A retrospective–present-day analysis on acquired premature ejaculation

Abstract Background Men with acquired premature ejaculation (APE) develop the condition after a period of normal ejaculatory function. This is the first article to focus on the developmental course of APE. Aim To retrospectively detail the developmental course of foreplay duration, ejaculatory latencies over multiple partnered sexual activities, and changes in PE symptomology in men with APE from age of sexual debut to the present. Methods From March 2024 through February 2025, 411 volunteers, aged 18-80 years, responded to an online sexual health and behavior questionnaire posted on multiple social media platforms. These men also met the preliminary qualifying criteria of having PE based on responses to an abridged Premature Ejaculation Diagnostic Tool (PEDT) and meeting other inclusion criteria. Of these, 77 men (mean age = 40 years, range 19-66) met the criterion of having APE as their symptoms developed only after an extended period of normal ejaculatory control. Outcome Significant changes in partnered ejaculatory latencies from the men’s sexual debut to the present are reported. Results Sexual debut typically occurred around age 19, with PE first reported on average at age 31. Overall, vaginal and anal ejaculatory latencies (EL) at sexual debut were 5.98, 5.01, and 4.7 min, respectively, but the overall, vaginal and anal ELs at the present time were 1.86, 0.97, and 0.75 min (P .001). Foreplay duration of approximately 12-13 min remained unchanged over the lifespan despite large decreases in ELs. Nearly 34% of the participants reported that their symptomology continued to worsen after it first appeared. Clinical Implications: The data highlight the major differences between present-day partnered sexual behaviors and time spent in foreplay and masturbation compared to sexual activities earlier in life. It suggests that under specific circumstances men have the ability to delay ejaculation. Strengths and Limitations The strength of this article is its developmental perspective in terms of examining the men’s past and present sexual behaviors. The major limitations are the retrospective–present-day methodology and recruitment via social media, which could lead to sample biases and reliance on men’s recall. Conclusions This study both confirms the presumed developmental course of ELs in men with APE and adds new insights regarding these men’s sexual experiences, including the comparability of their ELs with men having lifelong PE, the relationship between ELs and types of partnered sexual activity, and the lack of association between foreplay duration and EL. It also documents that one-third of men with APE experienced continued deterioration of their condition with age.