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Premature Ejaculation


Contact the UPMC Men's Health Center

To make an appointment at the Men's Health Center, call 1-877-641-4636 or fill out our form.


  • Overviews
  • Diagnosis
  • Treatments

What is Premature Ejaculation?

Premature ejaculation is when you ejaculate earlier than you or your partner would like, generally before or just after sexual penetration. It happens when there is limited sexual stimulation, and it often results in unsatisfactory sex for both partners. This, in turn, can lead to anxiety or negatively affect your relationship.

Premature ejaculation is one of the most common types of sexual dysfunction. Most men have experienced it, and about 1 in 3 men will have problems with premature ejaculation at some point in their lives.

Causes of Premature Ejaculation

Doctors haven't pinpointed the exact causes of premature ejaculation. However, feelings of anxiety, guilt, stress, or depression can make it worse. This condition is most often thought to be psychological, although it may involve a mix of psychological and medical factors.

Psychological causes

Possible psychological causes include:

  • Age: Being younger and having less sexual experience can cause premature ejaculation, or being older and experiencing physical changes to erections.
  • Concern over sexual performance: Nervousness of performance or being with a new person.
  • Lack of confidence/poor body image: Low self-esteem and anxiety.
  • Relationship problems: Interpersonal issues between you and your partner.
  • Sexual repression: Negative feelings about sex, often linked with feelings of guilt or shame.

Medical causes

Possible medical causes include:

  • Hormonal problems: Hormonal imbalances, such as testosterone.
  • Prostatitis: Inflammation or infection in your prostate.
  • Low serotonin or dopamine levels: Chemicals in the brain that are involved in sexual desire may shorten the time to climax.
  • Medications: Side effects of certain medications.

Premature Ejaculation Symptoms

This condition is indicated by uncontrolled ejaculation that happens before you expect it to or after little sexual stimulation.

Premature Ejaculation Diagnosis

Your doctor will ask you detailed questions about your medical history. Your answers may tell the doctor whether a medication change or lifestyle habit could be contributing to your condition. If your doctor suspects that your condition has a medical cause, they may order lab tests to uncover the cause.

While discussing your medical history, your doctor may also ask detailed questions about your sexual history. This helps them determine what may be causing the problem so that they're better positioned to recommend treatment.

Premature Ejaculation Treatment

Typically, this conditions bets better over time with age and experience. Treatment isn't always necessary. Lifestyle changes, counseling, and medication may be useful depending on the causes of your issue.

Lifestyle

Reducing the use of alcohol, quitting smoking, and avoiding illegal drugs can help you improve control. Relaxation techniques and distraction methods may also help you delay ejaculation.

Your doctor or a therapist can recommend several techniques, such as the squeeze method and the stop-start method. These involve your partner bringing you close to climax and then stopping until the urge passes. You can begin to recognize the sensations that lead to climax and control them to delay your ejaculation.

Counseling

Individual or couple's counseling can help you and your partner learn to use different techniques to delay ejaculation. A counselor or doctor may recommend trying different positions and communicating with your partner leading up to an orgasm to slow or stop stimulation.

Counseling can also aid you in reducing symptoms of stress, anxiety, or depression, along with stress directly caused by premature ejaculation.

Medication

Some antidepressants can prevent or slow an orgasm, which helps combat premature ejaculation. Your doctor may prescribe one of these medications and provide guidance on how to take it.

Your doctor may also recommend certain creams, gels, sprays, or wipes that lessen sensation. Often, these products are meant for topical pain relief, and they can cause your partner to feel reduced sensation as well. It's best to use them 20-30 minutes before sex and wash them off before penetration.

Wearing a condom can also help dull the sensation and may improve sexual function.

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