Are erectile dysfunction and premature ejaculation related?

Reviewed by Dr Bhavini Shah

The two most common male sexual problems are premature ejaculation (PE) and erectile dysfunction (ED), but it is less widely known that these two sexual dysfunctions often come as a pair.

In this article, we’ll debunk the myths around these conditions. Plus we’ll explore the differences and similarities between these conditions and available treatments.  

Difference between erectile dysfunction and premature ejaculation

The causes of ED can include physical and psychological issues, like restricted blood flow to the penis, nerve problems, stress or depression. PE is often caused by performance anxiety, muscle tension and sensory overload during sex.  

You can find out more about what is premature ejaculation or ED and what is normal erectile behaviour in our advice section. 

Can erectile dysfunction cause premature ejaculation?

Yes, ED can lead to PE. If you, like many men, have experienced erectile loss during sex, you may have found yourself in a vicious circle where you try to focus on your sexual excitement to avoid this loss. Unfortunately, this increase in sexual excitement can speed up ejaculation. To avoid ejaculating too soon, you find yourself focusing on reducing your sexual excitement, which leads to the loss of your erection. All the while this process is going on in your head, you become a spectator to your experience during sex and suffer from performance anxiety. So, you are not very present in the moment, neither enjoying your partner’s body, nor focusing on the pleasurable sensations of being touched by your partner.

The dilemma that unfolds basically offers two unsatisfactory choices during sex: ejaculate too soon or lose your erection. It is no surprise then that sex can become something to avoid; for fear that it will lead to disappointment, frustration and embarrassment.

Can a man have erectile dysfunction and premature ejaculation together?

Yes, ED and PE can happen at the same time. If you have one then you’re more likely to experience the other. Anxiety can make ED and PE worse, and many individuals or couples facing this double whammy may not know which issue to address first.

Typically, addressing ED first means your confidence in maintaining erections increases. This means that anxiety tends to reduce, which helps prevent premature ejaculation.

How to cure erectile dysfunction and premature ejaculation naturally

Learn to relax

Lower your anxiety in general, by exercising regularly and practicing ‘mindfulness techniques.’ There are many internet resources and apps to help to do these quick and simple breathing exercises daily to train you to stay focused and relaxed.

Being relaxed during sex will help you to focus your attention on pleasurable sensations, rather than being preoccupied with your erection or ejaculating too soon.

Dr Bhavini Shah: “Stress can affect different elements of sex from desire to performance. Stress, anxiety, depression and other mental health conditions can make it harder to get and keep an erection."

Practise losing and gaining erections

A useful exercise for ED is to practice getting an erection, then letting the penis go flaccid (either with or without your partner). Do this until you become used to the idea that with the right state of mind and stimulation, erections come, go and come back again.

Also, it can be helpful to get more acquainted with your flaccid penis – it is not the enemy and can give you and your partner pleasure. 

Experimenting with an erection ring

An erection ring is a round elastic plastic cylinder that is worn at the base of the penis to help maintain an erection. They can only be worn for a limited time during sex.

Pelvic floor exercises

Pelvic floor exercises may help with ejaculatory control and erections. Your pelvic floor muscles are between your legs from your tailbone to pubic bone. You can squeeze and relax them by imagining you are holding in wind or urine. Squeeze and relax these muscles, both as quick flicks and slowly by holding them for 10 seconds and resting for four seconds a few times a day.

N.B. Make sure you are not also squeezing your buttocks, thighs or tummy muscles and don’t hold your breath whilst doing these pelvic floor exercises.

Practise the ‘stop start technique’ for PE

A useful exercise for PE is to stop and start your arousal, so that you really get to know your own arousal process and can identify the point before you are going to ejaculate. With lots of practice, you should become more confident at controlling your arousal and ejaculation. 

Stimulation

Try stimulating your partner so their arousal is heightened, then ejaculating quickly upon penetration may not be such an issue.

Open up and talk

If you are in a relationship, try talking to your partner first. Many couples are amazed at how effective talking about sex and other relationship issues can be. If you feel you need further help, you may wish to consider seeking specialist psychosexual and relationship therapy.

How to treat erectile dysfunction and premature ejaculation

As well as managing stress, eating well and regularly exercising there are also medical treatments that can help ED and PE. 

1. Medical treatments for ED

Medical treatment known as PDE5 inhibitors can help you get and keep an erection. These medications include:

• Viagra - works in one hour
• Cialis - effects lasts up to 36 hours
• Tadalafil - works in 30 minutes
• Vitaros - works in 5-30 minutes
• Tadalafil Daily - enables spontaneous erections

Using these medications for a limited time can help you regain your confidence. Our clinicians can recommend the right medication for you and your needs. Visit our ED service to find out more.   

2. Medical treatments for PE

Medical treatments for PE, such as Priligy (Dapoxetine) work by delaying the chemical reactions causing ejaculation by increasing serotonin, and may double or triple your current time to ejaculate. Another option is EMLA cream which numbs the penis which can delay ejaculation. You can find out more about these treatments in our guide. 

For more information and advice on PE medication visit our PE service.

How do I deal with premature ejaculation and erectile dysfunction?

If you’re experiencing erectile problems, it can feel like you’re the only one. However these issues are common. PE and ED can impact relationships, mental health causing stress and low moods. It’s important to talk to someone and ask for help. If your partner is experiencing erectile issues, talking to them can help. Find out more about supporting your partner.

Dr Bhavini Shah: “It’s important to highlight that whilst it may feel embarrassing, ED is extremely common and if you are concerned, talk through your options with a medical professional."

Conclusion

Remember, penetration is not the be all and end all. It is only one of many sexual activities and many people take great pleasure from other kinds of stimulation. There are ways you can help yourself to last longer in bed and make sure everyone involved feels satisfied.  

Sexual dysfunctions can be caused by many factors. They might be physical, and/or psychological and a medical consultation may be necessary to investigate any underlying health issues. Treatments for PE and ED are available and may help boost your confidence in the bedroom.  

References

https://www.baus.org.uk/patients/conditions/8/premature_ejaculation/