Donatucci Craig F
Division of Urology, Duke University Medical Center, Durham, NC 27710, USA.
J Sex Med. 2006 Sep;3 Suppl 4:303-8. doi: 10.1111/j.1743-6109.2006.00305.x.
Ejaculation is comprised of three stages of the male sexual response cycle, namely emission, ejection, and orgasm; however, in comparison with erection, which is a well-understood component of male sexual response, the pathophysiology of ejaculation has yet to be fully delineated. Premature ejaculation (PE), the most common sexual disorder in men, while believed to have a multifactorial etiology, is even less well understood.
This article reviews the physiology of ejaculation, and the multifactorial pathophysiology of PE.
The Sexual Medicine Society of North America hosted a State of the Art Conference on Premature Ejaculation on June 24-26, 2005 in collaboration with the University of South Florida. The purpose was to have an open exchange of contemporary research and clinical information on PE. There were 16 invited presenters and discussants; the group focused on several educational objectives.
Data were obtained by extensive examination of published peer-reviewed literature.
Evidence supports that biologic mechanisms associated with neurotransmitters such as norepinephrine, serotonin, oxytocin, Gamma-amino-butyric acid, and nitric oxide (NO) as well as the hormone estrogen play central roles in ejaculation, and subsequently may mediate PE. There is also emerging evidence to show that hyperthyroidism may be a causal factor in PE. Recent data also suggest that psychogenic factors include high level of any experience by some men with PE.
The pathophysiology of both lifelong and acquired PE appears to be both neurobiogenic and psychogenic. While psychogenic factors appear to be contributory to PE, pharmacologic intervention of PE can modify intravaginal ejaculatory latency time (IELT), which suggests that IELT is a biological variable, and is likely biologically dependent upon neurotransmitters and hormones.
射精由男性性反应周期的三个阶段组成，即射精、射出和性高潮；然而，与勃起这一男性性反应中已被充分理解的组成部分相比，射精的病理生理学尚未完全阐明。早泄（PE）是男性最常见的性功能障碍，虽然其病因被认为是多因素的，但人们对它的了解更少。
本文综述射精的生理学以及早泄的多因素病理生理学。
北美性医学协会于2005年6月24日至26日与南佛罗里达大学合作举办了一次早泄最新技术会议。目的是就早泄的当代研究和临床信息进行公开交流。有16位受邀演讲者和讨论者；该小组专注于几个教育目标。
通过广泛查阅已发表的同行评审文献获得数据。
有证据支持，与去甲肾上腺素、5-羟色胺、催产素、γ-氨基丁酸和一氧化氮（NO）等神经递质以及雌激素相关的生物学机制在射精中起核心作用，随后可能介导早泄。也有新出现的证据表明甲状腺功能亢进可能是早泄的一个致病因素。最近的数据还表明，心理因素包括一些早泄男性的高水平任何经历。
终身性和后天性早泄的病理生理学似乎既是神经源性的也是心理源性的。虽然心理因素似乎对早泄有促成作用，但早泄的药物干预可以改变阴道内射精潜伏期（IELT），这表明IELT是一个生物学变量，并且可能在生物学上依赖于神经递质和激素。
