Premature ejaculation (PE) is a common sexual issue in men, informally defined as ejaculation that happens sooner than desired – often within a minute of penetration. The causes of PE are not fully understood, but they may be linked to both psychological and biological factors. Some men with PE experience high anxiety or depression, while others may have an overactive ejaculatory reflex or genetic predisposition towards early ejaculation.

Impulse control refers to the ability to delay immediate gratification and manage urges. Some researchers suggest that PE may be linked to difficulties in delaying ejaculation that could be similar to how people with impulse control disorders struggle to resist certain behaviors. Therefore, the authors of a new study set out to explore whether impulse control might play a role in lifelong PE.

Understanding the possible connection between more severe PE and impulse control could help improve treatment strategies, such as behavioral techniques that teach men how to manage arousal and delay ejaculation. This research may open new doors for treating PE beyond traditional psychological or biological explanations.

The new study examined 40 men with lifelong PE and compared them to 40 healthy men. Participants were recruited from a hospital in Turkey between March 2023 and March 2024. PE was diagnosed based on DSM-5 criteria, and ejaculation time was measured using a stopwatch during vaginal intercourse.

To be included, participants had to be cisgender, heterosexual men between 18-45 years of age with a history of regular sexual activity for at least six months. Those using medications affecting sexual function or with major psychiatric or medical conditions were excluded.

Researchers used several psychological and clinical assessments to measure impulsivity, depression, anxiety, and sexual satisfaction. Then, comparisons between the PE and control groups were made using a variety of statistical tests.

The researchers found that the men with PE scored higher on impulsivity tests, including poor planning, urgency, sensation-seeking, and difficulty persevering. They also had higher depression and anxiety scores. The control group had higher scores on the Arabic Index of Premature Ejaculation (AIPE), suggesting better ejaculatory control.

When analyzing PE severity, men with shorter ejaculation times had even higher impulsivity scores. Those with the most severe PE (precoital ejaculation) had the highest scores in poor planning, urgency, and sensation-seeking.

Overall, these findings suggest a strong link between premature ejaculation and impulsivity, anxiety, and depression. The more severe the PE, the higher the impulsivity. This suggests that psychological factors may play a key role in PE and should be considered in treatment approaches (in addition to biological factors).

While the study provides valuable insights, limitations include a small sample size and the challenge of accurately measuring ejaculation time. More large-scale studies are needed to explore the relationship between impulsivity, mood disorders, and PE. Furthermore, future treatments should consider addressing both neurobiological and psychological factors (such as depression, anxiety, and impulsivity).

References:

• Sağlam, T., Takım, U., Kavla, Y., Demir, D. Ö., & Turan, Ş. (2025). Impulse control and its association with ejaculation time in men with premature ejaculation. The Journal of Sexual Medicine, 22(2), 250–257. https://doi.org/10.1093/jsxmed/qdae169