Multi-country Study of Intravaginal Ejaculation Latency Times ( IELT )by PEhomepage.com Editorial Team
Most researchers and physicians agree that PE is one of the most common male sexual dysfunctions. Part of the difficulty lies in defining the condition, as well as determining what is a “normal” IELT [ more about IELT ]. Most studies measure effectiveness according to the increase in IELT after treatment. Knowing what constitutes normal vs. premature or delayed ejaculation could assist in developing appropriate treatments and designing clinical trials.
Waldinger and his associates conducted a study of 500 couples in the
Netherlands,
United Kingdom,
United States,
Spain, and
Turkey in order to “define the distribution of IELTs in the general population of sexually active adult men in a stable sexual relationship.” They assessed the impact of the country where the men resided, condom usage during sex, and whether or not the male was circumcised. A secondary component of the study would help physicians in determining whether or not the male had normal or abnormal ejaculatory latency times.
Participants in the study were recruited through a variety of methods including: advertisements, existing research databases, Internet interest panels, and recruitment drives. In order to be eligible to participate, the men had to be older than 18, heterosexual, and involved in a stable relationship that had lasted at least six months that involved regular intervals of sexual intercourse. Each couple was visited at
home and given detailed information about the study and detailed instruction for participation. IELT was measured by a stopwatch by either the male or female partner. The couple was given detailed instructions concerning how to measure IELT and was asked to consistently let the same person measure it with the stopwatch. During the 4-week study, the couple was asked to record the IELT in a sexual event diary along with the time and date of the encounter. A second home visit by the study personnel retrieved the diary and the male in the study was asked to fill out a survey indicating whether or not he was circumcised and if condoms had been used in any encounter.
The final analysis included 491 men whose mean age was 40 ± 12 years (range = 18-73 years). Age was categorized as 18-30 years, 31-50 years, and >51 years. In addition, 4,000 sexual events were timed with the stopwatch. The mean frequency of sexual activity was 8 ± 4 events per couple per month. The frequency of sexual activity varied by country, with a mean of seven events per couple in
Spain and the
Netherlands and 10 events in the
United States. Circumcision status was categorized as “circumcised” or “not circumcised,” and condom usage further categorized as “never used condoms in the study” vs. “sometimes used condoms in the study.”
The median IELT regardless of country was 5.4 minutes. In order to calculate a continuum, researchers calculated the 0.5 and 2.5 percentiles and determined endpoints to be .9 minutes and 1.3 minutes, respectively. Despite other studies that found no noticeable age differences, this study found that younger men had higher median IELT. For example, the 18-30 year old men had median IELT of 6.5 minutes while the >51 year old men had median IELT of 4.3 minutes. Median IELT varied by country ranging from 3.7 minutes in
Turkey to 7.6 minutes in the
United Kingdom. Condom usage showed no appreciable differences in IELT. The median IELT in circumcised men was 4.4 minutes vs. 6.0 minutes in the not-circumcised group. After reviewing data from
Turkey, in which all men were circumcised, researchers made the decision to exclude values from this country in order to get a better assessment of how circumcision could affect IELT. After excluding this country, median IELT for the circumcised men was 6.7 minutes compared to 6.0 minutes in the not-circumcised men. This difference was not statistically significant in the final analysis.
In the discussion researchers suggest that studies using IELT as a determining factor of PE status should use cut-off values of 1 to 2 minutes when deciding which men to include in the study. There are several limitations of this first study, however, since researchers restricted the study to men in a stable relationship of at least six months in length, it could have excluded men who are unable to maintain long-term relationships due to PE. Also, by asking couples to engage in intercourse at least one time per week, it could have excluded couples who did not engage in sex on such a frequent basis. Finally, despite using several methods to recruit couples for participation, there could be a “selection bias” that excluded otherwise healthy participants from participation in the study. Future studies are needed to determine if results from this analysis truly depict premature, normal, and delayed ejaculation times.
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