The following factors may be relevant in the evaluation of any sexual dysfunction:
1) partner factors (e.g., partner’s sexual problems, partner’s health status); 2) relationship fac-
tors (e.g., poor communication, discrepancies in  desire for sexual activity); 3) individual
vulnerability factors (e.g.,  poor body image, history of sexual or emotional abuse), psychiatric
comorbidity (e.g., depression, anxiety), and stressors (e.g., job loss, bereavement); 4) cultural/
religious factors (e.g., inhibitions related to prohibitions against sexual activity; attitudes
toward sexuality); and 5) medical factors relevant to prognosis, course, or treatment.
Prevalence
Estimates of the prevalence of premature (ear ly) ejaculation vary widely depending on the
definition utilized. Internationally, more than 20%–30% of men ages 18–70 years report
concern about how rapidly they ejaculate. Wi th the new definition of premature (early)
ejaculation (i.e., ejaculation occurring within approximately 1 minute  of vaginal penetra-
tion), only 1%–3% of men woul d be diagnosed with the disorder. Prevalence of premature
(early) ejaculation may increase with age.
Development and Course
By definition, lifelong premature (early) ejaculat ion starts during a male’s initial sexual ex-
periences and persists thereafter. Some men may experience prematur e (early) ejaculation
during their initial sexual encoun ters but gain ejaculatory contro l over time. It is the persis-
tence of ejaculatory problems fo r longer than 6 months that determines the diagnosis of pre-
mature (early) ejaculation. In contrast, some  men develop the disorder after a period of