Are you concerned about premature ejaculation? You are not alone. Research shows that premature ejaculation, or PE, is one of the most common forms of sexual disorder, affecting as many as 39 percent of the male population.
Various factors could potentially contribute to premature ejaculation, from penis sensitivity to psychological issues such as depression, performance anxiety, and stress.
The good news: While premature ejaculation can negatively affect your sex life in the short term, it is usually treatable with a combination of medications, therapy and/or simple lifestyle changes.
Below, we explain what premature ejaculation is and what factors can play a role in its occurrence. We've also listed the symptoms of premature ejaculation and how they differ from other sexual health issues.
Finally, we've discussed your options for treating premature ejaculation, improving your sexual performance, and improving your sex life.
What is Premature Ejaculation?
Premature ejaculation is a common sexual problem among men where you reach orgasm and ejaculate prematurely during sexual contacts. Men of all ages can suffer from it, and it can contribute to everything from frustration during sex to issues such as depression.
PE any form of ejaculation that occurs “during sexual activity with a partner approximately 1 minute after vaginal penetration and before the person wishes, during all or almost all sexual activity”.
Simply put, premature ejaculation occurs when you have no control over ejaculation, causing you to reach orgasm and ejaculate too early during intercourse or other sexual activity.
As a medical condition, premature ejaculation is also known as “rapid ejaculation” or “premature ejaculation”. Whatever you want to call it, it's a serious problem that can have major personal consequences, both for your sex life and your overall well-being.
What are the symptoms of premature ejaculation?
The main symptom of premature ejaculation is reaching orgasm and ejaculating very quickly during sexual activity -- usually within a minute or less of penetration.
To speak of premature ejaculation (rather than simply reaching orgasm and ejaculating quickly, which can happen during normal sexual activity), ejaculation should normally occur before the person in question would like it during most or all sexual activities.
If you have premature ejaculation, you may experience some or all of these symptoms:
You ejaculate very quickly after vaginal penetration. Mild PE usually involves ejaculating 30 to 60 seconds after penetration, while severe PE may involve ejaculating before inserting your penis into your sexual partner.
You don't want to cum so early. For example, you are in no hurry to orgasm during sex and would prefer to have sex longer, but find that difficult or impossible.
You feel anxious because of your premature ejaculation. For example, you may feel less interested in sex due to shame or fear, feel that you have little desire to have sex, or feel that your short ejaculation time is affecting your overall quality of life.
To a certain extent, people have not yet decided on the exact length of time that defines ejaculation as normal or premature.
While one minute is the common standard, some experts use a slightly longer period of time and define premature ejaculation as orgasm and ejaculation that occur within four minutes of vaginal penetration.
Others use less specific, more subjective definitions. For example, some researchers define PE based on the female partner's level of satisfaction.
Not all cases of premature ejaculation are specifically seen as premature ejaculation. For example, if you want to reach orgasm quickly and orgasm during sex, this is usually not seen as a form of ejaculation disorder.
However, if you often ejaculate within a minute of penetration, feel unhappy or concerned about it, or simply feel like you don't have normal ejaculation control or sexual stamina, you may be suffering from some form of premature ejaculation.
How is premature ejaculation diagnosed?
Because the average time to ejaculate varies so much from man to man, PE can be a difficult condition to diagnose. People can have different expectations when it comes to sex and there is no clear, widely accepted definition of PE.
To be diagnosed with premature ejaculation, you usually need to have the symptoms listed above, such as rapid ejaculation after penetration from your partner and some level of discomfort from your lack of ejaculation control.
Your symptoms must also occur without a clear explanation, such as drug or drug use, a related medical condition, or a problem in your relationship that affects your sexual function and performance.
In some cases, you'll reach orgasm and ejaculate sooner than you'd like, even if you don't have clinical premature ejaculation.
For example, it's not uncommon to ejaculate relatively quickly if you haven't had sex for a long time. In this situation, it's normal to feel more sexually aroused than usual and to orgasm faster than usual.
It's also common to feel like you're reaching orgasm and ejaculating too fast, even if your ejaculatory latency time (the time it takes you to ejaculate) is within the normal range.
Because it's normal to occasionally reach orgasm and ejaculate faster than you'd like, you usually have to show symptoms for at least six months to be diagnosed with PE.
During a PE consultation, your healthcare provider may ask you about your sexual history to determine how long you've been suffering from these symptoms.
Premature ejaculation can be lifelong (meaning it has been present since your first sexual encounter) or acquired (meaning it develops after some time of normal sexual function). It can also occur generally or in certain situations, such as when having sex with a specific partner.
If your healthcare provider asks you questions about your average time to ejaculation, “success rate” during sex, or other factors that may play a role in ejaculation, try to answer them as clearly and honestly as possible.
While ejaculation can be an embarrassing and uncomfortable topic to discuss, it's important to keep in mind that your healthcare provider is there to help you, not to make assumptions about your overall sexual life or current relationship.
The more information you can provide and the more accurately you can answer your doctor's questions, the more likely they are to make an accurate diagnosis and help you overcome PE and improve your sexual performance.
How common is premature ejaculation?
Premature ejaculation is common. While data may vary, most self-reported studies suggest that four to 39 percent of men experience premature ejaculation at some point in their lives.
Other research suggests that up to 75 percent of otherwise healthy adult men suffer from premature ejaculation in one way or another.
In short, if you suffer from premature ejaculation, you are certainly not alone and you don't have to feel anxious either. Premature ejaculation is common and occurs among men of all ages, backgrounds, and sexual experience levels.
Interestingly, despite many men's fears, research shows that premature ejaculation isn't that bad at all for most women.
One study published in the journal Archives of Sexual Behavior, which used data from more than 150 heterosexual couples, concluded that men see rapid ejaculation as a bigger problem than their female partners.
This study also found that while rapid ejaculation is associated with lower sexual satisfaction, it does not cause significant problems in interpersonal relationships.
What causes premature ejaculation?
What causes premature ejaculation? As with other sexual problems such as erectile dysfunction, there are many widespread but scientifically incorrect “theories” about why PE develops in men.
For example, you may have heard that premature ejaculation can occur if you masturbate too often, or if you use a grip that is too aggressive while masturbating (a problem referred to as the “death grip” syndrome).
You may also have read that premature ejaculation occurs when you don't have sex often enough, or if you have a problem with your sexual technique.
The reality is that researchers do not yet know exactly what causes premature ejaculation and that there is no single explanation for premature ejaculation and other forms of sexual dysfunction in men.
Simply put, there is usually no single cause that your healthcare provider can identify as the problem behind this common condition.
Instead, researchers believe that a range of factors can all contribute to premature ejaculation in some way, from physical health issues such as inflammation in certain parts of your penis and prostate to depression, anxiety, and other psychological disorders.
Physical causes of premature ejaculation
Certain physical and biological factors may cause or contribute to premature ejaculation. These include:
Abnormal hormone levels. Certain hormones, such as prolactin, luteinizing hormone (LH), and thyroid stimulating hormone (TSH), can contribute to premature ejaculation.
Abnormal serotonin levels. Research suggests that low levels of the neurotransmitter serotonin may reduce the time it takes to reach orgasm and ejaculate.
Inflammation and/or infection. Infections and/or inflammations that affect your prostate or urethra can affect your sexual function and contribute to premature ejaculation.
Some experts also believe that the physical sensitivity of your penis may play a role in how long it takes you to reach orgasm and ejaculate during sex.
Psychological causes of premature ejaculation
Research suggests that psychological factors may contribute to various types of sexual dysfunction, including premature ejaculation.
Psychological factors associated with PE include depression, stress, anxiety, guilt, poor body image, lack of self-confidence, and a history of sexual abuse.
Premature ejaculation can also be caused by performance anxiety. A form of anxiety related to sexual performance that can also play a role in problems such as erectile dysfunction (ED).
How to treat premature ejaculation
While premature ejaculation can be frustrating, the good news is that it is usually treatable so that, with the right approach, you can increase sexual stamina and enjoy a higher sexual quality of life.
Various techniques are used to treat premature ejaculation, including different types of medication, behavioral techniques, and counseling.
Antidepressants for premature ejaculation
Currently, there are no medications that have been specifically approved by the EMA as a treatment for premature ejaculation. Premature ejaculation, however, is often treated off-label with a class of antidepressants called selective serotonin reuptake inhibitors, or SSRIs.
If you normally ejaculate in a short time, an SSRI can help you last longer and enjoy more satisfying sex.
Several SSRIs are used off-label to increase ejaculation time, including escitalopram, sertraline, fluoxetine, paroxetine clomipramine, and other medications.
Sertraline for premature ejaculation
Sertraline, the active ingredient in Zoloft®, is one of the most commonly used SSRIs for premature ejaculation.
Although sertraline was not specifically developed for the treatment of PE, numerous studies have shown that it is effective in delaying ejaculation and increasing intravaginal ejaculatory latency time.
For example, in a 1998 study, men with premature ejaculation who were treated with sertraline increased their average ejaculation interval (the time before they reach orgasm and orgasm) from one minute to a maximum of 16.4 minutes.
Like other SSRIs, sertraline may cause side effects. For many men, however, it is an effective and beneficial treatment that allows for more satisfying sex.
We offer sertraline as a treatment for premature ejaculation online, after a consultation with a licensed healthcare provider who will determine whether a prescription is appropriate.
Premature Ejaculation Creams and Sprays
Premature ejaculation can often be treated with topical creams and sprays that alter the sensitivity of your penis.
These topical creams and sprays contain topical anaesthetics such as lidocaine or prilocaine and are intended for use before sex. The ingredients are absorbed into the skin of your penis to reduce sensitivity without affecting your partner.
As with SSRIs, research shows that sprays and numbing creams for PE can slow the process of reaching orgasm and ejaculation.
For example, one study found that men with premature ejaculation who used a lidocaine spray before sex were able to have sex longer, on average, than men with PE who used placebo treatment.
They also had sex more frequently, suggesting that the spray helped improve their overall sexual experience and performance.
Unlike SSRIs, which require a prescription, most premature ejaculation creams and sprays are available without a prescription.
Our Men's Delay Spray, which contains lidocaine, is available online as a convenient option to reduce sensitivity, increase stamina and improve sexual function.
Behavioral therapy for premature ejaculation
Behavioral therapy consists of identifying unhealthy or harmful behaviors and then taking meaningful steps to change those behaviors. When this type of therapy is used to treat sexual health issues such as premature ejaculation, it is often referred to as sex therapy.
Studies have found that a combination of psychotherapy and medication may be more effective for treating PE than medication alone.
Behavioral therapy for PE may include a combination of psychotherapy and physical techniques to delay or prevent ejaculation.
Common physical techniques include the “stop-start” approach, where you stop during sex to prevent orgasm and ejaculation, and the “squeeze” technique, which involves squeezing the base of the penis during sex.
You can learn more about these techniques and their effects in our guide to home remedies for premature ejaculation.
Some physical exercises that strengthen the muscles around your penis and bladder can help improve ejaculation control and reduce the severity of premature ejaculation.
For example, research shows that kegel exercises - exercises that train your pelvic floor muscles - can improve control over the ejaculation reflex and increase ejaculatory latency in men with PE.
Assistance with premature ejaculation
Counseling is a useful and effective treatment option for many sexual problems, including premature ejaculation.
During counseling, you and a psychologist will discuss your PE symptoms, their effects on the quality of your life, and the factors you think could contribute to them.
Over time, counseling can help you take control of your feelings and deal with issues that may play a role in premature ejaculation, such as anxiety about sexual performance or body image issues.
We offer online counseling as part of our range of mental health services, so you can talk to a licensed counselor and make progress from the privacy and comfort of your own home.
Erectile dysfunction (ED) drugs for premature ejaculation
Research shows that some erectile dysfunction medications, or ED, may also offer benefits as a treatment for premature ejaculation.
For example, several studies have found that sildenafil, the active ingredient in Viagra®, or generic Viagra, increases ejaculatory latency or improves sexual satisfaction and self-confidence in men suffering from PE.
However, it's important to note that there hasn't been much research on the effects of ED drugs online on ejaculatory latency. Our full guide to sildenafil and premature ejaculation goes into more detail about these treatments and the potential benefits they offer.
In addition to sildenafil there are other medications to treat ED, such as tadalafil (the active ingredient in Cialis®), vardenafil (Levitra®), and avanafil (Stendra®).
We offer numerous ED medications online, after a consultation with a licensed healthcare provider who will determine whether a prescription is appropriate.
Can you prevent premature ejaculation?
While little research has been done on the most effective ways to prevent premature ejaculation, a physically and mentally healthy lifestyle can help improve your sexual performance and reduce your risk of developing common sexual problems. Try the following:
Move regularly. Research shows that men who exercise regularly are less likely to suffer from premature ejaculation than men with a sedentary lifestyle.
You don't have to train like a competitive athlete, but a regular workout routine can improve your physical health and sexual performance.
Focus on your mental health. Like other sexual problems, premature ejaculation often occurs at the same time as mental health problems such as depression or some anxiety disorders.
If you're concerned about premature ejaculation, focus on improving and maintaining your mental health.
If you suffer from premature ejaculation, or if you simply find yourself reaching orgasm too early, you can also try the following techniques.
Masturbate before sex. Many men find that they are better able to delay ejaculation during the second round. If you are sensitive to PE, try masturbating a few hours before sex. keep in mind the refractory period.
Use condoms for premature ejaculation. Some condoms contain a local anaesthetic to reduce sensitivity, allowing you to last longer during sex. You can find these in most local shops and supermarkets.
Talk to your partner. If premature ejaculation is caused by a psychological problem or a problem in your sexual relationship, talking openly and honestly with your partner can help you work it out together.
Premature ejaculation is treatable
Premature ejaculation is a common, normal form of sexual dysfunction that can affect men of all ages and backgrounds. It can be a serious annoyance when it occurs, but the good news is that there are options available to help you control it and improve your sexual function.
Most commonly, premature ejaculation can be treated with behavioral therapy, evidence-based prescription drugs such as sertraline, or over-the-counter products such as sprays, wipes, and condoms.
In some cases, changing your lifestyle or practicing certain techniques can also help you have more control over your orgasms and ejaculation.
If you have premature ejaculation, it's best to talk to a healthcare provider about options for extending ejaculation time and improving sexual performance.
Request an online early ejaculation consultation to talk to a healthcare provider to access us, if applicable range of treatments for premature ejaculation.
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