Premature Ejaculation

What Is Premature Ejaculation?

Premature ejaculation (PE) is when you have an orgasm before intercourse or less than a minute after you start. There is no set time when a man should ejaculate during sex, but if you ejaculate and lose your erection this soon, you and your partner may feel there’s not enough time to enjoy it.

It can be frustrating and even embarrassing, but it’s a common issue for men. Between 30% to 40% have it at some time in their life. So, keep in mind -- it’s not something to worry about if it happens only occasionally.

Premature Ejaculation Causes and Risk Factors

The cause is not really known. But your brain chemistry could be at least partly the reason. Men who have low levels of the chemical serotonin in their brains tend to take a shorter time to ejaculate.

Emotional factors can play a role:

Stress

Depression

Anxiety

Guilt

Relationship problems

Lack of confidence or poor body image

Concern over your sexual performance

Negative feelings about the idea of sex (sexual repression)

Some physical conditions may also cause PE, including:

Unusual hormone levels

Irregular levels of neurotransmitters (an imbalance of the chemicals in your brain that pass messages or impulses to the rest of your body)

Inflammation or an infection in your prostate or urethra (the tube that runs from your bladder and sends pee out of body)

Genetic traits you inherit from your parents

Sometimes PE can be a problem for men with erectile dysfunction (ED). That’s when the penis doesn’t remain firm enough for sex. Men who are worried they could lose their erection may develop a pattern of rushing to ejaculate. It can be a hard habit to break.

Treating the erectile dysfunction may make the premature ejaculation go away. There are many medication options.

Premature Ejaculation Diagnosis

Your doctor probably will start by asking if you’ve always had the problem or if it’s a new thing. They may ask about your sex life or your relationships. You’ll probably get a physical exam, too.

If your doctor thinks emotional issues are causing your PE, they may refer you to a mental health professional who works with people who have trouble with sex. If a physical problem is causing it, they might recommend that you see a doctor called a urologist, who specializes in conditions that affect your urinary system.

Premature Ejaculation Treatments and Home Remedies

Ninety-five percent of men are helped by behavioral techniques that help control ejaculation.

Stop and start: You or your partner stimulate your penis until you feel like you’re going to have an orgasm. Stop the arousal for about 30 seconds or until the feeling passes. Start the stimulation again and repeat three or four more times before you ejaculate.

The Squeeze: It works the same way as the start and stop method. But, when you feel like you’re reaching orgasm, you or your partner squeezes the head of your penis until you lose the erection. Repeat this a few times before ejaculating.

Some men find that if they think of something else during sex they can last longer.

If those don’t work for you, you can try a few other things:

Strengthen your muscles: Weak pelvic floor muscles sometimes contribute to PE. Kegel exercises may help strengthen them. Find the right muscles to tighten by stopping your urine in midstream. Hold them tight for 3 seconds and then release them for 3 seconds. Do this 10 times, at least three times a day.

Wear a condom: It may desensitize you enough so you can last longer.

Get busy before you “get busy”: Some men find that masturbating a few hours before sex helps them stay in control during intercourse.

Seek counseling: A psychologist or psychiatrist can help you work through problems like depression, anxiety, or stress that may be contributing to your PE.

If none of these help enough, your doctor may talk with you about medication. While there aren’t any drugs specifically approved to treat PE, medicines used to treat other things may help in some cases. This is called an off-label use.

These include:

Antidepressants: A side effect of some selective serotonin reuptake inhibitors (SSRIs) is delayed orgasm. But these medications also have side effects that include nausea and drowsiness. They also can throw a wet blanket on your desire to have sex. So, it’s possible you’re trading one problem for another. You and your doctor will decide what’s right for you.

Tramadol: This is a pain reliever that can delay ejaculation. It may be prescribed if antidepressants don’t help. This medicine is addictive, so it may not be an option for you.

Anesthetic creams or sprays: You put these on the head of your penis to make it less sensitive. Leave it on for about 30 minutes. It must be washed off before sex so you don’t lose your erection or cause loss of sensation for your partner.

Medications for erectile dysfunction: These drugs may also help men maintain an erection. They include sildenafil citrate (Viagra), tadalafil (Cialis), or vardenafil HCI (Levitra).

Premature Ejaculation Complications

If your relationship is affected by PE, talking about the problem is an important first step. A relationship counselor or sex therapist may be able to help.

Premature ejaculation may also make it hard to start a family because the sperm may not reach an egg to fertilize it or depression related to PE might affect your sex drive or performance. A fertility specialist can talk with you and your partner about some other options.

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