Premature Ejaculation Explained

Medically Reviewed By Kevin Martinez, M.D.
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Premature ejaculation is when a male ejaculates sooner than they would like during sexual activity.

Sex and gender exist on a spectrum. This article uses the term “male” to refer to sex that was assigned at birth. 

Learn more about the difference between sex and gender here.

This article will explain what premature ejaculation is. It will also discuss the causes and treatments for it, as well as self-help tips.

What is premature ejaculation?

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Premature ejaculation is the most common sexual dysfunction among males. It occurs when a male ejaculates sooner than he or his partner would like during sexual activity. There is some debate as to what the definition of premature is. However, the common consensus is between 1–2 minutes after penetration or quickly after beginning any other sexual activity.

The severity of premature ejaculation varies. It ranges from mild to severe as follows:

  • Mild: Mild premature ejaculation occurs within 30 seconds to 1 minute of penetration.
  • Moderate: Moderate premature ejaculation occurs within 15–30 seconds of penetration.
  • Severe: Severe premature ejaculation occurs before or at the beginning of sexual activity, or within 15 seconds of penetration.

Occasional occurrences of premature ejaculation are typically nothing to be concerned about. However, chronic episodes of premature ejaculation can lead to embarrassment and shame. They may also cause distress and impairment to sexual activity and relationships.

There are two types of premature ejaculation. Those types are:

  • Primary: This type means you have always had the issue.
  • Secondary or acquired: This type means you have recently developed the issue after a period of relatively typical sexual function.

Premature ejaculation affects approximately 30% of males from ages 18–59 years old. However, treatments and therapies are available to help you manage the issue. If you experience premature ejaculation regularly and it is affecting your sexual pleasure or relationships, contact your doctor.

What causes premature ejaculation?

The exact cause of premature ejaculation is not known. However, certain psychological issues may play a big role in those who experience the condition. There are also possible biological factors that can increase your risk of experiencing premature ejaculation.

The biological factors include:

  • low levels of serotonin
  • unusual levels of other hormones, such as the thyroid-stimulating hormone (TSH) and prolactin
  • inflammation or infection of the prostate or urethra

Psychological issues that can lead to premature ejaculation include:

  • depression
  • anxiety
  • stress
  • guilt
  • unrealistic expectations
  • lack of confidence or low self-esteem
  • sexual abuse
  • a history of sexual repression
  • relationship problems

Read about 5 surprising sex drive killers.

How do doctors treat premature ejaculation?

The most common medical treatments for premature ejaculation include a combination of therapies and medication.

Psychological therapy

Psychological therapy aims to discover the source of your issues and learn solutions that may help with premature ejaculation. Psychological therapy can also:

  • help couples grow closer than before
  • help you become less nervous about your sexual performance
  • give you greater self-confidence
  • help you understand your partner’s sexual needs

Behavioral therapy

Behavioral therapy aims to train your body to move away from premature ejaculation. To do this, you learn certain exercises to help build tolerance and delay ejaculation.

These exercises can either be done on your own or with your partner and include:

  • The squeeze method: In this exercise, you or your partner stimulates your penis until you feel close to ejaculating. Then, you or your partner squeezes the head of your penis until your erection begins to go down, typically for around 30 seconds. This allows you to become familiar with the sensation you feel before you ejaculate. Repeat the process a few times before you allow yourself to ejaculate.
  • The stop-start method: With this method, you or your partner stimulates your penis until just before you feel the need to ejaculate. At this time, you stop until your urge to climax dies down. When you feel you have regained control, you or your partner begins stimulation again. Repeat this process three times, allowing yourself to climax the fourth time.

Medication

There is no specific medication that the Food and Drug Administration (FDA) has approved to treat premature ejaculation. However, selective serotonin reuptake inhibitors (SSRIs) are typically one of the first medications doctors recommend to help with premature ejaculation. Doctors usually prescribe SSRIs as antidepressants.

People who take antidepressants have reported having delayed orgasms. Therefore, your doctor may recommend a low dose SSRI to help manage your premature ejaculation.

Numbing creams or sprays may also help with sensitivity. Use the spray or cream on the head of your penis 20–30 minutes before having sex. Just remember to wash it off 5–10 minutes before penetration, as it can also have a numbing effect on your partner if left on.

Speak with your doctor for suggestions on what cream or spray might be the most effective for you.

What are self-help tips for premature ejaculation?

You can try various self-help techniques to manage premature ejaculation. You can try these instead of medical care from your doctor or alongside it.

Self-help tips for premature ejaculation

Self-help tips include:

  • masturbate 1–2 hours before having sex
  • use a thick condom to decrease sensitivity
  • take a deep breath to shut down your ejaculatory reflex
  • have sex with your partner on top, and have them pull away when you feel ready to ejaculate
  • take breaks during sex and think about other things to distract yourself

Learn about hormones and sex drive in males.

Summary

Premature ejaculation is when you ejaculate during sex or sexual activity before you expect to. It is the most common sexual dysfunction among males.

Premature ejaculation is typically considered a psychological issue. However, certain biological factors may play a role in it as well.

Treatment generally includes a combination of therapy and medication. There are also self-help techniques you can try to reduce your sensitivity.

Contact your doctor if you are experiencing premature ejaculation regularly and it concerns you.

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Medical Reviewer: Kevin Martinez, M.D.
Last Review Date: 2022 Jun 28
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.