15% à 30% of men experience difficulty controlling their ejaculation and are therefore classed as premature ejaculators. The considerably large size of this group shows how difficult it is to diagnose the condition. However, there is one factor that is common to all these men: the psychological suffering that they experience as a result of the condition. Philippe Kempeneers, of the Department of Public Health Sciences of the University of Liege, and a psychologist at the Psychiatric Clinic of Alexiens, has been working on the subject for several years and has been researching re-education methods, in particular, through “bibliotherapy”: a small booklet containing different exercises and explanations has been created. It is published at De Boeck editions.

So-called premature ejaculation is a personal subject to the point of being taboo, yet it is a particularly subjective notion. When you factor in a strong cultural element to the issue you get an understanding of just how difficult it is to define the problem in any precise scientific way. There is quite simply no universally accepted definition of premature ejaculation. “There are two main strands of thought on the subject”, explains Philippe Kempeneers, a lecturer at the Department ofPublic Health Sciences of The University of Liege: “On one hand, there are those who take into consideration the lack of control over ejaculation and the suffering that this can cause and on the other, there are those who concentrate on the length of time before ejaculation occurs following penetration”. There are some who attempt to reconcile the two points of view.  

This is the case of the American Psychiatric Association (APA) which, until recently, suggested a definition that met the agreement of several specialists. In the fourth edition of its nosographic manual, the famous DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revised), it considers that premature ejaculation has occurred when it happens before an individual wants it to happen, but only if it occurs before, during or just after intromission.  ‘Just after’ therefore leaves room for a certain amount of subjectivity because it does not specify a timescale. Moreover, the APA adds that problems of rapid ejaculation due to disease such as urino-genital infection, for example, or medicinal treatments such as opiate withdrawal should be excluded. Lastly, the Association considers that account must be taken of parameters that can influence the duration of the excitation phase such as age, experience, the newness of the relationship and the frequency of sexual activity. If it is possible to use these parameters to establish the reality of premature ejaculation, then it would be necessary to determine whether the condition has always been present (it would then be described aslifelong), or if it happened after a period of normal duration (it would then be described asacquired); it can also be sporadic according to situations and partners.

Suffering in particular

Because this notion of time is not determined, some researchers who form a group within the International Society for Sexual Medicine (ISSM) have suggested that the inability of a man to withhold ejaculation for less than one to two minutes after intromission should be considered a pathological condition. Beyond this, the duration could be considered normal. But different cases can vary greatly: while one man may ejaculate less than two minutes after penetration causing general insatisfaction, another may be capable of ‘lasting’ five, eight or ten minutes but without satisfying his partner and therefore feel frustrated. Based on his research and clinical work, Philippe Kempeneers has formed an idea: “The first criterion to be taken into account is certainly the frustration and psychological suffering of the man and the couple. Taking account only of the duration of the penetrationis not sufficient: what distinction can be made between a penetration which lasts 1 minute and 40 seconds and another which lasts two minutes and 20 seconds, can one be considered pathological and the other not? Because if the partners are satisfied despite the short-lived penetration, why should such a “premature ejaculation” be considered a disorder?"

(1) Kempeneers Ph., Bauwens S., Andrianne R., Lutter contre l'éjaculation précoce. Guide pratique, De Boeck Solal, 2015.