Men with lifelong premature ejaculation tend to score higher on measures of impulsivity, suggesting that difficulties with self-control may contribute to the severity of this common sexual dysfunction. The findings, published in The Journal of Sexual Medicine, also indicate that depression and anxiety are more prevalent among affected individuals, highlighting the complex psychological dimensions of the condition.
Premature ejaculation is the most frequently reported sexual dysfunction in men and is typically defined as ejaculation that occurs earlier than desired—often within one minute of vaginal penetration. While treatments and explanations for the condition have varied, researchers have long debated whether psychological, neurobiological, or relational factors are primarily to blame. The current study aimed to better understand how impulse control might relate to the severity of premature ejaculation, particularly among men with lifelong symptoms.
The research team focused on a sample of 80 heterosexual men between the ages of 18 and 45. Forty men diagnosed with lifelong premature ejaculation were recruited from a psychiatric outpatient clinic in Türkiye, while the control group of 40 men had no history of sexual or psychiatric dysfunction. To be eligible, participants had to be in regular sexual relationships for at least six months and engage in vaginal intercourse at least once a week.
Ejaculation times were objectively measured by participants and their partners using stopwatches during intercourse, a method chosen to minimize bias and subjectivity. All participants completed a battery of psychological assessments. These included the Arabic Index of Premature Ejaculation to evaluate symptom severity, the UPPS Impulsive Behavior Scale and the Barratt Impulsiveness Scale to assess various aspects of impulsivity, and two widely used inventories measuring depression and anxiety.
The researchers found that men with premature ejaculation scored significantly lower on the Arabic Index of Premature Ejaculation, indicating more severe symptoms. These men also had consistently higher scores across all measures of impulsivity. On the UPPS scale, they exhibited greater urgency, poorer planning, more sensation-seeking, and less perseverance compared to the control group. Similarly, scores on the Barratt scale revealed higher levels of motor impulsiveness, attentional impulsiveness, and poor planning.
Notably, anxiety and depression scores were also elevated among men with premature ejaculation. On average, they scored roughly six times higher on measures of depression and nearly five times higher on anxiety compared to the control group. While the study could not determine whether these psychological symptoms caused premature ejaculation or resulted from it, the data suggest a strong connection between the two.
The researchers also explored how varying levels of premature ejaculation severity might be linked to different psychological profiles. They divided the men with premature ejaculation into four subgroups: those who ejaculated before penetration (precoital), within 15 seconds after penetration, within 15 to 30 seconds, and within 30 to 60 seconds. Across these categories, those with the shortest ejaculation times tended to score highest on impulsivity measures, particularly in the areas of urgency and motor impulsiveness. These individuals also showed more sensation-seeking behavior and lower persistence, suggesting a potential relationship between low self-control and extremely rapid ejaculation.
Interestingly, while depression and anxiety were more common in the premature ejaculation group as a whole, they did not vary much between subgroups based on ejaculation time. This suggests that while mood disorders may be common among men with premature ejaculation, they are not necessarily tied to how quickly ejaculation occurs. In contrast, the different levels of impulsivity showed a clear association with shorter ejaculation times.
The authors note that these results support a growing body of research linking premature ejaculation with not only neurobiological and hormonal factors but also behavioral traits like impulsivity. They draw on previous theories suggesting that the inability to delay ejaculation may be similar in nature to other impulse control disorders. In both cases, individuals struggle to delay gratification or resist urges, often leading to undesirable consequences despite awareness of the risks.
The researchers acknowledge several limitations. One of the main challenges was accurately measuring ejaculation times, which required the cooperation of both participants and their partners. This requirement may have discouraged some individuals from participating and limited the size of the study. Additionally, the researchers did not specifically assess sexual distress, which can be an important factor in understanding how premature ejaculation affects overall well-being.
Because of the modest sample size and reliance on a specific cultural context, the authors caution against overgeneralizing their results. Future studies with larger and more diverse populations are needed to confirm these findings and clarify the role of impulsivity in premature ejaculation. They also suggest that more attention should be paid to the different subcomponents of impulsivity, such as urgency and sensation seeking, which may be especially relevant for treatment.
These findings open the door to new treatment possibilities. Traditionally, premature ejaculation has been treated with behavioral techniques or medications that affect serotonin levels. But if impulsivity is a key factor in the condition, therapeutic approaches that improve self-regulation—such as cognitive behavioral therapy or mindfulness-based training—could offer additional benefits.
The study’s authors propose that clinicians evaluating men for premature ejaculation should consider assessing impulsivity and mood symptoms as part of the diagnostic process. By doing so, they may better understand the underlying causes and tailor treatments that address both the physical and psychological aspects of the disorder.
The study, “Impulse control and its association with ejaculation time in men with premature ejaculation,” was authored by Tarık Sağlam, Uğur Takım, Yasin Kavla, Demirhan Örsan Demir, and Şenol Turan.
