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Andrology. 2019 Mar;7(2):163-171. doi: 10.1111/andr.12579. Epub 2018 Dec 16.

Clinical characteristics of men complaining of premature ejaculation together with erectile dysfunction: a cross-sectional study.

Author information

Sexual Medicine and Andrology Unit, Department of Experimental Clinical and Biomedical Sciences 'Mario Serio', University of Florence, Florence, Italy.
Endocrinology Unit, Medical Department, Azienda Usl Bologna Maggiore-Bellaria Hospital, Bologna, Italy.
I.N.B.B. - Istituto Nazionale Biostrutture e Biosistemi, Rome, Italy.



Premature ejaculation (PE) is present in up to 30% of men with erectile dysfunction (ED).


To assess the clinical features of men complaining of both ED and PE (ED-PE) as compared to men reporting only ED or PE.


A consecutive series of 4024 men (mean age 51.2 ± 13.2 years) consulting for sexual dysfunction was studied. The population was categorized into ED-only (n = 2767; 68.8%), PE-only (n = 475; 1.8%), and ED-PE (n = 782; 19.4%). Sexual symptoms were evaluated using the structured interviews SIEDY and ANDROTEST. Penile color Doppler ultrasound (PDCU) parameters were also assessed.


When compared to PE alone, ED-PE reported more sexual complaints, including impaired morning erections [OR = 5.8 (4.1; 8.3)], decreased sexual desire [OR = 2.6 (1.8; 3.7)], decreased ejaculate volume [OR = 2.7 (1.8; 4.0)], and reduced frequency of sexual intercourse [OR = 1.4 (1.0; 2.0)]. Conversely, ED-PE and ED-only men had a similar prevalence of sexual symptoms. In ED-PE men, the characteristics of ED were similar to ED-only men, whereas the characteristics of PE were milder than in PE-only men. ED-PE men had a significantly higher prevalence of hypertension, diabetes, and cardiovascular (CV) diseases [OR = 1.8 (1.1; 3.0), 2.7 (1.3; 5.6) and 2.7 (1.1; 6.5), respectively] than PE-only subjects. Moreover, ED-PE men showed worse dynamic peak systolic velocity at PDCU [B = -12.0 (-17.7; -6.2)] and a greater 10-year estimated CV risk [B = 3.8 (2.5; 5.1)] than PE-only patients. Conversely, comorbidities and PDCU parameters were similar in ED-PE and ED-only men.


The present results suggest that men reporting ED and PE should be considered as patients with ED-only, at least at first glance. Consequently, the diagnosis-including the CV risk stratification-and treatment should be primarily focused on the erectile problem.


Erectile dysfunction-PE patients present several similarities with those consulting only for ED, whereas their characteristics are different from PE-only men. In agreement with the guidelines, our results confirm that ED-PE men might be considered (and managed) primarily as patients with ED.


clinical characteristics; concomitant occurrence; differences; erectile dysfunction; premature ejaculation; similarities


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