One of the problems with the diagnosis and treatment of PE is that until recently there has not been agreement on what constitutes a premature ejaculation. Many men believe they orgasm more quickly than they should only to discover that their time to orgasm is well within the average range. Other men might orgasm in 2 minutes but find it is neither a cause for concern for them nor for their partner.

1. According to the International Society of Sexual Medicine (ISSM) premature ejaculation is a male sexual dysfunction characterized by the following: Ejaculation that always or nearly always occurs prior to or within about 1 minute of vaginal penetration from the first sexual experience—Lifelong Premature Ejaculation (LPE), OR a clinically significant reduction in latency time (the time it takes to reach orgasm after engaging in sex), often to about 3 minutes or less–Acquired Premature Ejaculation (APE);

2. The inability to delay ejaculation on all or nearly all vaginal penetrations; and

3. Negative personal consequences, such as distress, bother, frustration, and/or the avoidance of sexual intimacy.

All three elements must be included for PE to be diagnosed. Men with PE generally fall into two groups: those who have it from their first sexual experience and those who develop it later. The good thing is that many of the interventions work for both groups.
Another definition of PE that has been suggested by the World Health Organization (WHO) is “persistent or recurrent ejaculation with minimal stimulation before, on, or shortly after penetration and before the person wishes it, over which the sufferer has little or no voluntary control which causes the sufferer and/or his partner bother or distress.” This second definition is more flexible. It is also inclusive of gay men and their partners, which is a welcome addition to the definition.