Premature ejaculation

It is difficult to diagnose premature ejaculation (PE) because intercourse is of varying lengths. Occasional episodes of premature ejaculation usually aren’t anything to worry about. You may need treatment if PE occurs frequently or has occurred for an extended period of time.


There are several reasons for premature ejaculation, but most are psychological. 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
  • depression
  • 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
  • stress


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.


Premature ejaculation is the most common sexual disorder in men and affects men of all ages. It is difficult to define exactly, because intercourse is of varying lengths, but 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.


Some signs of premature ejaculation may be:


  • ejaculation before you start intercourse
  • ejaculation after a minute of intercourse
  • feeling you have little or no control over your ejaculation


There are two types of premature ejaculation:


  • Lifelong (primary) ejaculation – which means you have always had early ejaculation
  • Acquired (secondary) ejaculation – which means you have not always had early ejaculation.

What you can do for yourself

There are many ways you take control of your ejaculation:


  • Use a condom – condoms reduce sensitivity and can extend the time before ejaculation. There are also condoms specifically made to delay ejaculation.
  • Talk-therapy – it can reduce your anxiety and stress. It can also help solve problems that may be causing premature ejaculation. If you have a partner, it is better if you both can participate. 
  • Exercise the pelvic floor muscles (muscles located in the lower abdomen) which helps control both your ejaculation and erection.


Feel free to ask a sexologist (specialist on sexuality), what is best for you.


If you find that premature ejaculation is a problem for you and your partner, there is help. In addition to the remedies above, there are different types of prescription drugs that can help: Anesthetic creams and sprays containing a numbing agent are sometimes used to treat premature ejaculation. These products are applied to the penis 10 to 15 minutes before sex to reduce sensation and help delay ejaculation. A side effect of certain antidepressants is delayed orgasm. For this reason, selective serotonin reuptake inhibitors are used to help delay ejaculation. Consult your doctor about treatment options.

When to consult a doctor

If premature ejaculation causes relationship problems, seek help.
You may start with a primary care physician or seek out a urologist.

How APPOTEK can help

  • Consulting
  • Psychological treatment
  • Individual assessment and prescriptions if needed
  • Referral to urologist if necessary.

Valeria Chernikova, Neurologist, M.D.