The hidden half of premature ejaculation: partner factors and shared determinants: a couple-based cross-sectional study

Background: Premature ejaculation (PE) is one of the most common male sexual dysfunctions, yet it is often perceived as an individual disorder, despite growing evidence suggesting a couple-based pathophysiology. Objectives: This study aimed to explore the shared demographic, behavioral, and psychosocial determinants of PE among heterosexual couples. Materials and methods: A cross-sectional study was conducted between 2023 and 2025, including 661 heterosexual couples (n = 1,322 individuals) attending a tertiary urology clinic. Participants completed validated instruments: the Arabic Index of Premature Ejaculation (AIPE), Premature Ejaculation Diagnostic Tool (PEDT), International Index of Erectile Function (IIEF-5) for males, and Golombok–Rust Inventory of Sexual Satisfaction (GRISS) for females. PE was defined according to the AIPE and PEDT cutoffs. Logistic regression analyses were performed to identify predictors of PE among male participants based on both partners’ variables. Results: PE was identified in 272 (41.1%) men. Men with PE were significantly older, less physically active, and had lower educational levels than men without PE (p < 0.05). Female partners of men with PE were also older, more frequently affected by chronic comorbidities, and less likely to exercise regularly. Multivariate regression revealed that older age (OR = 1.057, 95% CI: 1.039–1.075, p = 0.001), physical inactivity (OR = 1.759, 95% CI: 1.126–2.749, p = 0.013), and low education (OR = 2.224, 95% CI: 1.413–3.501, p = 0.001) were independent predictors of PE in men. Among women, age (OR = 1.04, 95% CI: 1.016–1.066, p = 0.001), concomitant comorbidities (OR = 2.639, 95% CI: 1.312–5.307, p = 0.006), and physical inactivity (OR = 2.995, 95% CI: 1.778–5.044, p < 0.001) were associated with an increased risk of PE in their partners. Discussion: PE should not be accepted purely as a male-specific disorder. It should be regarded as a shared biopsychosocial condition influenced by the characteristics of both partners. Lifestyle modification, patient education, and couple-based counseling may improve ejaculatory control and relationship satisfaction. Conclusions: These findings highlight the importance of a comprehensive, couple-centered approach to PE management.