Premature Ejaculation: What Causes it and How to Overcome it

9 min read
Premature Ejaculation: What Causes it and How to Overcome it

Reaching orgasm during sex is one of the best feelings you can have. However, climaxing too soon, leaving your partner unsatisfied and frustrated can be demoralizing. This is known as premature ejaculation (PE). PE is a sexual dysfunction which affects up to 30% of men, making it one of the most common male sexual health issues.

Climaxing early sometimes is normal, everyone gets overly excited now and again. Yet, if you find it happening every time you engage in sexual activity, it can start to take a toll on your relationships, confidence and mental health. Despite PE being one of the most common male sexual dysfunctions, the treatment rate is surprisingly low.

Some people don’t know that premature ejaculation can be medically treated, while others may worry about the stigma and being viewed as “less of a man” if they open up. Whether you suffer from premature ejaculation or just want to learn more, this article will give you everything you need to know about PE.

What is premature ejaculation?

Premature ejaculation is when a man regularly ejaculates sooner than they would like to during sexual encounters. This usually happens before their partner has had a chance to climax, leading to embarrassment and disappointment. It can put a strain on intimate relationships as well as your mental health. Premature ejaculation is often a result of physical, behavioral and emotional factors.

Doctors don’t diagnose premature ejaculation, with men typically reporting the issue themselves. More often than not, it’s obvious when early ejaculation has become a problem. However, some men complain that they suffer from PE, despite having perfectly adequate sexual performance. This is due to unrealistic expectations and pressure from external influences.

Intravaginal ejaculation latency time (IELT) is the time between vaginal penetration and intravaginal ejaculation. This can be measured in an attempt to define premature ejaculation. Men with an IELT time of under 1 minute are considered to have “definite” PE. This doesn’t account for psychological difficulties associated with the test.

Premature ejaculation limits the duration of sexual intercourse significantly, reducing a male's period of stimulation compared with a regular sexual response. This is illustrated in the diagram below:

Types of premature ejaculation

There are two main types of premature ejaculation: lifelong (primary) and acquired (secondary).

Lifelong premature ejaculation affects people from their first sexual experience. This can take place before they've been sexually intimate with a partner, such as premature ejaculation brought on through masturbation.

Acquired premature ejaculation is when the condition develops even after prior sexual encounters without any ejaculation problems. Triggers for this can be behavior or emotion-based, such as getting into a new relationship or suffering from stress and anxiety.

In June 2018 the International Classification of Diseases (ICD-11) released a definition of PE which contained a third subset of premature ejaculation alongside lifelong and acquired, known as “subjective PE”.

This refers to men who believe that they have PE but have a normal IELT. This type of PE can be a result of beliefs derived from social factors such as the media or other people's expectations. The new definition also referred to premature ejaculation by a new name; “male early ejaculation”.

What are the symptoms of premature ejaculation?

The primary symptom associated with premature ejaculation is being unable to enjoy penile stimulation (through masturbation or with a partner) for a sustained timeframe without reaching climax.

The severity of PE can significantly vary between individuals so, establishing an exact definition for premature ejaculation has caused some confusion in the past. Some men will climax within minutes and consider it too soon, while others last a matter of seconds.

The first-ever definition (established in 1970 by Masters and Johnson) was described as:

The inability of a man to delay ejaculation long enough for his partner to reach orgasm on 50% of intercourse attempts

This definition was flawed, as some females are never able to achieve an orgasm through penetration. This would have meant that many men had PE regardless of how long they lasted with their partner, as the female orgasm never took place.

A more suitable definition from the International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) 2016 defined premature ejaculation as:

The inability to control ejaculation sufficiently for both partners to enjoy sexual interaction

Who is affected by PE?

Premature ejaculation is a common sexual dysfunction affecting millions of men worldwide. There’s no real pattern in the demographic of affected men, with all age groups and ethnic backgrounds prone to suffering from PE during their lifetime. So, providing you have a penis you could be susceptible to premature ejaculation.

What are the main causes of premature ejaculation?

The exact cause of premature ejaculation is unknown. Similar to other male sexual dysfunctions such as low libido, premature ejaculation is largely dependent upon physical, mental and social factors. It’s worth noting that lifelong and acquired PE have different root causes, some examples of these are identified in the table below:

 

Cause Explanation
Lack of sexual stimulation
Typically, the less frequently a male ejaculates the more sensitive their penis feels. This can create a vicious cycle as anxiety and reluctance to ejaculate early can prevent men from wanting to engage in sexual activity. This leads to increased sensitivity when they do engage in sexual contact, which in turn makes it more likely they will ejaculate early.
Low libido or arousal
If a man has low libido but participates in sexual acts because of social pressure or to satisfy their partner, they may encounter PE. Not being fully engaged and seeing sex as a chore rather than an act to enjoy can result in men getting used to climaxing early.
Early sexual experiences
For many men their first exposure to sexual stimulation is masturbation. This can teach them to ejaculate quickly with no partner to satisfy and the potential fear of getting caught encouraging prompt ejaculation. These sorts of early experiences can do long-term damage and lead to lifelong PE.
Lack of sexual maturity
Although PE can affect men of any age, those who have been sexually active for longer are likely to have learnt when they are near to climax. This allows them to take corrective action should they wish to prolong the sexual activity. For less experienced men, they can miss these cues and climax too soon.

 

Can premature ejaculation be controlled? Best treatments for premature ejaculation

Medications

There are medications available which can either be swallowed or applied to the skin that will slow down ejaculation by a few minutes. These are usually considered if PE has become a significant issue.

A common medicinal treatment is a drug known as selective serotonin reuptake inhibitors (SSRIs). These drugs are commonly used for treating depression and have been found to increase the time it takes to ejaculate.

Before considering medication, make sure you consult with your doctor. New treatments can conflict with existing medication and your health professional will be able to advise which type is suitable for you

The alternative medicines consist of creams and sprays which contain a local anesthetic. These can be directly applied to the penis to make it less sensitive, therefore prolonging the amount of time you can engage in sexual activity before ejaculating.

Before considering medication, make sure you consult with your doctor. New treatments can conflict with existing medication and your health professional will be able to advise which type is suitable for you.

Edging

Edging involves bringing yourself close to orgasm but stopping just before you reach your climax. This stretches out the time it takes to achieve an orgasm and prolongs pleasure from sexual stimulation. It can be an effective method for increasing the time it takes for a man to ejaculate.

Not only does edging teach you to last longer, but when you do finally ejaculate your orgasm will feel more intense

This can be done via masturbation or with a partner. If you’re planning on edging with a partner, communication is key. In severe cases, you may need to start stimulating yourself before introducing your partner's touch. Not only does edging teach you to last longer, but when you do finally ejaculate your orgasm will feel more intense.

Squeeze technique

This method is similar to edging in that you build towards an orgasm. Instead of stopping, you squeeze the tip of the penis to prevent you from reaching an orgasm. Again, it’s another technique that can be done alone or with a partner and is likely to take some practice.

If this technique causes you any pain or discomfort stop right away

When squeezing with your partner it’s key to help them understand how much pressure to apply. If this technique causes you any pain or discomfort stop right away.

Masturbation

If you’re planning on having sex, you can use masturbation a few hours before to help reduce penile sensitivity. Getting the right timing is crucial, as not having enough time in-between masturbation and the sexual interaction may mean you struggle to become aroused at all.

Kegels

Developed by Dr Arnold Kegel, this routine of exercises is designed to help strengthen the pelvic floor muscles which affect sexual function. Kegels are often associated with females but can also be used by men to help stop premature ejaculation, as well as erectile dysfunction.

Regular Kegels can help improve your strength in the pubococcygeus, the muscle that controls urination

Regular Kegels can help improve your strength in the pubococcygeus, the muscle that controls urination. After building enough strength, you will be able to contract your muscle the way you do when holding in urine to help prevent ejaculation.

LEARN MORE ABOUT KEGELS

Check our related blogs for more insights:

Using Condoms

Condoms are often considered a nuisance as they can reduce the amount of feeling experienced during sex. In the case of someone suffering from premature ejaculation, condoms can be a great help.

The layer of latex between partners can help to reduce penile sensitivity and increase the time it takes to ejaculate. If you find that your current condom doesn’t help, it’s worth exploring thicker options to further reduce sensitivity.

Sex Toys

Sex toys such as fleshlights and masturbation sleeves can help men simulate the feeling of penetration. Using sex toys to practice penile stimulation can help those suffering from PE to get used to stimulation with a partner. In addition, other sex toys such as vibrating cock rings can be used to help stimulate your partner even after you’ve ejaculated.

When to see a doctor

You should see a doctor if premature ejaculation is having a negative impact on your quality of life. If you find that PE is damaging your relationships or mental health, you should get in touch with a doctor.

Premature ejaculation is a part of sexual health that’s often overlooked in men

Premature ejaculation is a part of sexual health that’s often overlooked in men. Despite the sexual dysfunction affecting millions of men, not many of them seek medical help. This may be down to embarrassment or a lack of knowledge surrounding how the sexual dysfunction is clinically treated.

A medical professional will be able to assess the best options for treating the condition in line with any pre-existing medical conditions or allergies you may have.

Premature ejaculation FAQs

Can a cock ring help with premature ejaculation?

While there is no scientific evidence that cock rings prevent premature ejaculation, most users report that in fact they were able to prolong sexual activity while wearing one. They are known to cause a delayed orgasm, due to the tension that the ring places around the base of the penis and balls. Vibrating cock rings are also great for continuing to stimulate your partner if you do ejaculate early.

Can Kegels help with premature ejaculation?

Kegels have been known to reduce premature ejaculation, as well as erectile dysfunction. If you have a severe case of premature ejaculation, Kegels alone may not be effective. You can couple Kegels with PE medication issued by a medical professional.

Can prostate massaging help with premature ejaculation?

The quick answer is no. In the past, there have been unsubstantiated claims that prostate massages help with premature ejaculation. However, there’s no proof that prostate massages are an effective treatment for PE.

Are there any sex toys that would help with premature ejaculation?

Sex toys such as sleeves and fleshlights can familiarise you with the feeling of stimulation via penetration. Other sex toys such as vibrating cock rings and dildos can be used to pleasure your partner after ejaculation.

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