbitrary and not based on quantified research. For example, consider the sentence "orgasm in a male following a normal sexual excitement phase during sexual activity that the clinician, taking into account the person's age, judges to be adequate in focus, intensity, and duration," what one wonders is meant by "normal" and how may a clinician judge that the excitement phase has been adequate in focus, intensity, and duration. There are no well-controlled studies regarding average or "normal" time of stimulation and therefore it is difficult to determine what is a delayed time of stimulation.

In the absence of objective standards on orgasmic latency, the clinician must rely on the subjective judgment of the patient. Generally, if the patient feels that it takes too long to reach orgasm, the diagnosis of delayed orgasm will be considered.

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