Premature ejaculation: A psycho physiological approach for assessment and management

Michael E. Metz, Jon L Pryor

Research output: Contribution to journalArticlepeer-review

73 Scopus citations


This article distinguishes several subtypes of biogenic and psychogenic premature ejaculation (PE) according to their etiologic features: The physiological PE types of (a) neurologic constitution, (b) acute physical illness, (c) physical injury, and (d) pharmacologic side effect; and the psychological PE types of (a) psychological constitution, (b) acute psychological distress, (c) relationship distress, and (d) psychosexual skills deficit. Attention is given to assessment and differential diagnosis, and to specific treatment of the types of PE, such as the pharmacologic management of difficult neurologic cases. Effective psychosexual treatment combines multiple strategies such as physiological relaxation, pubococcygeal muscle training, cognitive and behavioral pacing strategies, and the involvement of the partner in the therapy. Treatment should determine the specific type of PE and comprehensively address its particular features in order to improve long-term treatment effectiveness.

Original languageEnglish (US)
Pages (from-to)293-309
Number of pages17
JournalJournal of Sex and Marital Therapy
Issue number4
StatePublished - Oct 2000


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