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)

The Prostate

Risk Factors

Things that may increase the chance of premature ejaculation include:

Lack of sexual experience
Lack of knowledge of male and female sexual responses
Fear of:
- 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

Symptoms

Regular premature ejaculation is the only symptom.

Diagnosis

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.

Treatment

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:

Behavior Therapy

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

Psychological Counseling

Counseling may be offered for an individual or for a couple. It can help with fear, guilt, or relationship problems.

Medicine

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.

Prevention

To help reduce your chances of premature ejaculation:

Learn more about male and female sexual responses.
Improve communication with your partner before engaging in sexual activity.
Have sex in private and relaxed settings.

RESOURCES:

Urology Care Foundation
http://www.urologyhealth.org

Family Doctor—American Academy of Family Physicians
https://familydoctor.org

CANADIAN RESOURCES:

Health Canada
https://www.canada.ca

Sex & U—The Society of Obstetricians and Gynaecologists of Canada
http://www.sexandu.ca

References:

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:
...(Click grey area to select URL)
Accessed September 4, 2020.

Last reviewed September 2020 by EBSCO Medical Review Board Adrienne Carmack, MD
Last Updated: 01/05/2021

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