Premature ejaculation: prevalence and association with lifestyle and psychosocial factors of 45-year old heterosexual men in Germany results of the German male sex-study
Herkommer, K1; Zehe, V1; Bosinski, HAG2; Dinkel, A3; Kron, M4; Arsov, C5; Imkamp, F6; Hadaschik, BA7; Gschwend, JE1
1: Department of Urology, Klinikum rechts der Isar, Technical University of Munich, Germany; 2: Practice for Sexual Medicine, Kiel, Germany; 3: Department of Psychosomatic Medicine and Psychotherapy, Technical University of Munich, Germany; 4: Institute of Epidemiology and Medical Biometrics, University of Ulm, Germany; 5: University Dusseldorf, Medical Faculty, Department of Urology, Germany; 6: Clinic for Urology and Urologic Oncology, Hannover Medical School, Germany; 7: Department of Urology, University Hospital Heidelberg, Germany
Objectives: To analyse Premature Ejaculation (PE) and its association with lifestyle and psychosocial factors among 45-year old, heterosexual German men.
Methods: Participants were recruited within the German Male Sex-Study. Data were collected within the first two years of the study between April 2014 – April 2016. Participants were given questionnaires about sociodemographic data, lifestyle factors and sexual behaviour. A short examination and a clinical interview were conducted by physicians. Inclusion criteria were heterosexual orientation identity and Caucasian origin. Results: 10.166 participants met the inclusion criteria. The prevalence of lifelong and acquired PE was 6.0%. Not engaging in physical exercise, poor overall health status and high body mass index (≥30 kg/m2) were associated with a higher risk for PE. Other lifestyle factors like smoking and alcohol were not significantly associated (p>0.05). Lower urinary tract symptoms (IPSS >7), erectile dysfunction (IIEF-6 <26) and antidepressant medication were significantly associated with PE. All other comorbidities like hypertension and diabetes mellitus were not significantly associated with PE. There was a strong association between PE and a low sexual self-esteem. Men with PE were less sexually confident, perceived higher social pressure with regard to sexual performance, had a poorer body image and a more traditional view of masculinity. Men with PE also showed difference in sexual behaviour. We found that men with PE had less lifetime sexual partners, were less sexually active within the last 3 months, were less satisfied with their sex-life and felt less sexual desire than men without PE (p<0.001).
Conclusion: We found significant associations between PE and several lifestyle, psychosocial, and clinical variables like not engaging in physical exercise, lower urinary tract symptoms and a poor overall health status. Most other factors like sexual behaviour and psychosocial factors were associated with PE, but their causal relationship is still unclear. Most comorbidities like hypertension and diabetes mellitus were not significant in this analysis. This is probably due to a low prevalence of these comorbidities in 45-year-old men and long-term effects cannot be seen at this relative young age.
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