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Background Although temperament-character traits and attitudes toward premature ejaculation (PE) are known to be associated with PE, it is of great significance to study them in PE. Moreover, few studies have evaluated these traits and attitudes in the new classification of 4 subtypes of PE. Aim We investigated the temperament-character traits and attitudes toward PE in 4 types of PE and their associations with PE. Methods Between December 2018 and December 2019, we conducted a survey in our hospital, and enrolled 350 men who complained of PE and 252 men without any complaint of PE. Temperament-character traits and attitudes toward PE were independently assessed by the Temperament and Character Inventory-Revised and several targeted questions, respectively. The Index of Premature Ejaculation (IPE) was used to evaluate ejaculation control, sexual life satisfaction, and distress caused by PE. Outcomes The outcomes included differences of temperament-character traits and attitudes toward PE among 2 groups and their associations with PE. Results Of the 2 groups, men with PE complaints had lower novelty seeking/self-transcendence (NS/ST) scores and higher harm avoidance (HA) scores vs men without any complaints of PE. Among the 4 types of PE, men with variable PE had the highest score of HA and lowest score of NS; the lowest score of ST was recorded in men with lifelong PE. Additionally, the total and subdomain scores of IPE in men with subjective PE were higher than the other subtypes of PE. After adjusting for age, positive correlations were observed in HA score and total and subdomain scores of IPE, whereas the inverse was true corresponding to NS and ST. Clinical Implications The current study has provided a new perspective for understanding the impact of psychological factors on PE. Strengths & Limitations This is the first study to systematically assess the effects of personality traits and attitudes on PE, especially among the 4 types of PE. The main drawback is that the generalizability of this study may be limited by the fact that it was conducted in a single cultural/societal background. Conclusion Men who complained of PE tended to react with indifference or rejection to novelty, tended to feel unsatisfied, cannot effectively adapt to changes in the surrounding environment, and tended to avoid situations involving risk. These characteristics could lead to their becoming disheartened when faced with PE. Furthermore, the attitude of men with PE reflects the needs of the patient during treatment from one aspect. Gao P, Gao J Wang Y, et al. Temperament-Character Traits and Attitudes Toward Premature Ejaculation in 4 Types of Premature Ejaculation. J Sex Med 2021;18:72–82.

A new classification of premature ejaculation (PE) has been proposed, including the categories of lifelong PE (LPE), acquired PE (APE), natural variable PE (NVPE), and premature-like ejaculatory dysfunction (PLED).The aim of this study was to evaluate the impact of intravaginal ejaculation latency time (IELT) and erectile function on anxiety and depression among patients with PE in general and according to the four types of PE.Between September 2011 and September 2012, we conducted a cross-sectional study in the Anhui province of China. We enrolled 4,000 men aged over 18 years, each of whom had been in a stable, monogamous, heterosexual relationship with the same partner for at least 6 months.Self-estimated IELT, the International Index of Erectile Function-5 (IIEF-5) and the Zung Self-Rating Anxiety and Depression Scales (SAS/SDS) were used to measure PE, erectile dysfunction (ED), anxiety, and depression, respectively, among the entire study population.Of the 3,016 men evaluated, 25.80% complained of PE. Distribution of the four types of PE among men with PE was as follows: LPE, 12.34%; APE, 18.77%; NVPE, 44.09%; PLED, 24.81%. Men with PE presented lower IIEF-5 scores and higher SAS and SDS scores vs. men without PE (P0.001 for all). Similar findings were observed in men with APE when compared with other PE syndromes. After adjustment for age in men with PE, IELT was negatively associated with SAS and SDS scores (SAS, adjusted r = -0.42, P0.001; SDS, adjusted r = -0.45, P0.001). IIEF-5 score was negatively associated with SAS and SDS scores (SAS, adjusted r = -0.54, P0.001; SDS, adjusted r = -0.50, P0.001). These negative relationships were strongest in men with PLED (IELT vs. SAS: adjusted r = -0.63, P0.001; IELT vs. SDS, adjusted r = -0.60, P0.001; IIEF-5 vs. SAS: adjusted r = -0.57, P0.001; IELT vs. SDS, adjusted r = -0.55, P0.001).APE patients reported higher rates of ED, anxiety, and depression than men with other types of PE. The negative relationships between IELT/IIEF-5 and SAS/SDS were strongest in men with PLED.

Introduction Although the new classification of premature ejaculation (PE) has been proposed by Waldinger et al., there have been few studies investigating the four PE syndromes in China. Aims We investigated the prevalence and factors associated with the complaint of PE and the four PE syndromes in Anhui province, China. Methods Between September 2011 and September 2012, subjects were selected from five cities in Anhui province, China. They participated in this survey by completing a detailed verbal questionnaire regarding their demographic data and medical and sexual history. Men with PE complaint were diagnosed as lifelong PE (LPE), acquired PE (APE), natural variable PE (NVPE), or premature‐like ejaculatory dysfunction (PLED). Main Outcome Measures PE complaint was divided into four PE syndromes. Anxiety, depression, and erectile dysfunction were independently assessed by the self‐rating anxiety/depression scale and the international index of erectile function‐5, respectively. Results Of the 3,016 men evaluated, 25.80% complained of PE. The distribution of the four PE syndromes in men with PE complaint was in the order of NVPE (44.09%), PLPE (24.81%), APE (18.77%), and LPE (12.34%). Patients with PE complaint were older and more likely to smoke, had more comorbidities, and a higher body mass index (BMI) than patients without the complaint ( P P = 0.012, cardiovascular P = 0.003, others P P Conclusion The prevalence of PE complaint in male population of Anhui province, China, was 25.80%, with the highest PE syndromes being NVPE and PLPE. Patients with PE complaint or APE were older and more likely to smoke, had more comorbidities, and a higher BMI. Gao J, Zhang X, Su P, Liu J, Xia L, Yang J, Shi K, Tang D, Hao Z, Zhou J, and Liang C. Prevalence and factors associated with the complaint of premature ejaculation and the four premature ejaculation syndromes: a large observational study in China. J Sex Med 2013;10:1874–1881.

Introduction Besides lifelong premature ejaculation (LPE) and acquired premature ejaculation (APE), Waldinger and Schweitzer proposed two addition PE syndromes (variable PE [VPE] and subjective PE [SPE]). Aim We assessed the associations between intravaginal ejaculatory latency time (IELT) and National Institutes of Health‐Chronic Prostatitis Symptom Index (NIH‐CPSI) in men with different PE syndromes. Methods From September 2011 to September 2012, a total of 4,000 men were enrolled from the Anhui province of China. Subjects were required to complete a verbal questionnaire, including demographic information, medical and sexual history (e.g., IELT), and self‐estimated scales (e.g., NIH‐CPSI). Main Outcome Measures IELT; NIH‐CPSI; the new classification of PE syndromes. Results Of 3,016 of the men evaluated, 25.80% complained of PE. Distribution of the four PE syndromes among men with complaints of PE was as follows: LPE, 12.34%; APE, 18.77%; VPE, 44.09%; and SPE, 24.81%. Men with complaints of PE reported worse NIH‐CPSI scores and lower IELT than men without complaints of PE ( P r = −0.68, P r = −0.70, P r = −0.67, P r = −0.64, P Conclusion Men with complaints of PE reported worse NIH‐CPSI scores than men without complaints of PE. Relationships between IELT and NIH‐CPSI scores were strongest in men with APE. Gao J, Xu C, Liang C, Su P, Peng Z, Shi K, Tang D, Gao P, Lu Z, Liu J, Xia L, Yang J, Hao Z, Zhou J, and Zhang X. Relationships between intravaginal ejaculatory latency time and National Institutes of Health‐Chronic Prostatitis Symptom Index in the four types of premature ejaculation syndromes: A large observational study in China. J Sex Med 2014;11:3093–3101.

Although infertility is known to be associated with psychological and sexual problems, the relationship between these two aspects in infertile men has not been well investigated.To investigate the incidence of sexual dysfunction and psychological burden, and their possible associations in infertile men.From June 2009 to June 2012, a total of 1,468 infertile men and 942 fertile men were evaluated. Premature ejaculation (PE) and erectile dysfunction (ED) were measured by the PE diagnostic tool (PEDT), the intravaginal ejaculatory latency time (IELT) and the international index of erectile function (IIEF)-5. Anxiety and depression, which reflect the degree of psychological burden, were measured by the self-rating anxiety scale (SAS) and self-rating depression scale (SDS), respectively.PE and ED were measured by the PEDT, IELT, and IIEF-5. Anxiety and depression were measured by the SAS and SDS, respectively.The incidences of PE and ED in the infertile group were significantly higher than those in the fertile group (PE: 19.01% vs.10.93%, P 0.001; ED: 18.05% vs. 8.28%, P 0.001). In addition, anxiety and depression were more prevalent in infertile than fertile men (Anxiety: 38.01% vs. 26.65%, P 0.001; Depression: 15.74% vs. 10.08%, P 0.001). Furthermore, after adjusting for age in the infertile group, the PEDT score was positively associated with anxiety (adjusted r = 0.57; P 0.001) and depression (adjusted r = 0.54; P 0.001). Moreover, the IELT were negatively associated with anxiety (adjusted r = -0.40; P 0.001) and depression (adjusted r = -0.52; P 0.001). Similar negative relationships were also observed between the IIEF-5 score and anxiety (adjusted r = -0.49; P 0.001) or depression (adjusted r = -0.50; P 0.001).This is the first study to systematically evaluate the incidence of sexual dysfunction and psychological burden, and their possible associations in infertile men in China. Further in-depth studies are needed to confirm and extend these results.

Introduction Because available definitions of premature ejaculation (PE) were unable to encompass the various forms of PE, Waldinger et al. proposed a new classification that distinguished four PE syndromes. However, few studies have examined the prevalence rates of these four PE syndromes. Aims The study aims to analyze the prevalence of and factors associated with four PE syndromes in outpatients who complained of ejaculating prematurely. Methods Between December 2009 and December 2011, outpatients who complained of PE completed a detailed verbal questionnaire regarding their demographic data and medical and sexual history. Each patient was classified as having one of four PE subtypes: lifelong PE (LPE), acquired PE (APE), natural variable PE (NVPE), or premature‐like ejaculatory dysfunction (PLED). Main Outcome Measures Based on the new classification scheme, PE was classified into four subtypes. The anxiety/depression status of patients was assessed by the Zung self‐rating anxiety/depression scales, and erectile function was assessed by the International Index of Erectile Function‐5 instrument. Results This study included 1,988 male outpatients who complained of PE, with mean ages and body mass index (BMI) scores of 35.52 ± 10.38 years and 25.34 ± 4.51 kg/m 2 , respectively. Prevalence rates of PE syndromes were 35.66% for LPE, 28.07% for APE, 12.73% for NVPE, and 23.54% for PLED. Patients with APE had the highest mean ages and BMI scores, and they more frequently reported several comorbidities, including sexual desire disorder, hypertension, diabetes mellitus, chronic prostatitis, and erectile dysfunction. The PLED group had a lower mean frequency of sexual intercourse than other groups and higher rates of anxiety and depression. Conclusion The prevalence of LPE was higher than that of other PE subtypes in an outpatient setting. Several comorbidities were more common in patients with APE and PLED. In particular, a lower frequency of intercourse and higher frequencies of anxiety and depression were found in patients with PLED.