ORIGINAL RESEARCH–EJACULATORY DISORDERS: Serotonin Transporter Promoter Region (5-HTTLPR) Polymorphism is Associated with the Intravaginal Ejaculation Latency Time in Dutch Men with Lifelong Premature Ejaculation

Authors

  • Paddy K.C. Janssen Pharm.D,

    1. Section of Psychopharmacology, Department of Pharmaceutical Sciences and Rudolf Magnus Institute for Neurosciences, Utrecht University, Utrecht, the Netherlands;
    2. Complex Genetics Section, DBG-Department of Medical Genetics, University Medical Center Utrecht, Utrecht, the Netherlands;
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  • Steven C. Bakker MD, PhD,

    1. Complex Genetics Section, DBG-Department of Medical Genetics, University Medical Center Utrecht, Utrecht, the Netherlands;
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  • Janos Réthelyi MD,

    1. Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary;
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  • Aeilko H. Zwinderman PhD,

    1. Department of Medical Statistics, Clinical Epidemiology and Biostatistics, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands;
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  • Daan J. Touw Pharm.D, PhD,

    1. Apotheek Haagse Ziekenhuizen, The Hague, the Netherlands;
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  • Berend Olivier PhD,

    1. Section of Psychopharmacology, Department of Pharmaceutical Sciences and Rudolf Magnus Institute for Neurosciences, Utrecht University, Utrecht, the Netherlands;
    2. Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA;
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  • Marcel D. Waldinger MD, PhD

    1. Section of Psychopharmacology, Department of Pharmaceutical Sciences and Rudolf Magnus Institute for Neurosciences, Utrecht University, Utrecht, the Netherlands;
    2. Department of Psychiatry and Neurosexology, HagaHospital Leyenburg, The Hague, the Netherlands
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Marcel D. Waldinger, MD, PhD, Department Psychiatry and Neurosexology, HagaHospital Leyenburg, Leyweg 275, 2545 CH The Hague, the Netherlands. Tel: +31-70-210-2086; Fax: +31-70-210-4902; E-mail: md@waldinger.demon.nl

ABSTRACT

Introduction.  Lifelong premature ejaculation (LPE) is characterized by persistent intravaginal ejaculation latency times (IELTs) of less than 1 minute, and has been postulated as a neurobiological dysfunction with genetic vulnerability for the short IELTs, related to disturbances of central serotonin (5-hydroxytryptamine [5-HT]) neurotransmission and 5-HT receptor functioning.

Aim.  To investigate the relationship between 5-HT transporter gene-linked polymorphism (5-HTTLPR) and short IELTs in men with lifelong PE.

Methods.  A prospective study was conducted in 89 Dutch Caucasian men with lifelong PE. IELT during coitus was assessed by stopwatch over a 1-month period. Controls consisted of 92 Dutch Caucasian men. All men with LPE were genotyped for a 5-HTT-promoter polymorphism. Allele frequencies and genotypes of short (S) and long (L) variants of 5-HTTLPR polymorphism were compared between patients and controls. Association between LL, SL, and SS genotypes, and the natural logarithm of the IELT in men with LPE was investigated.

Main Outcome Measures.  IELT measured by stopwatch, 5-HTTLPR polymorphism.

Results.  In men with lifelong PE, the geometric mean, median, and natural mean IELTs were 21, 26, and 32 seconds, respectively. There were no significant differences in the 5-HTT polymorphism alleles and genotypes between 89 Dutch Caucasian men with LPE (S 47%, L 53%/LL 29%, SL 48%, SS 22%) and 92 Dutch Caucasian controls (S 48%, L 52%/LL 29%, SL 45%, SS 26%). In men with lifelong PE there was a statistically significant difference between LL, SL, and SS genotypes in their geometric mean IELT (≤ 0.027); the LL genotypes had significantly shorter IELTs than the SS and SL genotypes.

Conclusions.  The 5-HTTLPR polymorphism is associated with significant effects on the latency to ejaculate in men with lifelong PE. Men with SS and SL genotypes have 100% and 90% longer ejaculation time, respectively than men with LL genotypes. Janssen PKC, Bakker SC, Réthelyi J, Zwinderman AH, Touw DJ, Olivier B, and Waldinger MD. Serotonin transporter promoter region (5-HTTLPR) polymorphism is associated with the intravaginal ejaculation latency time in Dutch men with lifelong premature ejaculation. J Sex Med 2009;6:276–284.

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