Abstract
BACKGROUND AND OBJECTIVE: Premature ejaculation (PE) and erectile dysfunction (ED) are two common sexual symptoms of male sexual dysfunction that can strongly affect men's mental health and quality of life, and they often coexist. This aim of this study was to explore the causes and relationships between PE and ED, with a focus on the progression of PE accompanied by high-frequency ED. A deeper understanding of the causes and treatments for PE combined with ED will help improve clinical diagnosis and treatment. METHODS: We conducted a literature review of the most relevant articles related to the outlined topic in the PubMed, Google Scholar, and Web of Science databases. We did not limit language, covering both English and non-English publications, and include Chinese and English papers published between January 1996 and March 2024. KEY CONTENT AND FINDINGS: The incidence of PE and ED increases with age. Approximately one-third of patients who complain of ED suffer from PE. Similarly, in a large-scale survey in the Asia-Pacific region, more than 30% of patients with PE reported concurrent ED. Various research findings indicate a strong correlation between PE and ED. Some scholars speculate that there is a vicious cycle between PE and ED. Men who attempt to control ejaculation can reduce the level of arousal, leading to ED, whereas men who try to achieve an erection will attempt to increase the level of arousal, which can lead to PE. This cycle of mutual influence may lead to reciprocal aggravation and persistence of sexual dysfunction in both parties. Although some studies have explored the relationship between PE and ED, the specific determinants and underlying factors have not yet been clarified. CONCLUSIONS: There is a close interrelationship between PE and ED, and a vicious cycle may exist between the two. This cycle of mutual influence may lead to the mutual aggravation and persistence of both sexual dysfunctions. However, the specific determining factors and potential factors underlying the correlation between the two have not been clearly identified and require further exploration.