Premature ejaculation: causes and treatment
What exactly is premature ejaculation?
A man could be described as experiencing PE if all of the following apply:
- Ejaculation occurs within less than one minute of penetrative sex
- This happens 75% of the time
- It occurs for a period of at least six months
- It causes distress
During sex, many men and their partners find that ejaculation sometimes occurs sooner than they would like it to. However, if there are also times when you are able to slow down and control your arousal and ejaculation during sex, then you probably wouldn’t be described as experiencing PE.
Life-long vs acquired premature ejaculation
PE may have always occurred since sexual development, which is known as ‘Life-long or Primary PE’, or it may have begun to occur at a later stage, suddenly or gradually, which is known as ‘Acquired or Secondary PE’.
Generalised vs situational premature ejaculation
PE might be ‘Generalised’, where it is a problem in every sexual context, e.g. during masturbation, foreplay with a partner and penetrative intercourse. ‘Situational’ PE is when it only occurs in certain situations, e.g. during partnered sex, rather than solo masturbation. Controlling sexual excitement and ejaculation might be absolutely fine during foreplay, but rapid ejaculation might always occur when penetrative sex begins. This might indicate that the causes are more psychological, rather than physical.
Relationships and premature ejaculation
With PE, it is often the case that penetration is not possible, as ejaculation always occurs before. This can cause relationship distress and frustration for both partners and bring about feelings of shame and inadequacy. If a couple want to have a baby, this can become a problem in trying to conceive naturally. Sadly, many men suffering with PE might avoid relationships altogether for fear of humiliation and disappointment leading them to withdraw socially, adding to the emotional strain.
Common psychological causes of premature ejaculation
PE can have many causes. Your state of mind has a huge influence on how your body reacts. It could occur simply due to infrequent sex, lack of sexual experience and over-excitement. It might also develop because when a man is worried about losing his erections, so focuses on increasing his sexual excitement to avoid erectile loss, leading to early ejaculation. Find out more about the link between premature ejaculation and erectile dysfunction.
Anxiety can cause PE, so it is important to train yourself to stay calm during sex. Depression and stress can also be factors contributing to PE. Other reasons to explain why sex might so often be over quickly could be due to unconscious fear, such as a fear of putting part of yourself inside another person’s body, a fear of pregnancy or STIs (so wear a condom and get an STI test) or another fear due to underlying relationship difficulties. It might be that your partner experiences pain or discomfort during sex, so you come quickly to reduce their discomfort.
It's also possible for some men to experience PE as soon as they become sexually active. This can be down to:
- Conditioning - early sexual experiences can have an impact on your future sex life. A good example of this is a teenager teaching themselves to ejaculate quickly to avoid being caught, it can be difficult to break the habit.
- Traumatic sexual experience in childhood - this can be anything from being caught masturbating to sexual abuse.
- Strict upbringing and beliefs about sex
- Biological reasons - some men have an extra sensitive penis
Common physical causes of premature ejaculation
PE can also have biological roots, e.g. it could be due to genetics or heightened sensitivity in the nerves of the penis, as well as conditions such as multiple sclerosis, diabetes, prostate disease, high blood pressure, under or active thyroid and low testosterone. Medication, recreational drugs and alcohol can also affect a man’s ability to control his ejaculatory reflex.
Is premature ejaculation treatable?
There are psychological and medical treatments available for PE ranging from talking therapy, as well as exercises that you can practice on your own to help you gain more control of your sexual arousal. Medical treatments might include Topical creams or oral medication. Visit the our PE clinic to begin a free online assessment. You can find out more about other PE treatments here.
How long should it take to ejaculate?
There is no set time for how long a man should ‘last’ in bed. So long as you and your partner are gaining pleasure from sex, it doesn’t matter how long it takes. Too much emphasis tends to get placed on reaching orgasm from long-lasting penetrative sex. Enjoying the arousal during mutual masturbation, oral sex and sensual massage can be just as good, if not more pleasurable than intercourse.
If you and your partner really value penetrative sex, but you often come before your partner, try stimulating your partner until they are about to climax before engaging in penetration, then you might both reach orgasm during intercourse. Many women actually enjoy clitoral stimulation more than penetration alone, because the highly sensitive nerve endings in women’s genitalia are located in the clitoris, rather than inside the vagina.
If you are experiencing difficulties with PE and require further help, contact your GP or LloydsPharmacy Online Doctor or search for an Accredited Psychosexual Therapist.
Charlotte Simpson is an Accredited Psychosexual Therapist and Relationship Counsellor in Private Practice in North West London.