Premature ejaculation (PE) is a condition in which a man is unable to sustain sex for longer than 2 minutes without ejaculating. PE tends to be a condition that comes and goes, and is very common – one British study found that almost 12% of men aged between 16 and 44 reported premature ejaculation within the last year.
Unfortunately, like many other types of sexual dysfunction, stigma still surrounds PE and many men are reluctant to speak to a doctor about it. The good news is that – as previously stated – PE is not a condition that tends to be permanent. And for those who are suffering from PE on a longer-term basis, there are some simple medical treatments that can help to combat the problem.
The causes of premature ejaculation
To understand PE and how to deal with it, it’s important to be aware of its causes. The first thing to know is that there are two main types of premature ejaculation: primary and secondary.
Primary PE is a problem from the time that you become sexually active and is more likely to be life-long; secondary PE is acquired later in life and is more likely to be temporary.
There are many different things that can cause premature ejaculation, and often multiple factors will combine to result in the condition. These factors tend to fall into the categories of psychological, physical and lifestyle, and can be subject to change.
Psychological trauma surrounding sexual activity is thought to be a leading cause of primary premature ejaculation, as is an upbringing that depicts sex as wrong or illicit. Teenage boys who ‘condition’ themselves to ejaculate quickly when masturbating may also find it hard to break this habit as they grow older.
In later life, depression, stress and anxiety can all contribute to premature ejaculation. Problems in a sexual relationship and the mounting anxiety that can surround sexual dysfunction are also leading causes of PE.
A definite link between genetics and premature ejaculation has not yet been proven. However, it is thought that men who have a father, brother, or son with PE are more likely to suffer the condition themselves. Physical causes include heightened sensitivity in the nerves of the penis, and conditions such as diabetes, multiple sclerosis, prostate disease, high blood pressure, and an under or overactive thyroid.
Using recreational drugs and drinking too much alcohol are the most common lifestyle choices which lead to PE – however both these things can also cause erectile dysfunction and delayed ejaculation as well.
Premature ejaculation treatment
The good news is that most of the factors listed above can be effectively managed using the correct treatments.
Psychological causes such as depression, anxiety, stress, trauma and emotional issues in a relationship are best tackled through counselling and – when appropriate – medication such as SSRIs.
Conditioned behaviours around ejaculation and heightened sensitivity can be countered with certain exercises such as the “stop-start” technique. See our recommended behavioural techniques for tackling PE.
In cases where counselling or exercises aren’t appropriate, or simply aren’t sufficient on their own, medicated treatments can be prescribed. These include numbing creams such as EMLA, desensitising condoms, and Priligy (a tablet which helps to delay ejaculation).
When is premature ejaculation most likely to be permanent?
Premature ejaculation is most likely to be long-lasting in men who have primary PE and have suffered with the problem since becoming sexually active. However, with the right psychological help, physical training and medical treatments, even men with this type of premature ejaculation stand a good chance of resolving – or at least improving – their condition.
In the case of diseases such as diabetes and multiple sclerosis, management of PE may not be easy. If the condition is becoming very problematic it’s a good idea to speak to your doctor about what to do – bearing in mind that a combination of treatments might be the best course of action.
Lastly, remember that for many men, premature ejaculation is a natural part of entering into a new sexual relationship, or engaging in a new kind of sexual activity. Some over-excitement and over-stimulation are bound to be part of the process, and PE can occur as a result of that – but the condition is unlikely to be a permanent problem.
The important thing is not to worry or let your anxiety build – if you’re like the majority of men, your premature ejaculation is something that will pass on its own.