Premature ejaculation is when a man has an orgasm sooner during intercourse than he or his partner would like. Premature ejaculation is a common complaint. Premature ejaculation early in a relationship is most often caused by anxiety and too much stimulation.
The primary symptom of premature ejaculation is the inability to delay ejaculation for more than one minute after penetration. This may range from before penetration to a point just after penetration. It may leave the couple feeling unsatisfied.
You may meet the diagnostic criteria for premature ejaculation if you:
- Always or nearly always ejaculate within one minute of penetration
- Are unable to delay ejaculation during intercourse all or nearly all of the time
- Feel distressed and frustrated, and tend to avoid sexual intimacy as a result
Some doctors believe that early sexual experiences may establish a pattern that can be difficult to change later in life, such as:
- Situations in which you may have hurried to reach climax in order to avoid being discovered
- Guilty feelings that increase your tendency to rush through sexual encounters
Other factors that can play a role in causing premature ejaculation include:
- Erectile dysfunction
- Relationship problems
A number of biological factors may contribute to premature ejaculation, including:
- Abnormal hormone levels
- Abnormal levels of brain chemicals called neurotransmitters
- Abnormal reflex activity of the ejaculatory system
- Certain thyroid problems
- Inflammation and infection of the prostate or urethra
- Inherited traits
- Nerve damage from surgery or trauma (rare)
Various factors can increase your risk of premature ejaculation, including:
- Erectile dysfunction
- Health problems
While premature ejaculation alone doesn’t increase your risk of health problems, it can cause significant problems in your personal life, including:
- Stress and relationship problems. A common complication of premature ejaculation is relationship stress.
- Fertility problems. Premature ejaculation can occasionally make fertilization difficult or impossible for couples who are trying to have a baby.
Exams and Tests
In addition to asking about your sex life, your doctor will ask about your health history and may perform a general physical exam. Your doctor may order a urine test to rule out possible infection. If you have both premature ejaculation and trouble getting or maintaining an erection, your doctor may order blood tests to check your male hormone (testosterone) levels or other tests.
In some cases, your doctor may suggest that you go to a urologist or a mental health professional who specializes in sexual dysfunction.
Practice and relaxation should help you deal with the problem. Some men try to distract themselves by thinking nonsexual thoughts (such as naming baseball players and records) to avoid getting excited too fast.
There are several helpful techniques you can try.
The “stop and start” method:
- This technique involves sexually stimulating the man until he feels like he is about to reach orgasm. Stop the stimulation for about 30 seconds and then start it again. Repeat this pattern until the man wants to ejaculate. The last time, continue stimulation until the man reaches orgasm.
The “squeeze” method:
- This technique involves sexually stimulating the man until he recognizes that he is about to ejaculate. At that point, the man or his partner gently squeezes the end of the penis (where the glans meets the shaft) for several seconds. Stop sexual stimulation for about 30 seconds, and then start it again. The person or couple may repeat this pattern until the man wants to ejaculate. The last time, continue stimulation until the man reaches orgasm.
- Antidepressants and other selective serotonin reuptake inhibitors (SSRIs) are often prescribed. These medicines can increase the time it takes to reach ejaculation.
- You can apply a local anesthetic cream to the penis to reduce stimulation. Decreased feeling in the penis may delay ejaculation. Condom use may also have this effect for some men.
- If distraction techniques and antidepressants do not help you keep an erection, other medications used for erectile dysfunction may help.
- Evaluation by a sex therapist, psychologist, or psychiatrist may help some couples.
In most cases, the man is able to learn how to control ejaculation. Education and practicing simple techniques are often successful. Chronic premature ejaculation may be a sign of anxiety or depression. A psychiatrist or psychologist can help treat these conditions.
If a man ejaculates very early, before entering the vagina, it may prevent a couple from getting pregnant.
A continued lack of control over ejaculation may cause one or both partners to feel sexually dissatisfied. It may lead to sexual tension or other problems in the relationship.
When to Contact a Medical Professional
Call your health care provider if you are having a problem with premature ejaculation and it does not get better using the methods described above.
There is no way to prevent this disorder. However, relaxation can make it less likely to occur.