Metabolic syndrome poses significant risk factor for premature ejaculation

Dr. David Samadi provides his expertise on a recent study investigating the relationship between metabolic syndrome and premature ejaculation and why there appears to be a significant association between the two.

A recent prospective, comparative study published in the International Journal of Impotence Research has found that the components of metabolic syndrome (MetS) to be significant risk factors for premature ejaculation (PE) after adjusting for age and total testosterone. Other studies have looked at the relationship between PE and diabetes or obesity, but this study appears to be the first to specifically evaluate the relationship between PE and MetS.

“This is an important area to investigate as premature ejaculation is one of the most common male sexual dysfunctions men experience ranking up there with erectile dysfunction, delayed ejaculation and low libido,” said Dr. David Samadi. “Premature ejaculation is when a man is not able to control ejaculation either shortly before or shortly after sexual penetration and is estimated to affect up to 30% of all men. This can result in unsatisfactory sex for both partners as a man will ejaculate too quickly leading to a great deal of anxiety and frustration for men when this happens.”

Premature ejaculation has long been considered to be a result of a psychological or learned condition.  However over the years, other factors such as thyroid diseases, prostatitis, and varicocele have now been considered as playing a role in the pathogenesis of PE.

Metabolic syndrome is a name for a group of risk factors that include obesity, insulin resistance, dyslipidemia, and hypertension.  When a person has all four of these conditions going on at the same time, this can significantly increase one’s risk for heart disease, stroke, and diabetes. 

“Over the years, it has been known the relationship between obesity, metabolic syndrome and erectile dysfunction,” stated Dr. Samadi. “This study wanted to analyze what association there might be between premature ejaculation and metabolic syndrome since there are so many men who have metabolic syndrome and who may be having difficulty with premature ejaculation and not understanding why it is happening.”

The study recruited 100 patients between the age of 20 and 60 years and with the complaint of acquired PE – acquired PE is when a man has previously had normal ejaculatory functioning before the PE began.  There were also 100 men recruited who were the control cases enrolled in the study but did not have PE. Detailed medical history including waist circumference, blood pressure and weight were taken along with ejaculation and erection functions evaluated by Premature Ejaculation Diagnostic Tool (PEDT) and International Index of Erectile Function-5 (IIEF-5).  

“The findings from this study were very remarkable in the differences between the men with acquired premature ejaculation and the control group,” exclaimed Dr. Samadi. “The prevalence of metabolic syndrome was only 24% in healthy men in the control group compared to 51% in the men with premature ejaculation.”

What was found was that men with PE had higher fasting blood glucose levels than the men without PE along with 59% of the men with PE had systolic blood pressures >130/85 mm Hg.  In addition, men with PE had higher waist circumferences of >102 cm and higher serum triglycerides levels of >150 mm dl when compared to the control group. 

Some of the reasons these factors may attribute to PE could be for the following – for example, in diabetes, diabetic neuropathy is common and can reduce the integrity of the autonomic nervous system along with both central and peripheral neurotransmitters that ejaculation depends on.  Plus there could be the psychological factor of performance anxiety regarding their erectile reliability rushing through intercourse believing they have limited time to complete the task.

“It appears that a man with metabolic syndrome could be at risk for acquired premature ejaculation,” said Dr. Samadi. “Even though more studies need to be conducted to confirm these results, one may assume that a man who presents with metabolic syndrome, may also be having premature ejaculation.  This would be where I as a urologist, need to discuss with him how his sex life is functioning to explore if premature ejaculation is an issue.”

Dr. Samadi went on to say, “The four components of metabolic syndrome – high blood pressure, diabetes, obesity, and elevated blood lipid levels – can be controlled with some lifestyle changes.  If a man has developed acquired premature ejaculation when he previously didn’t have it, we would want to evaluate these factors to see if they could be the reason behind his problem.  From there we can suggest ways to reduce the symptoms with dietary changes, exercise, and stress reduction.  Hopefully overtime, his metabolic syndrome can be reversed along with his premature ejaculation leading to a more fulfilling sexual life.”

Patients newly diagnosed with premature ejaculation or prostate cancer can contact world renowned prostate cancer surgeon and urologic oncologist, Dr. David Samadi, for a free phone consultation and to learn more about prostate cancer risk, call 212-365-5000.