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What is premature ejaculation?

Premature ejaculation (PE) is defined as a man ejaculating soon than desired during sexual intercourse. This is a common issue that roughly 1 in 3 men experience at some point in their lives. If it only happens occasionally, then this is nothing to worry about. The following signs can lead to a diagnosis of premature ejaculation: 

  • Frequently ejaculating within one minute of penetration 
  • Finding it impossible to delay ejaculation during sexual intercourse 
  • Avoiding sex due to feeling frustrated or inadequate 

What are ejaculation problems?

There are three main types of ejaculation problems in men. These are: 

  • Premature ejaculation- when a male orgasm occurs sooner than either partner would like 
  • Delayed ejaculation- when a man is either unable to ejaculate or experiences a noticeable delay in being able to. This is also known as male orgasmic disorder
  • Retrograde ejaculation- a rarer issue that causes semen to travel backwards towards the bladder. It causes either no or a small amount of semen during ejaculation

What causes premature ejaculation?

There are various factors that can cause premature ejaculation, both physical and psychological. These typically include: 

  • An overactive thyroid 
  • An underactive thyroid 
  • Prostate problems 
  • Drug and substance abuse 
  • Stress and anxiety 
  • Depression 
  • Relationship issues 
  • Anxiety around sexual performance 
  • Anxiety caused by past sexual experiences
  • Traumatic childhood experiences relating to sex
  • Conditioning and certain beliefs being instilled about sex from a young age 
  • Anatomy- having an extra sensitive penis 

Can premature ejaculation be controlled?

There are various things you can try to control premature ejaculation before seeking medical help. These methods can help to relieve sensitivity and regain control: 

  • Use a thicker condom such as the ‘extra safe’ variety 
  • Masturbate 1-2 hours prior to having sex 
  • Stop the ejaculatory reflex by taking a deep breath
  • Engage in a sexual position where your partner is on top so that they can pull away if you come close to ejaculation 
  • Take breaks or think about something neutral during sex 

Psychological causes of premature ejaculation

There are many psychological factors which can cause premature ejaculation. These include: 

  • Negative early sexual encounters 
  • Sexual abuse 
  • Negative body image 
  • Depression and anxiety 
  • Anxiety surrounding sexual performance  
  • Erectile dysfunction 
  • Problems in your relationship 

If any of these factors strike a chord with you then this may be the root cause of your ejaculation problems. If you are unsure, consult a doctor so that they can rule out underlying physical conditions. 

Biological causes of premature ejaculation

Biological factors which can cause premature ejaculation include: 

  • Disruption to hormone levels 
  • Disruption to the level of neurotransmitters in the brain 
  • Infection or inflammation of the prostate 
  • Infection or inflammation of the urethra 
  • Thyroid problems 
  • Using drugs 

Complications of premature ejaculation

Premature ejaculation can be distressing to experience, enhancing stress or anxiety. This can cause problems within relationships, particularly if you have not communicated with your partner about what is going on. Ejaculation problems can also make it difficult to father a child if sperm does not reach the vagina or is reduced. 


How quickly does premature ejaculation occur?

Premature ejaculation is defined as occurring within one minute of penetration. This may differ from person to person however, as there is no right or wrong way to have sex. In general, if ejaculation happens much sooner than either you or your partner would like, causing frustration or problems in your relationship, then this is where it becomes a problem. 

Primary vs secondary premature ejaculation

There are two types of premature ejaculation: primary and secondary. Primary premature ejaculation is something that has happened consistently since your first sexual experience. Secondary premature ejaculation is acquired after your first sexual experience.


How can you treat premature ejaculation?

Premature ejaculation can be treated in a number of ways depending on the cause, including: 

  • Counselling 
  • Couples counselling 
  • Antidepressants (Selective serotonin reuptake inhibitors)
  • Dapoxetine (an SSRI medication) 
  • Condoms and topical anaesthetics 
  • Viagra 
  • Cialis 
  • Levitra 

Self-help for premature ejaculation

There are self help methods recommended to help you overcome premature ejaculation: 

  • ‘Stop-start’ method: this is where the penis is stimulated until ejaculation almost occurs, stopping at this point before beginning again 
  • ‘Squeeze’ method: this is where the penis is stimulated until the point ejaculation almost occurs, squeezing the head of the penis until this sensation decreases 

Medication to help premature ejaculation

The following medications can help to treat premature ejaculation:  

  • Topical anesthetics- these are applied before sex to decrease sensation so that ejaculation can be delayed 
  • Antidepressants can help to delay ejaculation, particularly the SSRIs Escitalopram, Sertraline and Fluoxetine
  • Tramadol- usually used for treating pain, the side effects can delay ejaculation 
  • Phosphodiesterase-5 inhibitors- these include Viagra, Cialis and Levitra which are usually used to treat Erectile Dysfunction 
  • Dapoxetine- an SSRI specifically designed to treat premature ejaculation 

How do premature ejaculation treatments work?

The treatments prescribed for premature ejaculation are not usually specifically designed for it but are useful with off-label use. Antidepressants work by delaying orgasm, which is one of the side effects of the medication. Tramadol might be given if antidepressants don't work, it also has the same effect of delaying ejaculation. Anesthetic creams work by decreasing the sensitivity of your penis to delay ejaculation. 

Are there different treatments for primary and secondary premature ejaculation?

The best treatment for either primary or secondary premature ejaculation will depend on the underlying cause. Secondary premature ejaculation which has occurred as a result of negative experiences or anxiety may need talking therapy or couples counselling to treat effectively. 

What is the start-stop technique?

The start-stop technique is a method which you, or your partner, can use to help overcome premature ejaculation. It involves stimulating the penis until you feel you are about to ejaculate, stopping before this happens. Wait around 30 seconds before starting again. This can help to get your body used to sexual stimulation lasting longer. 

What is the squeeze technique?

The squeeze technique involves stimulating the penis, stopping just before ejaculation occurs. At this point, you squeeze the head of the penis for 30 seconds and begin again. You can do this by yourself or with your partner. 

How to discuss premature ejaculation with your partner

Premature ejaculation can leave you feeling inadequate and frustrated and it may feel daunting to bring it up with your partner. Being open and honest with them is a positive step forward. Let them know what the problem is, what type of stress or worries you have and what they can do to help. If you are struggling to do this, couples counselling may be a good environment to start a discussion in a safe space. 

Can watching porn help premature ejaculation?

Watching porn may be a contributing factor in causing premature ejaculation and there is no evidence to suggest it may help overcome it. 

Does masturbation help overcome premature ejaculation?

Masturbation can help to overcome premature ejaculation by taking it slowly to regain control. You can also implement the start-stop technique to train your body to delay orgasm. It may take a bit of practice to get it right but this has been proven to help. 

Does circumcision help premature ejaculation?

A study by Shiraz University of Medical Sciences found that circumcision did help men affected by premature ejaculation gain more control over their sexual performance. 

Will my premature ejaculation get better as I age and get more experience?

Premature ejaculation may go away on its own as you gain confidence and leave anxieties about sex behind. This may not happen, however and it's likely you'll need to try some self help techniques or address any underlying worries or anxieties you have in order to get past it. 


Does alcohol affect premature ejaculation?

Drinking too much alcohol can cause premature ejaculation to occur. It can also delay ejaculation. 

Can drugs cause premature ejaculation?

Drug abuse is a known cause of premature ejaculation and may contribute to other ejaculation problems. 

When should I see a doctor for my premature ejaculation?

If premature ejaculation only happens occasionally, then it's unlikely to cause any issues. However, if you experience this most or all of the time during sex, then you should see a doctor. They may get you to do a blood test to rule out any underlying physical conditions and recommended a suitable treatment based on your personal circumstances. 

Does premature ejaculation only apply to sex, or to masturbation as well?

Premature ejaculation can occur during masturbation as well as sex. This can happen due to conditioning, for example if you're used with rushing through masturbation through fear of someone walking in or hearing. 

Is premature ejaculation dangerous?

Premature ejaculation is not dangerous but it could be a sign of a thyroid or prostate issue. This is why it's important to see your doctor so that they can rule out any physical causes. 

Does stress influence premature ejaculation?

Stress is a common cause of premature ejaculation. It can be a vicious cycle: feeling under pressure to perform and then feeling stressed and frustrated about ejaculating prematurely. Talking to your partner about how you feel can help. 

Can medications cause premature ejaculation?

Medications used to treat Parkinson's disease may cause premature ejaculation.

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