Premature Ejaculation

Premature Ejaculation

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Navin Khosla NowPatientGreen tick
Created on 10 Jun 2024
Updated on 16 Jul 2024

Premature ejaculation is a type of sexual dysfunction that occurs during sex, where a man is unable to prevent ejaculation. Here, we will take a closer look at the causes, symptoms, and treatments available for this condition.

What is Premature Ejaculation?

Premature ejaculation is when you are unable to delay ejaculation long enough during sexual intercourse, for sexual satisfaction. There is no measure for premature ejaculation, but if it occurs during foreplay, within a minute or shortly after sexual penetration, this may be classed as premature ejaculation.

Causes of Premature Ejaculation

Premature ejaculation can be caused by:

  • Psychological factors, such as anxiety, stress, depression, guilt, and relationship problems, or
  • Physical factors such as erectile dysfunction, imbalances in hormone levels, inflammation or infection of the prostate gland or urethra, recreational drugs, or genetics

Premature ejaculation, on rare occasions may result from nervous system damage due to surgery or trauma.

Diagnosing Premature Ejaculation

Speak to your doctor or a sexual health provider if premature ejaculation is affecting your sex life. They will carry out physical examinations, discuss your medical history and any other medical conditions you have, and potentially carry out blood tests to rule out any underlying health conditions.

Behavioral techniques for managing Premature Ejaculation

These aim to improve your control over ejaculation and delay orgasm. Two common methods are:

  • The stop-start technique, where you stimulate the penis until you feel close to orgasm, then pause until the sensation stops
  • The squeeze technique, where you apply pressure to the base of the penis to temporarily reduce arousal

Other therapy may include masturbating 1 or 2 hours before sex, to prevent early ejaculation when you are with your partner.

Pelvic floor exercises for Premature Ejaculation

Strengthening pelvic floor muscles through Kegel exercises, can also help improve ejaculatory control. Kegel exercises involve contracting the muscles used to stop you peeing midstream, holding them for a few seconds, and then relaxing. Repeating this exercise multiple times a day will help strengthen your muscles.

Medications for Premature Ejaculation

  • Antidepressants, such as tricyclic antidepressants (clomipramine) and selective serotonin reuptake inhibitors (SSRIs), such as paroxetine, sertraline, fluoxetine, dapoxetine or Priligy. These may be prescribed off-label (for a reason other than the drug’s original use)
  • Anesthetic creams or sprays containing lidocaine or prilocaine, such as Emla, applied to the head of the penis to reduce sensitivity and delay ejaculation

Lifestyle modifications

Maintaining a healthy lifestyle, regular exercise, managing stress levels, and practising relaxation techniques can all help with your sexual health. Avoiding excess alcohol consumption, recreational drug use and smoking can all have an impact on sexual function.

Psychological counselling for Premature Ejaculation

A mental health or sex therapist can help address psychological factors such as anxiety and provide coping strategies and techniques to manage performance anxiety. In some cases, a combination of medications and counselling may be recommended.

Communication and support

Honest, open discussions, with your partner, can help strengthen your emotional connection and couples or sex therapy may be beneficial in addressing your sexual relationship.

Frequently asked questions about Premature Ejaculation

Who does Premature Ejaculation affect?

Premature ejaculation can affect men of all ages and nationalities, with up to one out of three men displaying symptoms.

What causes Premature Ejaculation?

Psychological factors such as low confidence, performance anxiety, and relationship issues, as well as biological factors such as neurotransmitter dysfunction, hormone imbalance and physical health conditions, can all play a role.

Does anxiety cause Premature Ejaculation?

Anxiety may be a factor when it comes to sexual performance, but it is not the only cause of premature ejaculation. Premature ejaculation is classed as a physical problem, but, psychological factors, such as anxiety can make it worse.

How do I know I have Premature Ejaculation?

Your doctor will carry out an assessment of your medical and sexual history to rule out any underlying health conditions. This will need you to be open and honest in order for them to give you an accurate diagnosis.

Can Premature Ejaculation be treated with medication?

Yes. Selective Serotonin Reuptake Inhibitors (SSRIs) are used to treat premature ejaculation due to their side effect of causing delayed ejaculation. Speak to a healthcare professional to discuss the most appropriate treatment for your specific situation.

What other treatment options are available for Premature Ejaculation?

Other treatment options include:

  • The pause and squeeze technique
  • Kegel exercises
  • Counselling and therapy
  • Yoga and relaxation techniques
  • Climax delaying gels and condoms

When should I get professional help for Premature Ejaculation?

Seek professional help if premature ejaculation is causing sexual problems, affecting your relationship or quality of life. Speak to a urologist, or sexologist for guidance, to develop a treatment plan based on your needs.


Premature ejaculation is a common problem caused by psychological, physical or a combination of both factors. With a proper diagnosis and treatment, it can, however, be managed. Behavioural therapy, Kegel exercises, medication, counselling, and changes to your lifestyle can all help improve your sexual experiences.


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