Premature Ejaculation affects one in five adult men
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Premature Ejaculation (PE) may be of primary or secondary origin and can be associated with Erectile Dysfunction (ED), the inability to maintain or sustain an erection.
In basic terms, Premature Ejaculation occurs on a background of Erectile Dysfunction, when a male knows they only have a short time to ejaculate before loss of their erection, therefore this precipitates an episode of PE whilst some erectile hardness is still present. Unfortunately this negative reinforcement can become ingrained so that episodes of Premature Ejaculation become more frequent. When Erectile Dysfunction is managed appropriately then the Premature Ejaculation can often resolve. If you find yourself ejaculating too early, or feeling immense pressure to stay erect, complete our free and confidential online consultation form, and our Doctors will get in touch with a treatment that's right for you. |
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Want to know more about Premature Ejaculation?
What is premature ejaculation?
Premature ejaculation happens when a man is unable to control the timing of ejaculation, and ejaculates before he and/or his partner feels ready for this to happen.
How soon is too soon when a man prematurely ejaculates?
For a heterosexual man, a commonly used definition of premature ejaculation is ejaculating before or within about one minute of his penis entering the woman’s vagina. However, there is no fixed time for ‘too soon.’ Premature ejaculation relates to the loss of control over ejaculation, and the distress it can cause to one or both partners, not the actual time it takes a man to ejaculate.
How common is premature ejaculation?
Premature ejaculation is the most common male sexual problem and affects men of all ages. Premature ejaculation is more common in younger men, as they are often less sexually experienced or secure with the situation in which they are having sex. However, in some cases with time and practice premature ejaculation can happen less often.
Are there different types of premature ejaculation?
There are two different types of premature ejaculation:
Lifelong premature ejaculation is when a man has not had control of ejaculation from the time of his first sexual experience. If left untreated, the premature ejaculation will continue for the rest of his life.
Acquired premature ejaculation is usually when there has been a period of normal functioning before the premature ejaculation began. Acquired premature ejaculation often happens as a result of psychological (relationship) issues or due to other erectile problems.
What causes premature ejaculation?
The cause of premature ejaculation depends on whether the premature ejaculation is lifelong or acquired.
Lifelong premature ejaculation can be caused by a chemical imbalance in important brain centres, which may result in a lower ejaculatory threshold. As these men need less stimulation before they ejaculate, ejaculation can happen sooner than desired.
Psychological problems including performance anxiety may be secondary rather than being the primary cause. Anxiety is often the main cause of acquired premature ejaculation.
Performance anxiety can be because of anxiety about sexual performance, fear of being caught in a sexual act or anxiety related to a specific situation, such as a new relationship. Some religious beliefs may also make a man feel anxious about having sex.
Acquired premature ejaculation can also be caused by erectile problems. This may be because of the need for intense stimulation to get and maintain an erection or from anxiety about the difficulty in getting and keeping an erection.
How is premature ejaculation diagnosed?
There are no tests for premature ejaculation as it is a self-reported diagnosis.
Your doctor will ask questions about your sexual history (including how long the premature ejaculation has been happening and when it first happened) and will talk about the possible causes of the problem based on your responses
What factors should be thought about when deciding on treatments?
Treatment for premature ejaculation should be based on the man’s relationship status and the cause of the condition (whether it is lifelong or acquired).
If a man is in a relationship, he should think about his own and his sexual partner’s needs when deciding which treatment option may work best.
What treatments are available for premature ejaculation?
Sex therapy
Men with acquired premature ejaculation caused by performance anxiety often find counselling with an experienced sex therapist the best treatment. Counselling can help identify and discuss any underlying sexual or relationship issues.
The anxiety that can develop with lifelong premature ejaculation may also be helped by professional counselling.
Behavioural techniques
Semans’ “stop-start” technique involves the man telling his partner to stop stimulation when he feels he is close to ejaculation. When the feeling has passed, stimulation can be started again. These steps of stopping and starting can be repeated as needed.
Masters and Johnson’s “squeeze” technique can be used for delaying ejaculation. With this technique, the end of the penis is squeezed for several seconds just before ejaculation to lessen the urge to ejaculate. This is repeated a number of times until the man and his partner are ready for ejaculation to happen. This
technique can help teach a man ejaculatory control.
Reducing penile sensation
Reducing penile sensation can help delay ejaculation. Local anaesthetic gels and creams can be used and should be applied up to 30 minutes before sexual intercourse and used with a condom to prevent absorption by the sexual partner.
Using two condoms may also reduce sensation and help a man take longer to ejaculate.
Oral medication
Some antidepressants — tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRIs) — have the side-effect of delayed ejaculation and are now commonly prescribed by doctors for premature ejaculation.
A tricyclic antidepressant has been shown to work better than SSRIs in some men. These drugs work only for as long as the man continues to take the medication. Taking SSRIs can have some side-effects such as decreased libido (sex drive), nausea, sweating, bowel disturbance and fatigue.
Erectile dysfunction treatment
If a man has erectile problems and premature ejaculation, treating the erectile problems first can help bring back normal ejaculatory control. Treatments for erectile dysfunction are commonly oral medications. Other treatments include vacuum devices, injections and penile
prostheses.
Management
What role do partners play in the treatment of premature ejaculation?
If a man is in a relationship, both the man and his sexual partner can be affected by premature ejaculation. Partners can give valuable support and help decide the best treatment option, and it is helpful to involve them when talking with your doctor.
Can premature ejaculation cause infertility?
Premature ejaculation does not usually cause infertility (in a couple), although sometimes it can cause problems for couples trying to become pregnant.
Many men who have premature ejaculation feel embarrassed when ejaculation happens before vaginal penetration. If this is the case, a doctor may use a treatment to delay ejaculation or refer the couple to a fertility specialist.
How can premature ejaculation affect men?
Many men who have premature ejaculation feel embarrassed about the condition. Premature ejaculation can cause great anxiety and men often feel more anxious when they try to find ways to manage the problem.
Partners of men with premature ejaculation may find it difficult to deal with their partner’s anxiety, particularly if they do not feel comfortable speaking to others about their concerns.
Emotional responses to premature ejaculation are quite normal and discussing these feelings with a partner and/or doctor can help.
Are there other types of ejaculatory problems?
Other forms of ejaculatory problems can affect men such as no ejaculation, delayed
ejaculation, retrograde ejaculation and painful ejaculation.
c/o Monash Institute of Medical Research Victoria Australia
Andrology Australia is an initiative funded by the Australian Government Department of Health and Ageing.
This information has been provided for educational purposes only. It is not intended to take the place of a clinical diagnosis or proper medical advice from a fully qualified health professional. Andrology Australia urges readers to seek the services of a qualified medical practitioner for any personal health concerns.
Premature ejaculation happens when a man is unable to control the timing of ejaculation, and ejaculates before he and/or his partner feels ready for this to happen.
How soon is too soon when a man prematurely ejaculates?
For a heterosexual man, a commonly used definition of premature ejaculation is ejaculating before or within about one minute of his penis entering the woman’s vagina. However, there is no fixed time for ‘too soon.’ Premature ejaculation relates to the loss of control over ejaculation, and the distress it can cause to one or both partners, not the actual time it takes a man to ejaculate.
How common is premature ejaculation?
Premature ejaculation is the most common male sexual problem and affects men of all ages. Premature ejaculation is more common in younger men, as they are often less sexually experienced or secure with the situation in which they are having sex. However, in some cases with time and practice premature ejaculation can happen less often.
Are there different types of premature ejaculation?
There are two different types of premature ejaculation:
- Primary (Lifelong)
- Secondary (Acquired)
Lifelong premature ejaculation is when a man has not had control of ejaculation from the time of his first sexual experience. If left untreated, the premature ejaculation will continue for the rest of his life.
Acquired premature ejaculation is usually when there has been a period of normal functioning before the premature ejaculation began. Acquired premature ejaculation often happens as a result of psychological (relationship) issues or due to other erectile problems.
What causes premature ejaculation?
The cause of premature ejaculation depends on whether the premature ejaculation is lifelong or acquired.
Lifelong premature ejaculation can be caused by a chemical imbalance in important brain centres, which may result in a lower ejaculatory threshold. As these men need less stimulation before they ejaculate, ejaculation can happen sooner than desired.
Psychological problems including performance anxiety may be secondary rather than being the primary cause. Anxiety is often the main cause of acquired premature ejaculation.
Performance anxiety can be because of anxiety about sexual performance, fear of being caught in a sexual act or anxiety related to a specific situation, such as a new relationship. Some religious beliefs may also make a man feel anxious about having sex.
Acquired premature ejaculation can also be caused by erectile problems. This may be because of the need for intense stimulation to get and maintain an erection or from anxiety about the difficulty in getting and keeping an erection.
How is premature ejaculation diagnosed?
There are no tests for premature ejaculation as it is a self-reported diagnosis.
Your doctor will ask questions about your sexual history (including how long the premature ejaculation has been happening and when it first happened) and will talk about the possible causes of the problem based on your responses
What factors should be thought about when deciding on treatments?
Treatment for premature ejaculation should be based on the man’s relationship status and the cause of the condition (whether it is lifelong or acquired).
If a man is in a relationship, he should think about his own and his sexual partner’s needs when deciding which treatment option may work best.
What treatments are available for premature ejaculation?
Sex therapy
Men with acquired premature ejaculation caused by performance anxiety often find counselling with an experienced sex therapist the best treatment. Counselling can help identify and discuss any underlying sexual or relationship issues.
The anxiety that can develop with lifelong premature ejaculation may also be helped by professional counselling.
Behavioural techniques
Semans’ “stop-start” technique involves the man telling his partner to stop stimulation when he feels he is close to ejaculation. When the feeling has passed, stimulation can be started again. These steps of stopping and starting can be repeated as needed.
Masters and Johnson’s “squeeze” technique can be used for delaying ejaculation. With this technique, the end of the penis is squeezed for several seconds just before ejaculation to lessen the urge to ejaculate. This is repeated a number of times until the man and his partner are ready for ejaculation to happen. This
technique can help teach a man ejaculatory control.
Reducing penile sensation
Reducing penile sensation can help delay ejaculation. Local anaesthetic gels and creams can be used and should be applied up to 30 minutes before sexual intercourse and used with a condom to prevent absorption by the sexual partner.
Using two condoms may also reduce sensation and help a man take longer to ejaculate.
Oral medication
Some antidepressants — tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRIs) — have the side-effect of delayed ejaculation and are now commonly prescribed by doctors for premature ejaculation.
A tricyclic antidepressant has been shown to work better than SSRIs in some men. These drugs work only for as long as the man continues to take the medication. Taking SSRIs can have some side-effects such as decreased libido (sex drive), nausea, sweating, bowel disturbance and fatigue.
Erectile dysfunction treatment
If a man has erectile problems and premature ejaculation, treating the erectile problems first can help bring back normal ejaculatory control. Treatments for erectile dysfunction are commonly oral medications. Other treatments include vacuum devices, injections and penile
prostheses.
Management
What role do partners play in the treatment of premature ejaculation?
If a man is in a relationship, both the man and his sexual partner can be affected by premature ejaculation. Partners can give valuable support and help decide the best treatment option, and it is helpful to involve them when talking with your doctor.
Can premature ejaculation cause infertility?
Premature ejaculation does not usually cause infertility (in a couple), although sometimes it can cause problems for couples trying to become pregnant.
Many men who have premature ejaculation feel embarrassed when ejaculation happens before vaginal penetration. If this is the case, a doctor may use a treatment to delay ejaculation or refer the couple to a fertility specialist.
How can premature ejaculation affect men?
Many men who have premature ejaculation feel embarrassed about the condition. Premature ejaculation can cause great anxiety and men often feel more anxious when they try to find ways to manage the problem.
Partners of men with premature ejaculation may find it difficult to deal with their partner’s anxiety, particularly if they do not feel comfortable speaking to others about their concerns.
Emotional responses to premature ejaculation are quite normal and discussing these feelings with a partner and/or doctor can help.
Are there other types of ejaculatory problems?
Other forms of ejaculatory problems can affect men such as no ejaculation, delayed
ejaculation, retrograde ejaculation and painful ejaculation.
c/o Monash Institute of Medical Research Victoria Australia
Andrology Australia is an initiative funded by the Australian Government Department of Health and Ageing.
This information has been provided for educational purposes only. It is not intended to take the place of a clinical diagnosis or proper medical advice from a fully qualified health professional. Andrology Australia urges readers to seek the services of a qualified medical practitioner for any personal health concerns.
