When Sex Ends Too Soon: What Men Should Know About Premature Ejaculation

Premature ejaculation occurs when a man reaches orgasm and ejaculates sooner than desired, often before or soon after penetration. If you find yourself in this situation, you are not alone. This common sexual disorder is estimated to affect between 30% and 70% of men in the United States at some point in their lives.

Types of Premature Ejaculation

There are two main types: primary and secondary. Primary premature ejaculation occurs when a man has experienced the condition from his first sexual encounter. Secondary premature ejaculation affects men who have previously had satisfying sexual experiences but then develop the issue occasionally or more frequently.

Risk Factors and Causes

The causes of premature ejaculation and its risk factors are closely related. Emotional or psychological factors typically cause premature ejaculation, although physical or biological issues can also play a role.

For men with primary premature ejaculation, risk factors and causes usually include psychiatric conditions or a history of severe trauma, such as sexual assault or incest.

Secondary premature ejaculation is typically associated with erectile dysfunction, feelings of guilt or anxiety about sexual performance, or relationship problems, which might cover a range of concerns, including sex, financial matters, children, and other stressful issues.

In rare cases, there might be a biological issue, such as hormone imbalance, thyroid problems, prostatitis (inflammation of the prostate), damage to the nervous system due to surgery or injury, or drug side effects related to mental health treatment.

Treatment of Premature Ejaculation

Premature ejaculation can be effectively treated. According to a review published in the January 2013 issue of the Journal of Sexual Medicine, all men seeking treatment should receive basic psychosexual education. Additionally, behavioral therapy is recommended when couples are addressing relationship or psychological challenges and often works best when combined with pharmacotherapy as part of an integrated treatment program.

To resolve relationship issues or lessen the anxiety of premature ejaculation, couples can seek marital or sexual therapy. Professional sex therapists can help couples learn techniques such as stop-and-start and squeeze-and-pause, which can help alleviate the problem. Kegel exercises can also help men strengthen and better control their pubococcygeus (PC) muscles, leading to better control over ejaculation.

Pharmacotherapy might involve the use of selective serotonin reuptake inhibitors (SSRIs; e.g., escitalopram, fluoxetine, paroxetine), a type of antidepressant that can delay orgasm. While this is often a downside, men with premature ejaculation may benefit from this side effect. Another option is anesthetic creams (e.g., lidocaine, prilocaine), which can desensitize the penis and help men last longer. The use of erectile dysfunction drugs (e.g., sildenafil, vardenafil) for treating premature ejaculation is controversial.

Men who experience both erectile dysfunction and premature ejaculation may need to treat both conditions simultaneously. A medical professional can help men and couples make informed treatment decisions.

Premature ejaculation can be treated successfully. It is essential for men and couples facing this challenge to consult a knowledgeable urologist and therapist for assistance. For more information about men’s health and prostate health, visit prostate.net.