PRL and obesity due to melanocortin 4 receptor deficiency: Although exact cause of premature ejaculatory dysfunction couldn’t be ascertained in general and RA patients however there are various factors related to it, Corona et al found that many men with premature ejaculation have, low serum prolactin levels.24 In RA there is wide prevalence of depression and dyslipidemia, diabetes mellitus, obesity, illicit drug use, so these might be affecting the sexual functions as well.25-27