Men with Various Subtypes of Premature Ejaculation Differ in the Perceived Cause of Their Problem

How men perceive the cause for their premature ejaculation (PE) impacts their understanding of their problem, likelihood of seeking treatment, and acceptance of and adherence to a treatment protocol. This study aimed to understand men's perceived reasons (attributions) for their PE, to explore differences across PE subtypes having different developmental progressions, and to identify covariates that might help explain subtype differences. 446 online survey respondents who indicated "ejaculating before desired" and met inclusion criteria were verified as having "definite" PE using an abridged version of the Premature Ejaculation Diagnostic Tool. Respondents were further classified into PE subtypes of lifelong (LPE), acquired (APE), and intermittent (IPE). These men provided detailed demographic, sexual-behavioral, and ejaculatory response information, and selected from a list of 11 options any and all perceived reasons for explaining their rapid ejaculation. Men with LPE tended to endorse biological/physiological arousal attributions more frequently than men with APE, who endorsed situational/relationship variables more frequently. Men with IPE endorsed nearly all attributions at higher frequencies than other PE subtypes, yet overall, they resembled LPE men more than APE men. Within the LPE subtype, men who experienced short ejaculation latencies during both partnered and solo sex were more likely to endorse biological/physiological arousal attributions. In addition to identifying four underlying "typal" attributions, specific control covariates were found to correlate with group differences in attribution frequencies. Subtype-specific attribution patterns have significant implications for treatment, including guiding targeted psychoeducation, treatment options and framing, and treatment acceptance by the man and his partner.