Everything You Wanted to Know about Premature Ejaculation…but Were Afraid to Ask

a picture of an older couple under bedsheets

Issues in the bedroom can be a challenging topic to discuss, but we are here to help answer your questions and share the best premature ejaculation (PE) treatment. When it comes to your libido and how well you can hold an erection, your lifestyle contributes greatly to whether you can go all night or not. Often the cause can be attributed to physical effects like high blood pressure, diabetes, a heart condition, vascular diseases, neurological disorders and low testosterone levels. Or it could be due to psychological issues like stress or anxiety. Men of all ages suffer from PE. The good news is that you don’t need surgery to treat premature ejaculation, as long as there is no medical reason for it. There are plenty of natural ways to manage this problem, and you’ll be back on track in no time. If you put in the work, take charge of your health and get help from a professional, we believe you can overcome this sexual health issue. 

What Is Premature Ejaculation? 

Premature ejaculation (PE) is a condition where a man ejaculates too quickly during sexual intercourse. Studies have shown that most men that experience PE report ejaculating within one minute after penetration. Premature ejaculation can be very distressing, and embarrassment is often felt when you are not able to satisfy your partner. We understand that the issue can be hard to ignore and can cause relationship problems, so we encourage you to seek professional help to resume a satisfying sex life for you and your partner.

Around one in three men have issues with premature ejaculation and problems maintaining an erection — it affects men of all ages, so don’t feel like you can’t discuss it with your doctor. While the exact cause of PE is unknown, we know that many factors can contribute to it. Your physical health and lifestyle habits, as well as your emotional wellbeing and mental health, can all affect your performance in the bedroom. 

There are two different types of premature ejaculation. Primary premature ejaculation (“lifelong”) is when a man has always had the problem. This affects around one in 50 men in the UK. Several recent studies suggest biology may play a role in cases of primary premature ejaculation — the nerve supply to the penis is extra sensitive, which takes less stimulation for climax.

Secondary premature ejaculation (“acquired”) develops in a man that has previously had a history of normal ejaculation, and it can be caused by psychological and physical factors. Secondary PE is far more common than primary PE. While secondary PE is temporary, in some cases it can progress to primary PE and become life-long.

How Do I Know If I’m Affected by Premature Ejaculation?

Many men are unsure of how long “normal” sexual intercourse should last before ejaculation. Studies have found that the average time for ejaculation is beyond five minutes after penetration. Although it is generally up to the individual and his partner to decide whether or not they are satisfied with the time it takes for him to achieve orgasm, most men present with premature ejaculation if climax happens within one minute of penetration. 

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 requires professional intervention. PE can be very distressing and confidence-destroying. It can create extreme performance anxiety during sexual activity, which can lead to more frequent occurrences of PE in return.

Many men find it difficult to come out of this vicious cycle without professional help and lifestyle changes. Medication is sometimes necessary to help men take back control of their sex lives. If left untreated, PE can cause feelings of shame and frustration, ruin self-confidence and affect relationships negatively. It may lead to a man avoiding sexual intimacy altogether, so please don’t be afraid to contact your healthcare provider. 

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 can be linked to, for example, having a traumatic sexual experience at a younger age. Causes of secondary premature ejaculation can be both physical and psychological.

Sexual issues can be caused by hypersensitivity of the skin of the penis but also by relationship issues, stress and performance anxiety. PE often occurs when men are dealing with new situations, including stress in a relationship or job, new relationships and new experiences. 

Below are some of the psychological causes that can contribute to premature ejaculation: 

Stress and anxiety

Poor self-confidence and body image

Performance anxiety (i.e. start of a new sexual relationship, or when a man has had previous problems with PE or ED)


Unresolved problems, conflicts or issues within a sexual or emotional relationships

A strict upbringing where sexual activity is only considered appropriate in marriage and for procreation purposes only 

Previous traumatic sexual experiences

Below are some of the physical causes that can contribute to premature ejaculation:

Abnormal hormone levels


High blood pressure

Thyroid problems

Prostate disease

Use of recreational drugs (i.e. cocaine or ecstasy) or alcohol in excess

Is Treatment Available or Is There a Premature Ejaculation Cure?

The good news is that there are many effective treatments for premature ejaculation. When we meet with patients trying to improve premature ejaculation naturally, we do comprehensive testing to make sure no specific medical or physical problems are causing PE. This way, we can start managing those issues right away, while we explore what other treatments are available to you. Below are some of our best tips on how to conquer premature ejaculation and any sexual issues you may be experiencing.

Lifestyle Changes

One of the most effective and natural ways to address problems in the bedroom is to revamp your lifestyle habits, which has the bonus of improving your health and longevity. What does your diet look like? It’s a good idea to increase the number of plant foods in your diet — which are great for the heart and circulatory system — and lower the amount of junk food. 

If you drink a lot of beverages with sugar and caffeine, try reducing them. They speed up your heart rate, which can cause anxiety and premature ejaculation. If you consume alcohol regularly, we suggest reducing it or cutting it out completely. Alcohol is a depressant, so it affects both your mood and your ability to maintain an erection. We also recommend that you cut down on nicotine as a method of improving your wellbeing.

When trying to treat premature ejaculation naturally, patients are also encouraged to avoid over-exhaustion. Get enough sleep each night — if you are pushing yourself to the limits, it doesn’t give your sex drive much to work with!


Treating the psychological issues that may be causing your premature ejaculation is an important step in the process of recovery. If you have emotional issues, depression or if you are ridden with anxiety, we recommend you speak with a therapist as soon as possible. If you are highly anxious or emotionally drained it will affect your performance in the bedroom, along with your relationship. Or if you had a traumatic experience surrounding sex, this could be affecting your libido and erection. Therapy is a brilliant experience that you can also share with your partner if there are some unresolved issues in your relationship that are holding back your sex life. 

Behavioural Methods

We recommend trying behavioural techniques and physical exercises to improve what is happening with your penis. We encourage clients to try the “stop and go” or edging technique/ Try reaching a mid-level of excitement, then —  at the point near orgasm — stop stimulating the penis and take some deep breaths for about 30 seconds. By training yourself to stop then start again, you will notice you gain more control over your orgasm.

The squeezing technique is another option to help those experiencing premature ejaculation. Using this technique with your partner, they place pressure at critical points on the penis to delay orgasm. The squeezing method can then be used to give a higher degree of control over premature ejaculation.

The breathing technique can give you more control. Focus on the lower stomach and take measured, deep breaths to allow for a more relaxing experience. When you are about to climax, try to breathe in as deeply and as long as possible, this is sometimes sufficient to cut off the switch to sympathetic overdrive to ejaculate and can buy you another round.

In addition to this, we can recommend that clients try Kegel/pelvic floor exercises, use a thicker condom to decrease sensitivity, masturbate an hour or two before sexual intercourse, try a position that will allow your partner to pull away when you are close to ejaculation and take short breaks during sex to distract yourself and think about something different.

Prescription Drugs

Some men can benefit from taking the prescription drug route to treat premature ejaculation. Many have luck with drugs like Viagra and Cialis. Antidepressants, like selective serotonin reuptake inhibitors (SSRIs), can also help delay ejaculation. Some older men may find they need testosterone replacement therapy to improve their libido and erection. We will discuss these options with you to find the right plan of action to suit your personalised needs.

At Harley Street MD, we have years of experience in treating premature ejaculation successfully. We understand the extent of the distress you are in and can assure you of the utmost empathetic, confidential and professional consultation. We will discuss in detail the various treatment methods, tips and tricks, and topical or oral medical treatments that are available to you.

Are you wanting to reverse and treat premature ejaculation? Book a consultation with our men’s health experts today. We offer the best treatments for ED, premature ejaculation and hormone therapy to meet your sexual health needs. 

Founder at Harley St M.D.
Dr. Chia Tan is a UK trained medical doctor that specialises in cosmetic and aesthetic medicine and testosterone replacement therapy. He is qualified as a medical doctor since 2003 and has since trained extensively. He has been featured in several leading magazines as well as invited to appear on TV to discuss aesthetic medicine and the latest cosmetic procedures.
Dr. Chia Tan
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