Twelve patients with premature ejaculation were evaluated and the hypothalamic anterior pituitary-testicular axis studied to determine whether hormonal abnormalities occurred. Plasma testosterone and free testosterone levels were found to be diminished, as were LH and FSH levels. Four of 12 patients with premature ejaculation had increased prolactin levels. The findings of decreased testosterone without the expected increases in gonadotropin in male patients between 24 and 25 years old points to hypothalamic pituitary dysfunction as a factor in the genesis of the hypogonadal state. Further studies are needed to document the association of premature ejaculation and hypogonadotropic hypogonadism, along with other possible clinical correlations that remain to be described.