444 Sexual Dysfunctions
Specify whether:
Generalized:  Not limited to certain types of stimulation, situations, or partners.
Situational: Only occurs with certain types of stimulation, situations, or partners.
Specify current severity:
Mild:  Ejaculation occurring within approximately 30 seconds to 1 minute of vaginal
penetration.
Moderate: Ejaculation occurring within approximately 15–30 seconds of vaginal pen-
etration.
Severe:  Ejaculation occurring prior to sexual activity, at the start of sexual activity, or
within approximately 15 seconds of vaginal penetration.
Diagnostic Features
Premature (early) ejaculation is manifested by ej aculation that occurs prior to or shortly af-
ter vaginal penetration, operationalized by an individual’s estimate of ejaculatory latency
(i.e., elapsed time before ej aculation) after vaginal penetr ation. Estimated and measured
intravaginal ejaculatory latencies are highly co rrelated as long as the ejaculatory latency is
of short duration; therefore, self-reported esti mates of ejaculatory latency are sufficient for
diagnostic purposes. A 60-second intravaginal ejaculatory latency time is an appropriate
cutoff for the diagnosis of lifelong prematur e (early) ejaculation in heterosexual men.
There are insufficient data to determine if th is duration criterion can be applied to ac-
quired premature (early) ejaculation. The du rational definition may apply to males of
varying sexual orientations, since ejaculatory latencies appear to be  similar across men of
different sexual orientations and ac ross different sexual activities. 
Associated Features Supporting Diagnosis
Many males with premature (early) ejaculation complain of a sense of lack of control over
ejaculation and report apprehension about thei r anticipated inability to delay ejaculation
on future sexual encounters.
The following factors may be relevant in the evaluation of any sexual dysfunction: