How Are Premature Ejaculation Treatment Evaluated?
How do specialists know what premature ejaculation treatment works? How do treatments are compared one with another? In medical research, there are two types of premature ejaculation treatment evaluation. Each one offers different insights on the treatment.
The standard tool to measure premature ejaculation treatment is an objective measure called IELT (intravaginal ejaculation latency time)1. It’s a measure of the time between the start of vaginal penetration and the ejaculation. The time is measured by a stopwatch controlled by the man’s partner.
Subjective Treatment Evaluation
The first type of evaluation is subjective. This means that it’s a measure personal to one person. Usually, subjective evaluation of treatments consists of questionnaires that each subject of the study has to complete. The survey will ask the participants the same questions at the start and the end of the study. If there is progress in the answers, researchers will conclude that there is some efficacity in the treatment.
Researchers ask various questions to measure a lot of things. For example, they could ask the perceived length of intercourse, the perceived level of control on ejaculation, the personal level of satisfaction with the treatment, etc. Also, some studies involved the partner too with a specific partner’s questionnaire.
Pros and Cons of Subjective Evaluation
One of the biggest weakness of the subjective measure is that … it is subjective. As you can read above, the answers contain words like perceived and personal. This flaws the testing for different reasons. First, everyone is a different judge. As one person may be harder to please than another, perceived levels of satisfaction will vary a lot based on the subjects. Second, there’s a discrepancy between the perceived length of intercourse and the objective one. Therefore, it’s hard to know what the real effect of the treatment is.
On the other hand, subjective evaluation allows us to measure things that are unmeasurable with strictly objective evaluation. For example, impact on the quality of life is an essential part of a treatment. If there’s a treatment that gives you 100% ejaculation control and increases your IELT as much as you like but has so much side effects that it’s ruining your life, it’s not a proper treatment. That’s why subjective measures are necessary too.
Objective Treatment Evaluation
An objective evaluation offers us a measure that is independent of the observer. As we mentioned, IELT, the stopwatch measure of vaginal penetration is the standard tool used to compare treatment. First introduced in the 70s, the stopwatch measure was reintroduced in the 90s when scientists started investigation drug treatment for premature ejaculation. It offers researchers a reliable measure to compare different drugs. Nowadays, some form of therapy also uses the IELT as an evaluation measure2.
The IELT effect of a treatment is measured in fold increase. For example, we measure a couple IELT for one month before treatment, and their average IELT is 1 minute. Then, after the treatment, their average IELT is 3 minutes. At the end, we have a three folds increase. If we take all participants, we can find the average fold increase for the treatment. In reality, it’s a bit more complicated than this, but basically, this is how a treatment efficacity is calculated.
Pros and Cons of Objective Evaluation
The most significant advantage is, of course, the reliability of the measure. As mentioned, this gives us a tool we can use to compare each treatment.
However, there’s a big downside to this type of measure. Unlike the subjective questionnaires, this measure doesn’t take into account the treatment’s effect on the patient.
- History of premature ejaculation (2013) Waldinger MD. Chapter 2 in Premature Ejaculation, from Etiology from diagnosis and treatment, Jannini, Emmanuele, McMahon, Chris G., Waldinger, Marcel D., Springer-Verlag Mailand, 2013 p.5-24, ISBN 978-88-470-2646-9.
- De Carufel F, Trudel G (2006) Effects of a new functional-sexological treatment for premature ejaculation. J Sex Marital Ther 32:97–11