Premature ejaculation (PE) is often shrouded in shame and embarrassment. In fact, it is one of the most common forms of sexual dysfunction among men, impacting 30 percent to 40 percent of men, both young and old.
The Facts About Premature Ejaculation
The condition is more common than you might think, but a variety of treatments are available.
What is premature ejaculation?
PE occurs when a man orgasms and ejaculates sooner than he or his partner would like. In most cases, this means ejaculation occurs before penetration or soon after, typically within the first minute.
Ejaculation, a reflex action that involves muscle contraction and the release of semen from the penis, is triggered when a man reaches sexual climax. Men of all ages and sexual experience levels can experience premature ejaculation.
For some men, PE is a chronic struggle, while others may experience it only sporadically.
Facts, stats and history
Statistics show that 1 in 3 men ages 18 to 59 experience premature orgasm and ejaculation at some point in their lives. Despite the misconception that PE is an issue that plagues only young, sexually inexperienced men, research has uncovered something different.
One Croatian study found the prevalence of PE ranged from 5.8 percent in the 35 to 38 age group to 30 percent in the 70 to 79 age group. Furthermore, the study found rates of premature ejaculation were the highest in the youngest and oldest groups in the study, at 15.7 percent and 12.5 percent, respectively.
The bottom line is that PE is a common problem and not one to be ashamed of, and it's nothing new, either. Descriptions of the condition in medical literature date back to 1887. It can make maintaining a fulfilling sex life more challenging for you and your partner. Fortunately, treatments are available, so don't hesitate to consult your doctor if you are struggling with PE.
Types of premature ejaculation
PE can be split into different categories:
- Primary premature ejaculation. People with primary PE have always struggled with the condition.
- Secondary premature ejaculation. Sometimes referred to as acquired PE, this condition refers to a man who has not always had PE and only recently developed it.
Causes of premature ejaculation
The medical community has not yet found a single cause that can explain the reasons for all cases of premature ejaculation. However, experts do believe it typically results from a combination of psychological and physiological factors.
Some common psychological causes include:
- History of sexual and emotional trauma
- Low self-esteem
- Depression, anxiety and guilt
- Relationship issues
- Substance use problems
- Poor body image
Physiological factors that may contribute to PE include the following:
- Unhealthy diet
- Erectile dysfunction (ED)
- Hormonal imbalance
- Nerve pain/damage
- Aftereffects of a stroke
- Constricted blood vessels
- Prostate or urethra inflammation and/or infection
It's important to note that serotonin may play an important role in some cases of premature ejaculation, according to the Urology Care Foundation. Serotonin, a neurotransmitter, is a substance produced by the brain that acts as a chemical messenger, sending messages to different parts of the brain. It plays a role in myriad bodily functions, ranging from cardiovascular health and digestion to sexual desire and sexual function. Experts believe high serotonin levels may increase the time it takes to ejaculate. Contrarily, low levels of serotonin may lead to a higher potential for ejaculating prematurely.
When to see a doctor
If you experience PE only sporadically or infrequently, it's probably not a cause for concern. If you find PE is happening more often than you and your partner would like, don't hesitate to consult your doctor.
Men commonly feel embarrassed about PE and are hesitant to talk about it. If you suffer from premature ejaculation, remember it is a common condition and there's no reason to feel ashamed. The sooner you talk to your doctor, the sooner you can find the treatment that's right for you.
Premature ejaculation diagnosis
To diagnose PE, your doctor first asks you some questions about your sex life and your medical history.
According to Mayo Clinic, you may be diagnosed with PE if you:
- Always or nearly always ejaculate within one to three minutes of penetration
- Are not able to delay ejaculation during sex all or nearly all of the time
- Feel distressed and frustrated and, as a result, tend to avoid sexual intimacy
In some cases, your doctor may administer a physical exam. In cases where the patient has trouble with premature ejaculation and erectile dysfunction, blood tests may be administered to investigate whether there is an issue with hormone levels.
Treatment for premature ejaculation often includes the implementation of behavioral techniques, medications and counseling. As you embark on your journey to find the right treatment option, be patient. The causes of PE are wide ranging, and it may take some time to discover the root of the problem and, therefore, which treatment option is best to address it.
The good news is there are many different avenues to explore and most men are able to find an effective solution.
Some of the most common and effective treatment options include the following:
- Behavioral techniques. Your doctor may recommend that you masturbate a couple of hours before you plan to have sex to delay ejaculation. You can take a short break from intercourse or engage in different types of sexual activity to help alleviate performance anxiety and build confidence.
- Kegel exercises. Strengthening the pelvic floor muscles may make it easier to delay ejaculation.
- Start-stop method. This approach involves ceasing all sexual stimulation when you feel you're about to climax. Once you stop the stimulation, breathe deeply and resume after 30 seconds. You can do this three times, allowing yourself to ejaculate on the fourth time. Gradually, you can add more pauses.
- Pause-squeeze method. This technique can be done during masturbation or sexual activity with a partner. Once you feel you're about to ejaculate, pause so either you or your partner can gently but firmly squeeze the head of the penis where it joins the shaft for several seconds until the urge to ejaculate goes away. Use this method until you're able to work up to five minutes before ejaculating. Allow some time for this method to take effect.
- Medication. Your doctor may provide a topical numbing agent to help reduce penis sensitivity during intercourse. They may also recommend oral medications such as antidepressants, pain relievers or phosphodiesterase type 5 (PDE5) inhibitors, a class of drugs often used to treat ED. Side effects from your current medications or recreational drug use may affect sexual health, and you may need to consider changing or discontinuing these drugs.
- Counseling. This option allows a person to individually, or with their partner, work through performance anxiety, mental health issues, and relationship and communication problems that may contribute to PE.
Can premature ejaculation be prevented or avoided?
There is no surefire way to prevent PE because the causes are often complex and involve multiple factors. You can reduce your risk by eating a balanced diet, exercising regularly, and abstaining from excessive alcohol consumption and substance use (those not provided by your doctor).
If you do experience PE, a number of methods may help you avoid it over time, though you should consult your doctor to find the right treatment for you.
Living with premature ejaculation
For many men, living with PE can be frustrating, discouraging and, at times, embarrassing. Fortunately, with open and honest communication with your partner, consultation with your doctor and a little bit of creativity in bed, you can get back to having a satisfying and fulfilling sex life for both yourself and your partner.
Individuals with ED and those who are under emotional or mental stress are at greater risk for developing premature ejaculation. Work on maintaining your physical and mental health and talk to your doctor about any sexual dysfunction you are struggling with as first steps toward doing what you can to address PE.
Once you have found the right treatment for you, it's important to continue to do the important work of communicating with your partner to stay connected as you work toward finding a solution. Fortunately, most men who pursue treatment for PE are eventually able to find a remedy.
Clinical trials and research
Plenty of research is underway to find additional treatments for PE that are safe and effective.
According to Mayo Clinic, research has found that the following drugs may be helpful:
- Modafinil is used to treat the sleeping disorder narcolepsy.
- Silodosin is used to treat prostate gland enlargement.
- OnabotulinumtoxinA (Botox) can be injected into the muscles involved in ejaculation, some researchers believe, and may help prevent PE.
Further research must be done before these drugs or any others are determined to be safe and effective for treating PE. Since they are different drugs with different mechanisms of action, it's important to make sure a thorough health screening is done before using any of them, and don't think you can easily substitute one for another.
Clinical trials play an important role in advancing medical research into potential treatments for PE and other conditions. If you are interested in finding a privately or publicly funded clinical trial for PE that might be right for you, you can explore all the clinical trials that are upcoming or currently recruiting at clinicaltrials.gov.
How can I cure my premature ejaculation?
Treatment for PE often includes the implementation of behavioral techniques, medications and counseling. If PE is a problem for you, consult your doctor so you can work toward finding a treatment option that is right for you.
Why do I last only 30 seconds in bed?
The medical community has not yet found a single cause that can explain the reasons for all cases of PE. However, experts do believe it is typically a result of a combination of psychological and physiological factors.
Is it normal for a guy to release quickly?
Statistics show that 1 in 3 men ages 18 to 59 experience premature orgasm and ejaculation at some point in their lives. If you are experiencing premature ejaculation, you're not alone. If PE is a consistent problem for you or happens more often than you or your partner would like, talk to your doctor about potential treatment options.