McNabney Sean M, Weseman Claire E, Hevesi Kriszta, Rowland David L
Department of Psychology, Valparaiso University, Valparaiso, IN, USA; Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, IN, USA.
Department of Psychology, Valparaiso University, Valparaiso, IN, USA.
Sex Med. 2022 Jun;10(3):100516. doi: 10.1016/j.esxm.2022.100516. Epub 2022 Apr 25.
The criteria for premature ejaculation (PE) have generally been limited to the diagnosis of heterosexual men engaging in penile-vaginal intercourse and therefore the applicability of PE diagnostic criteria to gay men and to activities beyond penile-vaginal intercourse has yet to be explored in depth.
To compare the prevalence of PE in gay and straight men and to assess whether PE-related diagnostic measures (ejaculatory control, ejaculation latency [EL], and bother/distress) can be applied with confidence to gay men or to men engaging in sexual activities other than penile-vaginal intercourse.
Gay and straight participants (n = 3878) were recruited to take an online survey assessing sexual orientation, sexual function/dysfunction (including specific PE-related measures), sexual relationship satisfaction, and various other sexual behaviors during partnered sex or masturbation.
Comparison of ejaculatory control, EL, and bother/distress across gay and straight men, as well as across different types of sexual activities.
A slightly lower PE prevalence among gay men became undetectable when other predictors of prevalence were included in a multivariate analysis (aOR = 0.87 [95% CI: 0.60-1.22]). Gay men with PE reported longer typical ELs (z = -3.35, P < .001) and lower distress (z = 3.68, P < .001) relative to straight men, but longer ELs and lower distress were also associated with anal sex.
Clinicians can feel confident about using existing criteria for the diagnosis of PE in gay men but should be aware of potentially longer ELs and lower PE-related bother/distress-probably related to the practice of anal sex-compared with straight men.
Although well-powered and international in scope, this study was limited by biases inherent to online surveys, the lack of a sizable sample of bisexual men, and a lack of differentiation between men with acquired vs lifelong PE.
Irrespective of sexual orientation, gay and straight men with PE reported shorter ELs, lower satisfaction, and greater bother/distress than functional counterparts. While PE-related diagnostic criteria (ejaculatory control, EL, and bother/distress) are applicable to gay men, accommodation for longer ELs and lower bother/distress in gay men should be considered. McNabney SM, Weseman CE, Hevesi K, et al. Are the Criteria for the Diagnosis of Premature Ejaculation Applicable to Gay Men or Sexual Activities Other than Penile-Vaginal Intercourse?. Sex Med 2022;10:100516.
早泄（PE）的诊断标准通常仅限于患有阴茎-阴道性交的异性恋男性，因此PE诊断标准对男同性恋者以及阴茎-阴道性交以外的性行为的适用性尚未得到深入探讨。
比较男同性恋者和异性恋男性中PE的患病率，并评估与PE相关的诊断指标（射精控制、射精潜伏期[EL]和困扰/苦恼）是否可以可靠地应用于男同性恋者或从事阴茎-阴道性交以外性行为的男性。
招募了男同性恋者和异性恋参与者（n = 3878）进行在线调查，评估性取向、性功能/功能障碍（包括与PE相关的具体指标）、性关系满意度以及在有性伴侣的性行为或自慰过程中的各种其他性行为。
比较男同性恋者和异性恋男性之间以及不同类型性行为之间的射精控制、EL和困扰/苦恼情况。
在多变量分析中纳入患病率的其他预测因素后，男同性恋者中略低的PE患病率变得无法检测到（调整后比值比[aOR] = 0.87 [95%置信区间：0.60 - 1.22]）。与异性恋男性相比，患有PE的男同性恋者报告的典型EL更长（z = -3.35，P <.001）且苦恼程度更低（z = 3.68，P <.001），但更长的EL和更低的苦恼也与肛交有关。
临床医生可以放心地使用现有的PE诊断标准来诊断男同性恋者的PE，但应意识到与异性恋男性相比，男同性恋者的EL可能更长，与PE相关的困扰/苦恼可能更低——这可能与肛交行为有关。
尽管本研究样本量充足且范围具有国际性，但受到在线调查固有的偏差、双性恋男性样本量不足以及获得性PE与终身性PE男性之间缺乏区分的限制。
无论性取向如何，患有PE的男同性恋者和异性恋男性报告的EL均较短、满意度较低且困扰/苦恼程度更高。虽然与PE相关的诊断标准（射精控制、EL和困扰/苦恼）适用于男同性恋者，但应考虑到男同性恋者的EL更长且困扰/苦恼更低的情况。麦克纳尼SM、韦斯曼CE、赫韦西K等。早泄的诊断标准是否适用于男同性恋者或阴茎-阴道性交以外的性行为？。性医学2022；10：100516。
