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Understanding Premature Ejaculation: Causes, Symptoms, and Treatment Options

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According to the Urology Care Foundation, Premature Ejaculation (PE) affects about 1 in 3 men in the US.

Bad sexual experiences due to PE are common among males.

PE can be annoying and embarrassing.

PE differs from Erectile Dysfunction (ED). 

ED is the inability to obtain and maintain an erection that permits a satisfying sexual encounter. 

However, you may also encounter PE in addition to Erectile Dysfunction.

Medications, counseling, and methods that delay ejaculation can enhance sexual performance.

The following article discusses Premature Ejaculation, its symptoms, causes, and treatment.

What is Premature Ejaculation

Premature Ejaculation is when a man ejaculates much sooner than desired during sexual intercourse.

There is no specific time a man should ejaculate during sex. 

Still, if you ejaculate within a minute or two after penetration, you and your partner may not enjoy the experience.

However, treatment of PE is available in the form of medicines.

Premature Ejaculation medicines such as antidepressants are effective in treating PE.

Common antidepressants such as Sertraline, Citalopram, Dapoxetine, and Paroxetine are used for treating PE

Besides these antidepressants, Surgery might also be an effective option to treat PE.

Want to know how surgery helps manage PE? Read Surgery for Premature Ejaculation: Exploring Treatment Options.

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  • Premature Ejaculation Symptoms

    If Premature Ejaculation occurs infrequently, there is no cause for concern.

    But if you are experiencing PE frequently, then you should consult a doctor.

    PE is usually either something you have always had or acquired.

    Lifelong (primary) PE means that you have always or almost always had this experience since your first sexual encounter.

    Acquired (secondary) PE means that you have had ejaculations that lasted longer in the past, but you now have PE.

    Some common Premature Ejaculation symptoms are:

    • You ejaculate within 1 minute after penetration
    • Rarely or never able to delay ejaculation during sexual activity

    To learn more about the possible symptoms of PE, Read What Are The Possible Premature Ejaculation Symptoms You Need To Know.

    Premature Ejaculation causes

    Medical factors, relationship issues, and physical factors can cause Premature Ejaculation and affect male ejaculation

    For instance, it may occur when a person is overly aroused or if their penis is particularly sensitive.

    Psychological and biological factors interact closely to cause Premature Ejaculation. 

    Psychological and physical factors

    A depressed man sitting down on the floor Source: Urbazon_from_Getty_Images
    Depression – Psychological factor

    Psychological factors heavily influence sexual desires, libido, and erections. 

    These factors further affect a man’s sexual performance and can lead to sexual performance anxiety

    In addition, unhealthy sleep patterns cause a decrease in Serotonin levels in the brain, which causes the body to ejaculate quickly. 

    The following psychological factors may play a role:

    • Early sexual encounters
    • Sexual abuse
    • Anxiety and tension
    • Depression
    • Negative body image 

    The following physical conditions can also contribute to PE:

    • Abnormal levels of hormones
    • Abnormal levels of neurotransmitters 
    • Genetic characteristics you derive from your parents
    • Inflammation or infection of the urethra or prostate 

    Medical causes

    In some cases, there may be a medical cause for PE.

    The following are some of the possible medical causes of PE:

    • Diabetes
    • High blood pressure
    • Thyroid issues
    • Recreational drug use
    • Excessive alcohol consumption
    • Multiple Sclerosis may also cause ejaculation issues like PE.

    Relationship issues

    Your and your partner’s interpersonal relationships may likely cause Premature Ejaculation. 

    Early ejaculation may cause you to lose sexual and emotional intimacy with your partner. 

    As a result, it affects not only the male suffering from early ejaculation but also their partner. 

    You may be furious, upset, and ashamed about your situation, which may cause you to withdraw from your spouse.

    Getting older

    diabetes and erectile dysfunctionSource: Monkey_Business_Images
    Checking diabetes level

    Age is not a direct factor in Premature Ejaculation. 

    Early ejaculation might have an impact even on young guys.

    As we age, we are more prone to health problems like diabetes, which can also lead to PE. 

    Also, our bodies change as we age, which can cause chemical-level fluctuations. 

    These chemical alterations cause variations in erection and ejaculation. 

    Men’s ability to keep a hard erection during sexual intercourse deteriorates as they age. 

    The anticipation of ejaculation may be shorter, resulting in early ejaculation.

    Erectile Dysfunction

    Erectile Dysfunction is a common cause of Premature Ejaculation. 

    Erectile Dysfunction refers to men’s inability to obtain or maintain a hard erection during sexual intercourse. 

    Thus, men who worry about getting or retaining an erection may rush to ejaculate, resulting in Premature Ejaculation.

    Premature Ejaculation treatment

    There is no fixed treatment for Premature Ejaculation.

    In some instances, you may be able to treat PE by modifying your sexual behavior.

    You may masturbate an hour before sexual activity, which may delay ejaculation.

    You may also try temporarily avoiding all intercourse and engaging in alternative sexual activity. 

    This may ease the strain associated with performing during intercourse.

    Below are some prescription and topical medications, natural remedies, and exercises that may help treat PE:

    Prescription Medication

    Do you need a prescription for ViagraSource: Getty_images_signature
    Doctor’s prescription

    Some prescription pills for Premature Ejaculation include:

    • ED medications
    • Antidepressants

    Dapoxetine is a Short-Acting Selective Serotonin Reuptake inhibitor (SSRI).

    It helps treat Premature Ejaculation. 

    A 2018 research found Dapoxetine effective and safe in treating Premature Ejaculation and delaying ejaculation.

    Although antidepressants help treat depression and anxiety only.

    Some antidepressants like Dapoxetine and Sertraline may be prescribed by the doctor for PE.

    Sertraline may increase the time required to ejaculate. 

    Healthcare professionals may recommend taking 25–50 mg of Sertraline daily for up to three weeks.  

    Apart from Antidepressants, Phosphodiesterase type 5 (PDE5) inhibitors, typically used to treat Erectile Dysfunction, may help treat PE.

    Some PDE5 inhibitors are:

    You can buy these ED medications from a reliable online pharmacy with a valid prescription.

    According to a study, PDE5 medications like Viagra may treat PE only in people with Erectile Dysfunction.

    Your doctor may also recommend couples therapy or counseling for your PE problem. 

    A 2019 study suggests that counseling and medication therapies may work better together.

    Consult a doctor before taking Premature Ejaculation pills because side effects and drug interactions are possible.

    Topical Medications

    Topical medications are the first-line treatment for PE.

    Also, topical medications are used more frequently than oral medications.

    They may come as numbing creams or sprays for the penis.  

    But, additional research is required to determine their cost-effectiveness, efficacy, and potential side effects.

    A 2021 review indicates that topical medications may have few side effects. 

    Below we have discussed some topical medications for PE:

    Topical creams

    You can apply the cream 20–30 minutes before sexual activity and wash it off 5–10 minutes beforehand. 

    These creams aid in decreasing sensation and slowing ejaculation.

    The application of topical lotions can delay ejaculation and enhance sexual satisfaction.

    A 2017 study showed that topical creams increase ejaculation time by a few minutes. 

    But, these creams can cause side effects like mild pain, and burning sensations. 

    It may also cause decreased libido and temporary loss of sensitivity.

    Premature Ejaculation wipes

    Premature Ejaculation wipes are a topical anesthetic that contains Benzocaine. 

    It can help delay ejaculation by reducing the sensation at the penile tip. 

    A 2017 study found that people who used it for around two months had less intercourse distress.

    Topical anesthetics may cause side effects in some people.

    You should consult a doctor before using them.

    Delay condoms for men

    Delay condoms are thicker or contain a numbing agent. 

    These condoms reduce sensitivity and prevent Premature Ejaculation. 

    These over-the-counter climax control condoms are readily available.

    They can be an effective method to manage Premature Ejaculation.

    Delay spray for men

    Lidocaine spray is a desensitizing agent. 

    It can help reduce hypersensitivity and delay ejaculation. 

    This spray should be applied 15 minutes before sex for the best results.

    You can read the following article to learn more about PE treatments: How to Stop Premature Ejaculation: Treatment Options.

    SSRI: Selective Serotonin Reuptake Inhibitors or SSRIs are a class of antidepressants that aids in treating Anxiety and Depression.

    Home remedies for Premature Ejaculation

    Various home remedies help with PE. These home remedies help to last longer in bed naturally.

    According to the Urology Care Foundation, individuals with PE may try these two approaches:

    Start-and-stop method

    The purpose of the start-and-stop method is to enhance ejaculatory control. 

    The start-and-stop method involves stimulating the penis by oneself or a companion. 

    When the individual feels like they are about to have an orgasm, they stop and resume once the sensation has passed.

    Squeeze Method

    A person or their companion will stimulate the penis using the squeeze method. 

    When the individual is on the verge of ejaculating, they squeeze the tip of the penis for approximately 30 seconds. 

    This should aid individuals in understanding the sensations preceding the climax, allowing them to control and defer ejaculation.

    Before allowing themselves to ejaculate, a person should attempt the above methods three or four times.

    To know more about home remedies, read Top 10 Simple Home Remedies for Premature Ejaculation.

    Making diet changes

    MagnesiumSource: Africa Images
    Foods rich in Magnesium

    Apart from the methods mentioned above, you can make diet changes to avoid PE.

    Supplements like zinc and magnesium help delay ejaculation. 

    Eat foods rich in zinc and magnesium, such as oysters, spinach, and dark chocolate. They can help improve your sexual health. 

    These foods may provide essential nutrients that contribute to healthy sexual function. 

    These food items can increase the time it takes you to climax. 

    As a result, it will reduce the likelihood of Premature Ejaculation.

    You can read the following article to learn more about such food items, Are There Any Foods to Cure Premature Ejaculation? Everything In Detail.

    Exercises for Premature Ejaculation

    There are various exercises that may help manage Premature Ejaculation.

    Kegel exercises or pelvic floor exercises may help effectively treat Premature Ejaculation.

    The following exercises will help improve your PE problem over time.

    Back Squeezes

    Begin by lying on your back with your palms flat on the floor, your knees bent, and pointing upwards.

    Try to draw your genitalia toward your body, hold for five seconds, and then let go.

    Now, contract your anus muscles as if attempting to stop a bodily movement, hold for five seconds, and then release.

    Floor Squeezes

    Lay on your side on the floor.

    Insert a cushion between your knees. 

    Ensure the pillow is large enough to allow you to stretch out your legs.

    Constrain your legs together for five seconds, then release.

    Chair Squeezes

    Find a comfortable position while sitting in a chair.

    Squeeze your penis with just its muscles as if you are trying to stop urine from coming out, hold for five seconds, then release.

    According to a 2019 study, this pelvic floor muscle training effectively treats PE.

    Wondering how kegel exercises help manage PE? Read Kegel Exercises for Premature Ejaculation: Do They Help in Treating PE?

    Surgical procedures

    Individuals with moderate to severe PE may consider a variety of surgical remedies, such as:

    Glans Augmentation

    In this procedure, a physician injects hyaluronic acid and a bulking agent into the glans of the penis to reduce nerve sensitivity.

    According to a study, participants who underwent Glans Augmentation experienced a reduction in PE.


    This surgical procedure removes enlarged capillaries from within the scrotum. 

    People experienced increased testosterone and physical efficiency after undergoing a Varicocelectomy

    Pulsed Radio Frequency Neuromodulation

    This procedure treats the penile nerves with radio frequency.

    After the procedure, people demonstrated significant improvements in PE with no major side effects.

    When to consult a doctor

    When PE interferes with your sexual pleasure, you should consult your doctor immediately. 

    The diagnosis is determined by if ejaculation occurs soon, late, or not at all.

    Generally, your healthcare provider will diagnose PE after a physical exam. 

    The doctor may ask some of the following questions:

    • How frequently does PE happen?
    • How long have you had this problem?
    • Does PE occur with each attempt at sex?
    • What kind of sexual activity (i.e., foreplay, masturbation, intercourse, use of visual cues, etc.) do you take part in, and how often?
    • Is there anything that makes PE better or worse (i.e., alcohol, drugs, etc.)?
    • Does this happen with just one partner or all partners?
    • How has PE transformed your sexual activity?
    • How are your relationships?

    Lab testing is only required if your doctor discovers something during your physical exam.

    Key Takeaways

    PE affects about one in three men in the U.S. between 18 and 59. 

    It happens when a person ejaculates earlier than expected during sexual stimulation.

    Most of the time, psychological factors result in PE. 

    But in some cases, this can be caused by health problems, like Diabetes or high blood pressure.

    You can try different treatments, such as prescription drugs, creams and sprays, home remedies, and workouts to treat PE.

    SSRIs like Dapoxetine and Sertraline are prescribed off-label for PE.

    You should consult a doctor before taking any medication for Premature Ejaculation.

    Frequently Asked Questions

    What causes Premature Ejaculation?

    The causes of Premature Ejaculation can be both psychological and physical. Psychological factors may include Anxiety, stress, performance anxiety, relationship issues, or early sexual experiences. Physical causes can involve hormonal imbalances or underlying medical conditions.

    How to avoid Premature Ejaculation?

    Several strategies can help you avoid Premature Ejaculation. These include practicing relaxation techniques, such as deep breathing or meditation. You can use distraction techniques, foreplay, and try different sexual positions. You can also use condoms or desensitizing creams and seek professional help.

    Is it normal for a guy to ejaculate quickly?

    Yes, it is normal for some men to ejaculate quickly during sexual activity. The ability to control ejaculation varies among individuals. Factors such as arousal levels, sensitivity, experience, and overall sexual health affect ejaculation. It becomes a concern when it consistently causes distress or affects the individual’s sexual satisfaction and that of their partner.

    Does Premature Ejaculation go away?

    In some cases, Premature Ejaculation may resolve on its own without treatment. It can improve with time, experience, and a better understanding of one’s sexual responses. However, if it persists or worsens, seeking medical advice is recommended to explore possible underlying causes and appropriate treatment options.

    Why is my Premature Ejaculation getting worse?

    Premature Ejaculation can worsen due to various factors. Psychological factors such as increased Anxiety, stress, or performance pressure can exacerbate the condition. Physical health issues, hormonal imbalances, or medication side effects may also worsen Premature Ejaculation. Consulting a doctor can help identify the underlying causes and provide appropriate guidance for management.

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    Photo of author Janet Fudge
    Janet Fudge is a highly skilled and experienced pharmacologist who serves as a contributing writer for With a strong academic background from a premier US University and a passion for helping others, Janet has become a trusted voice in the pharmaceutical world. After completing her Doctor of Pharmacy degree, Janet embarked on a successful career in the pharmaceutical industry, working with various clients, including hospitals, retail pharmacies, and drug manufacturers. Her in-depth knowledge of pharmacology and dedication to patient-centered care has led her to excel in her field. As a writer for, Janet uses her wealth of expertise to provide readers with accurate, reliable, and up-to-date information on various topics related to medicine and healthcare. Her engaging writing style and ability to break down complex topics into easily digestible content make her a valuable resource for healthcare professionals and the general public.
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