Many men have premature ejaculation at one time or another. It is only a problem when it happens often.
Ejaculation happens after a certain degree of sexual stimulation. Men can take steps to delay the process. Premature ejaculation often happens when a man is not able to recognize that he is about to ejaculate.
Psychological factors may also lead to premature ejaculation. This may include problems with a partner, guilt about sex, or fears related to sex.
In rare cases, premature ejaculation can be caused by:
- Prostate problems, such as prostatitis
- A problem with the nerves
- Medicine that increase sexual stimulation
- Certain health issues (such as thyroid problems)
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Things that may increase the chance of premature ejaculation include:
- Lack of sexual experience
- Lack of knowledge of male and female sexual responses
- Causing pregnancy
- Contracting a sexually transmitted disease
- Poor sexual performance
- Guilt about sex
- Problems between sexual partners
- Early sexual experiences that encouraged rapid ejaculation, usually from fear of being caught
Premature ejaculation cannot be diagnosed until symptoms are shared with the doctor. The doctor will ask about symptoms and past health. A physical exam will be done.
The doctor may look for medical causes if this is a sudden change or it is causing severe problems. Other medical issues or treatments will also be reviewed for a possible link.
The goal of treatment is to stop or decrease the number of events. The choice of treatments will depend on individual needs. Choices may include:
To help recognize when ejaculation is about to happen and how to delay it. Steps may include:
- Biofeedback—electrical feedback to teach muscles of ejaculation
- Start and stop method—stop sexual stimulation for 30 seconds when nearing climax, then resuming
- Squeeze method—same as start and stop method, but includes gently squeezing the base of penis before the 30-second stop period
- Sexual positions—different positions may allow greater control
Counseling may be offered for an individual or for a couple. It can help with fear, guilt, or relationship problems.
A desensitizing cream may help. It is put on the penis to lessen sexual stimulation.
Some antidepressant medicine may also slow the process to ejaculation. They do not cure the cause of premature ejaculation.
This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.
Edits to original content made by Denver Health.
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a (Rapid Ejaculation)
Urology Care Foundation http://www.urologyhealth.org
Family Doctor—American Academy of Family Physicians https://familydoctor.org
Health Canada https://www.canada.ca
Sex & U—The Society of Obstetricians and Gynaecologists of Canada http://www.sexandu.ca
Althof SE, McMahon CG, et al. An update of the International Society of Sexual Medicine's guidelines for the diagnosis and treatment of premature ejaculation (PE). J Sex Med. 2014 Jun;11(6):1392-1422.
Hatzimouratidis K, Giuliano F, et al; European Association of Urology (EAU). Guideline on Male Sexual Dysfunction. EAU 2019
Premature ejaculation. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/premature-ejaculation-19 . Accessed September 4, 2020.
Premature ejaculation. Family Doctor—American Academy of Family Physicians website. Available at: https://familydoctor.org/condition/premature-ejaculation. Accessed September 4, 2020.
What is premature ejaculation? Urology Care Foundation website. Available at: http://www.urologyhealth.org/urologic-conditions/premature-ejaculation?article=122. Accessed September 4, 2020.