What Causes Premature Ejaculation and How to Deal With it

Premature Ejaculation

What Is Premature Ejaculation?

Premature ejaculation (PE) is a common problem where a man ejaculates too quickly during sex. PE is typically defined as regularly ejaculating within one minute of starting sexual intercourse, but it’s up to you and your partner to decide if you’re happy with the time it takes you to reach orgasm. There is no set time when a man should ejaculate during sex, but if you find that you’re ejaculating and losing your erection more quickly than you’d like, you and your partner may feel that you’re not enjoying sex as much as you could be.

If ejaculation problems are causing you distress or making you feel anxious, this is a problem to address, and there are various forms of treatment that may help you. Read on for more information about causes, risk factors and how to stop premature ejaculation if this is something you’re struggling with.

Diagnosing Premature Ejaculation

Many men are unsure how long “normal” sexual intercourse should last before ejaculation, making it difficult to determine when there’s a problem. Although it’s up to the individual and their partner to decide whether or not they are satisfied with their own sex life, some people may find it helpful to know how long the average man can last during sexual intercourse. A study of 500 couples found that the average time for ejaculation was about five and a half minutes after starting sex, but of course, this can vary significantly from person to person. This time could also be longer for men who have sex with men.

As well as considering the length of time it typically takes for you to ejaculate, another factor to consider when diagnosing PE is how often you experience this issue. The inability to control and delay ejaculation for as long as both partners desire in more than 50% of sexual activities is usually regarded as a severe disruption to quality of life and therefore requires professional intervention.

Although premature ejaculation is a common issue, it can be distressing and confidence-destroying to those who experience it. Instances of ejaculating too early can cause extreme performance anxiety during sexual activity, which in turn often causes more frequent occurrences of PE and creates a long-term problem.

Many men find it extremely difficult to break out of this vicious cycle alone without professional help, and there is no shame in seeking advice or treatment. Medication is sometimes necessary to break the cycle and help men regain control over their sex lives. If left untreated, PE can cause feelings of shame, frustration and lack of self-esteem. It may even lead to a man avoiding sexual intimacy altogether — but this doesn’t have to be the case.

Symptoms of Premature Ejaculation

It is typical for men to report no other symptoms besides premature ejaculation itself, but suffering from PE can also lead to anxiety or depression. If this condition is getting you down, it’s vital to seek help from a medical professional before the situation leads to mental health problems or causes your personal life and relationships to suffer.

Types of Premature Ejaculation

There are two different types of PE: primary premature ejaculation and secondary premature ejaculation.

Primary premature ejaculation (PPE) is where a man has always had the problem, ever since becoming sexually active. PPE occurs from an individual’s first sexual encounter and continues throughout life. Although PPE is believed to be psychological in the majority of patients, studies suggest that biology may play a role in some cases, with hypersensitivity of the glans penis (the tip of the penis) thought to have an impact. In these cases, it’s thought that premature ejaculation may occur because it takes much less stimulation than is typical for the man to achieve orgasm. 

Secondary premature ejaculation — or acquired premature ejaculation — develops in a man who has previously had a history of normal ejaculation. In these cases, PE may occur suddenly or be experienced gradually over time. This can be caused by both psychological and physical factors. Secondary PE is far more common than primary PE, and although the condition may be temporary, it does become life-long in some cases.

What Causes Premature Ejaculation?

Much like erectile dysfunction, the causes of premature ejaculation can be both physiological and psychological. Most causes of primary premature ejaculation are psychological and could be linked to, for example, having a traumatic sexual experience at a younger age. Some cases of PPE may, however, be attributed to physical factors or be hereditary.

Causes of secondary premature ejaculation can be both physical and psychological. This type of PE may be caused by triggers such as diabetes, high blood pressure, excessive drinking or drug use. Depression, stress or anxiety may also cause secondary PE, as well as problems in an individual’s personal life such as relationship issues or financial hardship. Often, premature ejaculation also occurs due to sexual performance anxiety. PE is more common in under 35s and often occurs when men are dealing with new situations, including sexual encounters with a new partner or stressful situations in an established relationship.

Psychological Causes of Premature Ejaculation

Psychological causes of premature ejaculation include:

– Previous experience of erectile dysfunction (ED), i.e. anxiety over losing an erection causing the man to “rush” sexual intercourse

– Performance anxiety, i.e. the start of a new sexual relationship, or when a man has had previous problems with PE or erectile dysfunction

– Mental health problems such as depression or anxiety

– Unresolved problems, conflicts or issues within a sexual and emotional relationship

– Troubling personal circumstances that may cause stress

– A strict upbringing in which sexual activity is only considered appropriate in marriage and for procreation purposes — an individual may find it difficult to relax during sex or be unable to let go of the belief that sex for pleasure is wrong or sinful

– Previous traumatic sexual experiences

– Early sexual experiences in which a teenager conditioned themselves to ejaculate quickly to avoid being caught masturbating — men with this experience may find it difficult to break the habit later in life.

 Physical Causes of Premature Ejaculation

Physical causes of premature ejaculation include:

– Diabetes mellitus

– Prostate disease

– High blood pressure

– Hypothyroidism (underactive thyroid hormone)

– Use of recreational drugs (i.e. cocaine, ecstasy)

– Alcohol in excess.

How Common Is Premature Ejaculation?

We can’t say with certainty how common premature ejaculation is, but it’s thought that 20-30% of men have PE. One of the reasons it’s so difficult to get an accurate number is because less than a quarter of men with PE seek medical advice for their condition. There is an intense shame associated with premature ejaculation, even though it is the most common sexual complaint of men.

How to Stop Premature Ejaculation

There are several possible treatment options available to combat premature ejaculation. If your PE is caused by physical factors, treating the underlying condition should help, and a medical professional will be able to provide advice.

Treating premature ejaculation caused by psychological factors may not be quite as straightforward, but the majority of men who seek treatment and commit to working on the issue do find that they’re able to resolve it. By visiting a qualified clinician such as the men’s health experts at Harley Street MD, you’re taking the first step to tackle premature ejaculation and will be met with all the help and support you need to get your confidence, mojo and sexual satisfaction back. Below are some of the self-help techniques and treatment options available to men with PE.

Self-Help Techniques

Before seeking medical treatment, you may find it helpful to try the following techniques:

– Use a thicker condom to decrease sensitivity. 

– Masturbate an hour or two before having sex.

– Couples therapy.

– Choose a position that will allow your partner to pull away when you are close to ejaculation.

– The stop-start technique (repeated three or four times) — you or your partner stimulate your penis until you feel like you’re going to have an orgasm, then stop stimulation for around 30 seconds and begin again.

– The pause-squeeze technique (repeated three or four times) — have your partner squeeze the end of your penis for several seconds when you are nearing ejaculation.

– Take deep breaths to briefly shut down the ejaculatory reflex, or take short breaks to distract yourself and think about something different.

– Avoid intercourse for a while and focus on other types of sexual play to take the pressure away from your sexual encounters.

– Try exercises to strengthen the pelvic floor muscles, which may help you delay ejaculation.

Lifestyle Changes

As well as the above techniques, you may also find it effective to make some changes to your lifestyle and diet. Consuming an excess of caffeine, sugar and alcohol can play a part in the onset of premature ejaculation, as can not getting enough sleep or failing to take time out to relax and unwind. Being stressed, exhausted and having an unhealthy lifestyle is bound to impact your sex drive, so these are all excellent places to start.

Medical Treatments for Premature Ejaculation

Below are some of the medical treatments available to men experiencing premature ejaculation. Keep in mind that what works for one patient may not work for another and that it may take time to find the treatment or combination of treatments that are right for you.

– Oral medicines such as selective serotonin reuptake inhibitors (SSRIs), Viagra or Cialis

– Testosterone replacement therapy (some older men find this helps to improve libido and maintain an erection)

– Anaesthetic creams and sprays — designed to reduce sensitivity

– Behavioural therapies such as cognitive behavioural therapy (CBT).

At Harley Street MD, we have years of experience in treating premature ejaculation successfully. We understand the distress you feel and can assure you of an empathetic, confidential and professional consultation. When you visit our expert team, we’ll provide a solution and a plan, working with you to find the right treatment options for you.

If you’re experiencing premature ejaculation, don’t suffer in silence. Book a consultation with one of our professional men’s health experts today to find a solution and regain your confidence.

Dr. Chia Tan
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