Premature Ejaculation

Overview

What is premature ejaculation?

Premature ejaculation happens when a man has an orgasm sooner than he or his partner would like. Premature ejaculation can happen before or shortly after penetration.

There is no set time for how long a man should "last" during sex. But when a man has an orgasm before he wants to, he loses his erection and can’t continue with intercourse. Premature ejaculation can be frustrating and embarrassing. You may feel you don’t have enough time to enjoy sex. You may have difficulty satisfying your partner. For some men, embarrassment about premature ejaculation can cause problems with intimacy and damage their relationships.

Premature ejaculation is a common problem among men. About 30% to 40% of men have this problem at some time in their lives.

Causes & Risk Factors

What causes premature ejaculation?

A number of emotional and physical factors can lead to premature ejaculation. It may happen when a man becomes too excited or stimulated, or if his penis is very sensitive. It may also happen if a man is nervous or uncomfortable with a new partner. Other common causes include the following:

Men who have a low amount of a special chemical called serotonin in their brain may have problems with premature ejaculation.

  • Anxiety about performance

  • Guilty feelings

  • Depression

  • Stress

  • Relationship problems

Is premature ejaculation a sign of a serious health problem?

Not in most cases. Rarely, premature ejaculation results from a serious health problem, such as nervous system damage from surgery or trauma.

Treatment

How is premature ejaculation treated?

Premature ejaculation often goes away without treatment. But if it happens frequently, and it makes you or your partner unhappy, you may want to talk to your family doctor. There are several possible methods for delaying orgasm.

Behavioral methods

Behavioral methods are helpful for more than 95% of men who have premature ejaculation.

In this type of treatment, you practice controlling your ejaculation, either alone or with a partner.

In addition to using a behavioral method, you may want to try thought distractions. For example, while you’re being sexually stimulated, think about the names of players on your favorite sports team.

  • In the start-and-stop method, you or your partner will stimulate your penis until you feel like you are about to have an orgasm. Then the stimulation stops for about 30 seconds. Once you regain control of your response, stimulation begins again. This process is repeated 3 or 4 times before you allow yourself to have an orgasm.

  • The squeeze method works in a similar way. When you feel like you are about to ejaculate, you or your partner will gently squeeze the head of your penis for about 30 seconds so that you begin to lose your erection. You repeat this process several times before you allow yourself to reach orgasm.

Psychological assistance

Anxiety, depression and other emotional issues can lead to premature ejaculation. For these issues, seeking the help of a psychologist, psychiatrist or sex therapist may be helpful. Couples therapy may also help if relationship problems are the cause of premature ejaculation.

Medical treatments

Several medical treatments may help men who have premature ejaculation. Some antidepressants seem to help delay ejaculation, including antidepressants called selective serotonin reuptake inhibitors (SSRIs). These antidepressants are available with your doctor’s prescription. However, the U.S. Food and Drug Administration (FDA) has not approved the use of these medicines to treat premature ejaculation. Also, antidepressants may cause side effects such as nausea, dry mouth and drowsiness. Antidepressants may also decrease your desire to have sex. Your family doctor can help you decide if an antidepressant is right for you.

Anesthetic creams can also be used to prevent premature ejaculation. These creams are applied to the head of the penis to make it less sensitive. Usually, the cream is applied about 30 minutes before sex and then washed off once it has decreased the feeling in your penis. The cream must be washed off before sex. If it is left on, it can cause a loss of erection and vaginal numbness.

For some men, simply wearing a condom can help delay ejaculation because it may make the penis slightly less sensitive.

Other Organizations

Questions to Ask Your Doctor

  • What can I do to stop myself from ejaculating so quickly?

  • Is there a medicine that I can take that will help?

  • I’m embarrassed by this—is there someone I can talk to about it?

  • Premature ejaculation is causing problems in my relationship; should we go to counseling?

  • Should I wear a condom when I have sex?

  • Is there an underlying problem that could be causing my premature ejaculation?