ORIGINAL RESEARCH article
Front. Reprod. Health
Sec. Andrology
Volume 7 - 2025 | doi: 10.3389/frph.2025.1711365
This article is part of the Research TopicMale Infertility and Erectile Dysfunction: Shared Pathways, Diagnostics, and Therapeutic InnovationsView all articles
Distinct Phenotypic Signatures between Anejaculation and Premature Ejaculation: Evidence from a Large Clinical Cohort
Provisionally accepted
- First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Background: Anejaculation (AE) and premature ejaculation (PE) are clinically distinct but mechanistically complex disorders. While both contribute substantially to male sexual health burden, their comparative profiles have not been systematically delineated in large cohorts. Methods: We retrospectively analyzed 542 men (AE = 249, PE = 293) at a tertiary andrology clinic. All participants underwent vibration perception threshold (VPT) testing at ten standardized sites, spinal MRI reviewed by blinded radiologists, expressed prostatic secretion microscopy with supportive ultrasound for prostatitis, and validated psychological assessments (PHQ-9, GAD-7, SDI-2). Statistical comparisons used Mann–Whitney U tests, chi-squared tests, and multivariate analysis of variance (MANOVA). Results: AE patients exhibited higher composite VPT thresholds than PE (7.12 ± 1.75 vs 6.60 ± 1.26, p<0.001), with MANOVA confirming distinct sensory profiles (Wilks' λ=0.907, p<0.001). Cervical-only abnormalities were markedly more frequent in PE (33.4% vs 2.8%), whereas AE more often showed either no abnormality (45.8% vs 28.0%) or combined cervical–lumbar involvement (14.5% vs 7.5%; overall χ²=84.46, p<0.001). Chronic prostatitis was present in nearly half of AE cases but only one fifth of PE (47.4% vs 20.1%, p<0.001). Depressive symptoms were modestly higher in AE (PHQ-9: 8.31 ± 5.96 vs 7.15 ± 5.65, p=0.024), while sexual desire and anxiety scores did not differ significantly. Conclusions: AE and PE display distinct clinical signatures. AE was linked to higher vibration thresholds, greater prevalence of prostatitis, and elevated depressive symptoms, while PE was predominantly associated with isolated cervical spine abnormalities.Recognizing these patterns may refine clinical assessment and guide more individualized management.
Keywords: Anejaculation, Premature Ejaculation, Vibration perception threshold, Spinal MRI, Depression
Received: 26 Sep 2025; Accepted: 13 Oct 2025.
Copyright: © 2025 Zhang, Shi, Wang, Zheng, Nan and Lv. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Rui Wang, andrology_zzu@163.com
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