Premature Ejaculation - Symptoms, Causes & Treatment

Premature ejaculation (PE)^[1] is when a man ejaculates too quickly during sex, often before he or his partner wants it to happen. It's common, affecting around 20-30% of men^[2] at some point in their lives.

It can happen because of things like feeling stressed, anxious, or because of problems in the relationship. Some men may also have physical reasons, like being too sensitive down there. PE can make people feel embarrassed, upset, or strain relationships.

But the good news is, there are ways to help. Techniques like slowing down or taking breaks during sex, therapy to address any emotional issues, or medications can all make a big difference.

Making healthy lifestyle changes like exercising, eating well, and managing stress can also help improve things. It's important to talk to a doctor or therapist if you’re struggling because there are premature ejaculation treatments and support available to help you feel better and enjoy sex more.

Symptoms

The symptoms of premature ejaculation include:

• Ejaculation happens quickly during sexual activity
• Ejaculation occurring with minimal sexual stimulation
• Difficulty controlling ejaculation, even when desired
• Feelings of frustration, embarrassment, or distress
• Recurring pattern of early ejaculation during sexual encounters

The different types of premature ejaculation

If you experience premature ejaculation inconsistently, alongside normal ejaculation at other times, you might receive a diagnosis of natural variable premature ejaculation.

Premature ejaculation is typically classified as lifelong (primary) or acquired (secondary). Lifelong PE refers to experiencing rapid ejaculation consistently or nearly always since your first sexual encounters.

On the other hand, acquired PE means that you've had longer-lasting ejaculations at some point, but have developed premature ejaculation over time.

Is premature ejaculation and erectile dysfunction the same?

Premature ejaculation (PE) and erectile dysfunction (ED) are different sexual problems. Premature ejaculation means ejaculating too quickly during sex, while erectile dysfunction means having trouble getting or keeping an erection.

Though they can happen together, they have separate causes and treatments. Premature ejaculation often comes from mental reasons, while erectile dysfunction might be because of physical issues like blood flow problems or anxiety.

Causes

Premature ejaculation can happen due to different reasons, including how you feel, how you get along with your partner, and even how your body works. Feeling anxious or stressed, having trouble with your partner, or even your body's own sensitivity can all play a part in PE.

Sometimes, if a man has trouble keeping an erection, he might rush to ejaculate to avoid losing it, which can lead to PE. Not having much experience or not having sex often can also make it more likely.

Some people might even have genes that make them more prone to PE. Understanding these reasons can help you find ways to treat and improve premature ejaculation.

Diagnosis

Diagnosing premature ejaculation involves a discussion with a healthcare provider, typically a doctor, like your GP, or a mental health professional. The process includes reviewing your sexual history to understand when the issue started, how often it occurs, and its impact on your life and relationships.

While a physical examination may be done to rule out underlying medical conditions, the focus is often on assessing specific symptoms of PE, such as the duration of sexual activity before ejaculation and any associated distress or emotional factors like anxiety or depression.

Treatment

Behavioural techniques

Techniques like the start-stop method and the squeeze technique can help delay ejaculation by interrupting sexual activity when nearing climax and applying pressure to the base of the penis to temporarily reduce arousal.

Pelvic floor exercise

Strengthening the pelvic floor muscles through exercises^[3] known as Kegels may improve ejaculatory control and sexual function.

Counselling or therapy

Psychological counselling, including cognitive-behavioural therapy (CBT)^[4] or sex therapy, can help address underlying psychological issues contributing to premature ejaculation, such as anxiety, stress, or relationship problems.

Medications

Certain medications, such as selective serotonin reuptake inhibitors (SSRIs)^[5] or topical anaesthetics, may be prescribed to help delay ejaculation.

SSRIs, which are commonly used as antidepressants, can have the side effect of delaying ejaculation. Topical anaesthetics, applied to the penis before intercourse, can reduce sensation and help delay ejaculation.

Lifestyle changes

Making lifestyle modifications such as reducing stress, improving communication with your partner, and maintaining a healthy lifestyle through regular exercise and balanced nutrition can also help improve sexual function and manage premature ejaculation.