A. A persistent or recurrent pattern of ejaculation occurring during partnered sexual activity
within approximately 1 minute following vaginal penetration and before the individual
Note: Although the diagnosis of premature (early) ejaculation may be applied to individuals
engaged in nonvaginal sexual activities, specific duration criteria have not been
established for these activities.
B. The symptom in Criterion A must have been present for at least 6 months and must be
experienced on almost all or all (approximately 75%–100%) occasions of sexual activity
(in identified situational contexts or, if generalized, in all contexts).
C. The symptom in Criterion A causes clinically significant distress in the individual.
D. The sexual dysfunction is not better explained by a nonsexual mental disorder or as a
consequence of severe relationship distress or other significant stressors and is not attributable
to the effects of a substance/medication or another medical condition.
Premature (early) ejaculation is manifested by ejaculation that occurs prior to or shortly after
vaginal penetration, operationalized by an individual’s estimate of ejaculatory latency
(i.e., elapsed time before ejaculation) after vaginal penetration. Estimated and measured
intravaginal ejaculatory latencies are highly correlated as long as the ejaculatory latency is
of short duration; therefore, self-reported estimates of ejaculatory latency are sufficient for
diagnostic purposes. A 60-second intravaginal ejaculatory latency time is an appropriate
cutoff for the diagnosis of lifelong premature (early) ejaculation in heterosexual men.
There are insufficient data to determine if this duration criterion can be applied to acquired
premature (early) ejaculation. The durational definition may apply to males of
varying sexual orientations, since ejaculatory latencies appear to be similar across men of
different sexual orientations and across different sexual activities.