Premature Ejaculation

What is it Premature Ejaculation?

Premature (early) ejaculation (PE) is defined by a persistent or recurring pattern of ejaculation occurring during sex with a partner before the individual wants it to happen. Many men experiencing this issue may have a sense of lack of control and apprehension about future sexual encounters. This may cause avoidance of intimate activities or other related sexual issues such as erectile dysfunction or low libido.

Some men are embarrassed to speak to their doctor about this issue, but it is important to talk to your medical provider about any issues you experience. Your doctor may ask you questions about when PE occurs, how long it’s been present, and severity to gather more information about your condition. PE is generally categorized by the following:

• When it happens
  • Generalized: Not limited to types of situations, stimulations, or sexual partners.
  • Situational: Issue only happens in certain situations or with certain sexual partners.
• How long it has been present
  • Lifelong: Issue has been present since first becoming sexually active.
  • Acquired: The issue began after a relatively normal period of sexual functioning.
• Severity
  • Mild: Ejaculation occurs within 30 seconds to 1 minutes of penetration.
  • Moderate: Ejaculation occurs within 15-30 seconds of penetration.
  • Severe: Ejaculation occurs at the start or within 15 seconds of penetration.

For some men, it may help to ejaculate the previous day or a few hours prior to intercourse and see if this helps to reduce symptoms. It is important to remember that what constitutes a normal ejaculation time varies across individuals, relationships, and cultures.

What causes Premature Ejaculation?

• Feelings of guilt and/or sexual shame may lead to distraction or rushing intercourse.
• Poor body image or low self-esteem can lead to performance anxiety.
• Past or recent physical or psychological trauma.
• Relationship issues can contribute to the problem.
• Unmanaged depression or anxiety.
• Erectile problems may cause anxieties about maintaining an erection, which can lead to rushing a sexual encounter.
• Alcohol or substance abuse.
• Medication side effects.
• Medical conditions:
  • Certain thyroid problems
  • Infection or inflammation of the prostate or urethra
  • Hormonal imbalance
  • Inherited or genetic traits (more so for lifelong PE)

Treatments for Premature Ejaculation

• Use a male or female condom to reduce sensitivity.
• Penile desensitizing cream/spray: To reduce the chances of also desensitizing your partner's genitals, you can apply the cream and then put on a condom. The condom will provide a barrier so you partner can still experience full sensations.
• Distraction methods: Thinking about an unrelated topic (e.g. baseball), changing sexual positions, or taking breaks to use your mouth or fingers to stimulate your partner can often help.
• Strengthen your pelvic floor by doing daily kegel exercises.
• Masturbating the previous day or a few hours prior to intercourse.
• Relaxation techniques such as deep breathing to reduce anxiety.
• Using the sensate focus technique.
• Participating in tantric sex techniques with your partner: Tantric sex is more about establishing an intimate connection through slow rocking motions and ceasing stimulation when you feel the need to orgasm. This can be especially helpful with premature ejaculation issues.
• Communication with your partner about needs, desires, and fears. Read more on Tips for Talking With Your Partner.
• Treatment and/or counseling for relationship or individual issues.
• Treatment for existing medical conditions.
• Medications such as antidepressants are sometimes used to treat PE because a common side effect is delayed ejaculation.