Premature ejaculation

Ejaculation is when semen is expelled from the penis during male orgasm. Premature ejaculation is when this happens earlier than you or your partner would like; it may also be described as “cumming too soon”. It is the most common sexual health problem in men and affects between 30 to 50% of men. 

On average a man ejaculates between 5 and 7 minutes after starting penetrative sex. The medical definition of premature ejaculation is ejaculating within 1 minute of penetration. Occasional premature ejaculation is normal and nothing to worry about, and for some couples, premature ejaculation may not be a problem. But for many couples, premature ejaculation can reduce the quality of their sex life, cause problems in the relationship, and even lead to depression. 

This article look at some of the causes of premature ejaculation, some of the treatments available, and some things you can do yourself to stop it. 

Premature ejaculation can be caused by psychological or physical factors. It can be a problem you’ve always had (primary premature ejaculation) or something that develops later in life. 

Some physical causes of premature ejaculation include: 

• drinking too much alcohol
• using recreational drugs
• thyroid problems such as an underactive or overactive thyroid
• inflammation of the prostate (prostatitis)
• the penis being extra sensitive
• difficulty getting or keeping an erection (erectile dysfunction) 
• low levels of serotonin (a hormone) in the brain
• being circumcised 
• getting older

Some psychological causes of premature ejaculation include: 

• stress
• depression
• anxiety about sexual performance
• relationship problems

Some men experience premature ejaculation since first becoming sexually active (primary premature ejaculation). This is less common than secondary premature ejaculation but may be caused by:

• traumatic early sexual experience such as being caught masturbating or sexual abuse
• conditioning to ejaculate quickly, for example, to avoid being caught masturbating or having sex
• a strict upbringing and feelings of shame related to sex

Erectile dysfunction is when you find it difficult to get, or maintain, an erection that is hard enough to have penetrative sex. It is a complex condition that can have physical and psychological causes. Erectile dysfunction can cause premature ejaculation, because you may have to stimulate your penis a lot to get, or maintain, your erection, which may result in ejaculating early. If you have erectile dysfunction, getting treatment for this will often resolve premature ejaculation. 

Treatment for premature ejaculation depends on the cause. Some treatments focus on the physical causes of premature ejaculation and some on the psychological causes. Common treatments include:

• self-help techniques
• medication
• couples therapy
• therapy with a therapist or sex counsellor 

There are some things you can do yourself to help with premature ejaculation including: 

• wearing a thick condom to reduce sensation
• taking breaks during sex when you feel you are getting too excited, and distracting yourself by thinking about something non-sexual
• masturbating an hour or two before sex
• having sex with your partner on top, allowing them to pull away when you are close to ejaculating
• taking a deep breath when you are close to ejaculating. This shuts down the ejaculatory reflex and may help delay ejaculation

In this method, when you are about to ejaculate, you or your partner gently squeeze the head of your penis between your thumb and forefinger for about 30 seconds. This will reduce your erection and prevent ejaculation. You can repeat this technique until you are ready to ejaculate. 

This technique involves stimulating the penis until you are about to ejaculate, then stopping for about 30 seconds (or until the urge goes away). Repeat the process 3 or 4 times before allowing yourself to ejaculate. 

These exercises strengthen the muscles of the pelvic floor and can help with premature ejaculation. Your GP or healthcare provider can show you how to do these exercises correctly. 

In couples therapy, you and your partner see a therapist together. Your therapist will explore any issues within your relationship that may be causing your premature ejaculation and may teach you some techniques like the stop-start technique and the squeeze technique described above.

Sex therapists and behavioural and cognitive therapists explore the psychological causes of your premature ejaculation as well as teaching techniques to change behaviour and thought processes. They also focus on sexual skills and communication techniques. Therapy is often used in combination with medication to treat premature ejaculation. 

Selective serotonin reuptake inhibitors (SSRIs) are commonly used to treat depression, but one of their side effects is delaying ejaculation. Dapoxetine is an SSRI that has been developed specifically to treat premature ejaculation. It is taken as needed, 1 to 3 hours before sex. This medication should not be taken more than once a day. 

Other SSRIs that are sometimes used to treat premature ejaculation include sertraline, paroxetine, and fluoxetine. These medications are also used to treat depression and anxiety and need to be taken every day and normally take a week or 2 to have an effect. 

Anaesthetic, or numbing, creams or sprays like lidocaine or prilocaine can help make the penis less sensitive, particularly if used with a condom. 

If you are worried about premature ejaculation and would like to talk about treatment options, make an appointment with one of our NHS-trained doctors today. 

Making an appointment with Medicspot is quick and easy online. Simply choose a time that is convenient for you and have your GP consultation by video link from your phone wherever you are. 

 

Urology Care Foundation: What is premature ejaculation? July 16th 2020 (Accessed August 24th 2022) 

NHS: Can premature ejaculation be controlled? July 21st 2020 (Accessed August 24th 2022) 

NHS: Ejaculation problems July 24th 2019  (Accessed August 24th 2022) 

NIH: Premature ejaculation overview September 12th 2019 (Accessed August 24th 2022) 

NIH: Premature ejaculation. What can I do on my own? September 12th 2019  (Accessed August 24th 2022) 

BMC Urology: The prevalence of premature ejaculation and its relationship with polygamous men: a cross-sectional observational study at a tertiary hospital in Somalia December 16th 2021 (Accessed August 24th 2022) 

PubMed: Psychosexual therapy for premature ejaculation August 2016 (Accessed August 24th 2022)