Premature Ejaculation

Last Updated August 2021 | This article was created by editorial staff and reviewed by Peter Rippey, MD, CAQSM

What is premature ejaculation?

Premature ejaculation happens when an individual has an orgasm sooner than they or their partner would like. Premature ejaculation can happen before or shortly after penetration.

There is no set time for how long a person should “last” during sex. But when an individual has an orgasm before they want to, they lose their 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 people, embarrassment about premature ejaculation can cause problems with intimacy and damage their relationships.

Premature ejaculation is a common problem. Up to 40% of individuals have this problem at some time in their lives.

Symptoms of premature ejaculation

Most often, you will have no other symptoms other than the premature ejaculation itself.

What causes premature ejaculation?

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

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

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.

How is premature ejaculation diagnosed?

If premature ejaculation is interfering with your sex life, talk to your doctor. They will perform a physical exam and ask you some questions. Based on your answers, your doctor may order some lab work and will provide a diagnosis. They will also be able to answer your questions and reassure you that this is a common problem.

Can premature ejaculation be prevented or avoided?

Premature ejaculation can be prevented or avoided, depending on what is causing it. Most of the time, using the behavioral methods listed below will work to prevent it.

Can premature ejaculation be prevented or avoided?

Premature ejaculation can be prevented or avoided, depending on what is causing it. Most of the time, using the behavioral methods listed below will work to prevent it.

Behavioral methods

Behavioral methods are helpful for more than 50% of people who have premature ejaculation.

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

 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.

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.

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 may be the cause.

Medical treatments

Several medical treatments may help people 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 doctor can help you decide if an antidepressant is right for you.

Medicines used to treat erectile dysfunction may also help prevent premature ejaculation. Your doctor may prescribe one of these medicines alone or in combination with an antidepressant.

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

Living with premature ejaculation

Premature ejaculation is very common. But if it happens frequently, talk to your doctor. There are many techniques you can use that may help prevent it. You should also talk to your partner. Often, they may feel responsible or disconnected. Talking about it can help put both of you more at ease. Also, your partner can help with the strategies described above for controlling your ejaculation.

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?