What is premature ejaculation?
Ejaculation is the release of semen from the penis during an orgasm. When ejaculation occurs faster than you or your partner would like, it’s known as premature ejaculation (PE).
PE is common. About one in three men between the ages of 18 and 59 experiences PE at some point.
PE is also known as:
- rapid ejaculation
- premature climax
- early ejaculation
Is premature ejaculation a type of sexual dysfunction?
PE is considered a type of sexual dysfunction. Sexual dysfunction refers to any of several types of problems that keep a couple from fully enjoying sexual activity.
PE isn’t the same as erectile dysfunction (ED). ED is the inability to achieve and maintain an erection that allows for a satisfying sexual experience. However, you may experience PE along with ED.
Occasional episodes of PE usually aren’t anything to worry about. You may need treatment if PE occurs frequently or has occurred for an extended period of time.
The main symptom of PE is the regular inability to delay ejaculation for more than a minute after penetration during intercourse. Rapid climax during masturbation may also be an issue for some people.
If you experience premature ejaculation sometimes and normal ejaculation other times, you may be diagnosed with natural variable premature ejaculation.
PE is usually categorized as lifelong or acquired.
Lifelong (primary) PE means you’ve had this experience always or almost always since your first sexual experience.
Acquired (secondary) PE means you’ve had longer lasting ejaculations in your life, but have developed PE.
There are psychological or emotional components to PE, but there are also other factors that contribute to it.
Some psychological components may be temporary. For example, a person may have experienced PE during early sexual experiences, but as they grew older and had more sexual encounters, they learned strategies to help delay ejaculation.
Likewise, PE may become an issue as a person gets older and has more trouble maintaining an erection.
PE may be caused by underlying conditions or mental health concerns too, including:
- poor body image or poor self-esteem
- history of sexual abuse, either as the perpetrator, or as the victim or survivor
Guilt may also cause you to rush through sexual encounters, which can lead to PE.
Other things that can lead to PE include:
- worrying about ejaculating too early
- anxiety about limited sexual experience
- problems or dissatisfaction in your current relationship
Physical causes can also play a major role in PE. If you have difficulty maintaining an erection because of ED, you may rush through intercourse so that you complete it before losing the erection.
Abnormal levels of certain hormones, such as testosterone, or chemicals produced by nerve cells called neurotransmitters may contribute to PE. Inflammation of the prostate or urethra can also cause numerous symptoms, including PE and ED.
Talk with a doctor if PE:
- is occurring or has occurred enough times to cause relationship problems
- makes you feel self-conscious
- keeps you from pursuing intimate relationships
You may start with a primary care physician or seek out a urologist. A urologist is a doctor who specializes in the health of the urinary system and male sexual function.
When you see your doctor, have the following information available:
- How long have you been sexually active?
- When did PE become a concern?
- How often does PE occur?
- How long does it usually take before you ejaculate during intercourse and when you masturbate?
- Do you use drugs or medications that may affect sexual performance?
- Have you had sexual encounters that included “normal” ejaculation? If so, what was different about those experiences and the times when PE was an issue?
In addition to working with a urologist or other physician, you may be advised to work with a mental health professional who specializes in sexual dysfunction.
In some cases, you may be able to treat PE with some changes to your sexual routine.
You may be advised to masturbate an hour or so before intercourse, as this may help you delay ejaculation with your partner.
You may also try temporarily avoiding intercourse altogether and engaging in other sexual activity and play with your partner. That may help relieve the pressure of performing during intercourse.
Start-and-stop and squeeze methods
Two strategies you and your partner can employ are the start-and-stop method and the squeeze method.
With start-and-stop, your partner stimulates your penis until you’re close to ejaculation. Then your partner should stop until you feel you’re in control again.
Ask your partner to repeat this two more times. Then engage in a fourth attempt, allowing yourself to ejaculate.
The American Urological Association recommends trying this three times a week until you feel you’re better able to control when you ejaculate.
With the squeeze method, your partner stimulates your penis until you’re close to ejaculating. Then your partner firmly squeezes your penis until your erection starts to weaken. This should help you better realize the sensation just before climaxing so you can develop better control and be able to delay ejaculation.
These strategies could take several weeks to become effective, and there is no guarantee that they alone with solve the issue.
Pelvic floor exercises
Certain muscle exercises may also help. In particular, you may benefit from male pelvic floor exercises.
To find your pelvic floor muscles, concentrate on stopping urination in midstream or using certain muscles to keep you from passing gas. Once you understand where the muscles are, you can practice exercises known as Kegel maneuvers. You can do them standing, sitting, or lying down.
To do Kegel maneuvers:
- Tighten your pelvic floor muscles for a count of three.
- Relax them for a count of three.
- Do this several times in a row throughout the day
Work your way up to three sets of 10 repetitions each day.
When doing Kegel exercises, be careful not to use your abdominal or buttock muscles instead of your pelvic floor muscles.
Training your muscles may also take weeks or months to make a difference, depending on whether this is at the root of your PE.
Decreasing the sensitivity of your penis during intercourse may also help.
Wearing a condom may decrease your sensitivity just enough to help you maintain your erection longer without ejaculating.
There are even condoms marketed for “climax control.” These condoms contain numbing medications such as benzocaine to help dull the nerve responses of your penis slightly.
Applying numbing agents directly to your penis about 15 minutes prior to intercourse may also be helpful, but discuss your options with your doctor first.
If ED is a contributing factor, talk with your doctor about ED medications, such as tadalafil (Cialis) and sildenafil (Viagra). They may help you maintain an erection, which could lead to delayed ejaculation.
These and other ED medications can sometimes take an hour to begin working. Getting the right dose may take some trial and error too, so be willing to work with your prescribing healthcare professional.
If you experience PE, it’s important to talk about it with your partner, rather than ignore it or deny that it exists. Be calm and discuss your options.
Both of you should understand that:
You may be able to overcome PE after trying a combination of therapy, home strategies, or medication.
You and your partner may also be able to enjoy a sexually fulfilling and intimate relationship with less emphasis on intercourse. Focus on oral sex and the use of sex toys while seeking treatment for PE.
Or look for ways to enhance your emotional intimacy through nonsexual activities.
The key is to understand that PE can usually be resolved and that it’s only one part of a couple’s physical relationship. Being supportive and understanding of each other’s needs and concerns is the best way to approach PE or any challenge you face as a couple.