A Population Analysis of Delayed Ejaculation Using a Claims Database: Characteristics and National Trends in Prevalence, Incidence, and Pharmacotherapy

Abstract Delayed ejaculation (DE) is rare disorder of sexual function reported to affect between 1-5% of men. However, due to the lack of a standard definition, the true prevalence, incidence, and treatment trends remain unclear. Herein, we assess the trends in prevalence and incidence of DE diagnosis as well as the medications and comorbidities in men when diagnosed with DE and treatment patterns using a large claims database. The TriNetX Diamond database was queried to identify adult males diagnosed with DE. Prevalence was determined by comparing men with a diagnosis of DE to the total population of men evaluated in the inpatient, outpatient, and emergency settings in six-month intervals within the database. Similarly, incidence was determined by comparing men with a new diagnosis to the total population of men without a previous diagnosis. Pharmacotherapy rates were calculated by comparing the number of men receiving a prescription to the total number of men in one-year intervals. We identified 23,164 men with a diagnosis of DE. In the final period, 2,747 (0.02%) men were diagnosed with DE and 1,375 (0.01%) received a new diagnosis of DE, with prevalence and incidence increasing over time. The most common medications prescribed in the final period were testosterone (9.5%), bupropion (6.6%), and buspirone (2.3%). Additionally, 916 (19.4%) received any prescription, with the rates of these medications increasing consistently over time. Delayed ejaculation is rarely diagnosed but has increasing prevalence. Rates of pharmacotherapy remain low. Further work is needed to investigate first-line medical therapy if behavioral modifications and psychotherapy fail.