DSM: delayed ejaculation (Men)

Question 1

criteria delayed ejaculatie

Answer 1

Delayed Ejaculation (men)
Criteria
A. Either of the following symptoms must be experienced on almost all or all occasions (approximately 75%–100%) of partnered sexual activity (in identified situational contexts or, if generalized, in all contexts), and without the individual desiring delay:
1. Marked delay in ejaculation.
2. Marked infrequency or absence of ejaculation.
B. The symptoms in Criterion A have persisted for a minimum duration of approximately 6 months.
C. The symptoms in Criterion A cause clinically significant distress in the individual.
D. The sexual dysfunction is not better explained by a nonsexual mental disorder or as a consequence of severe relationship distress or other significant stressors and is not attributable to the effects of a substance/medication or another medical condition.

Specify whether:
- Lifelong: The disturbance has been present since the individual became sexually active.
- Acquired: The disturbance began after a period of relatively normal sexual function.

Specify whether:
- Generalized: Not limited to certain types of stimulation, situations, or partners.
- Situational: Only occurs with certain types of stimulation, situations, or partners.

Specify current severity:
- Mild: Evidence of mild distress over the symptoms in Criterion A.
- Moderate: Evidence of moderate distress over the symptoms in Criterion A.
- Severe: Evidence of severe or extreme distress over the symptoms in Criterion A.

Question 2

Associated features supporting diagnosis

Answer 2

The man and his partner may report prolonged thrusting to achieve orgasm to the point of exhaustion or genital discomfort and then ceasing efforts. Some men avoid sexual activities, partners may be less attracted.
With specifying, look at partner, relationship, individual vulnerability, psychiatric comorbidity, stressors, culture/religion, and medical factors.

Question 3

Prevalence

Answer 3

Prevalence is unclear because of the lack of a precise definition of this syndrome. It is the least common male sexual complaint. Only 75% of men report always ejaculating during sexual activity, and less than 1% of men will complain of problems with reaching ejaculation that last more than 6 months.

Question 4

Development and course

Answer 4

Lifelong delayed ejaculation begins with early sexual experiences and continues throughout life. By definition, acquired delayed ejaculation begins after a period of normal sexual function.
Delayed ejaculation appears to remain relatively constant until around age 50 years, when the incidence begins to increase significantly.

Question 5

risico factoren, cultuur en functionele consequenties

Answer 5

Risk and prognostic factors
Genetic and physiological. Age-related loss of the fast-conducting peripheral sensory nerves and age-related decreased sex steroid secretion may be associated with the increase in delayed ejaculation in men older than 50 years.

Culture-related diagnostic issues
Complaints are more common among men in Asian populations than in men living in Europe, Australia, or the United States.

Functional consequences of delayed ejaculation
Difficulty with ejaculation may contribute to difficulties in conception. Delayed ejaculation is often associated with considerable psychological distress in one or both partners.

Question 6

differential diagnosis en comborbidity

Answer 6

Differential diagnosis
- Medical condition;
- Substance/medication use;
- Dysfunction with orgasm.

Comorbidity
There is some evidence to suggest that delayed ejaculation may be more common in severe forms of major depressive disorder.