Premature Ejaculation

Quick Facts

  • The inability to delay ejaculation for more than one minute
  • A common sexual problem that may be caused by psychological or physiological factors
  • May be treated with exercise, medication, or counseling

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What is Premature Ejaculation?

Premature ejaculation is the release of sperm earlier than preferred by a man.

Primary premature ejaculation is a chronic and consistent inability to delay ejaculation.

Secondary premature ejaculation is the sudden inability to delay ejaculation after experiencing normal ejaculation during sexual experiences.

Premature ejaculation is a common sexual problem. One in three men experience premature ejaculation in their lifetime.

Premature Ejaculation Symptoms

Primary symptoms of premature ejaculation include:

  • Ejaculating within a minute of sexual activity on a consistent basis
  • Inability to delay ejaculation

Premature Ejaculation Causes

Premature ejaculation may be caused by psychological factors, physiological problems, or a combination of the two.

Psychological factors include:

  • Stress
  • Depression
  • Sexual abuse
  • Performance anxiety
  • Poor self-esteem
  • Shame or guilt about sexual encounters

Physiological causes include:

  • Erectile dysfunction
  • Hormone or chemical imbalance
  • Infection or inflammation of the reproductive system
  • Family history of premature ejaculation

Premature Ejaculation Diagnosis

To diagnose premature ejaculation, the physician will evaluate the patient’s health history and perform a physical examination. The physician may also order a blood test to check hormone levels. If results are inconclusive or require further examination, the patient may be referred to a urologist or a mental health counselor.

Premature Ejaculation Treatment

Treatment for premature ejaculation varies depending on the cause, but may include exercise, medication, and counseling, or a combination of the three.

Exercises  

  • Pre-coital masturbation, to aid in ejaculatory delay.
  • Intercourse alternatives, to relieve performance anxiety.
  • Pelvic floor exercises, to strengthen the muscles involved in intercourse and ejaculation.
    • Tightening the pelvic floor muscles, holding them for three seconds, releasing them for three seconds, and then repeating, ten times, three times a day.
  • The pause-squeeze technique, in which the man’s partner squeezes and holds the area of the penis between the head and the shaft until the urge to ejaculate passes
  • The stop-start technique, in which sexual activity proceeds until the urge to ejaculate arises, and then sexual activity stops until the urge to ejaculate passes.

Medications

  • Numbing agents, in condoms and topical sprays and creams, to decrease penis sensitivity.
  • Antidepressants, especially serotonin reuptake inhibitors (SSRIs) such as escitalopram, sertraline, paroxetine, or fluoxetine, which may help delay ejaculation.
  • Tramadol, an analgesic, which may help delay ejaculation.
  • Phosphodiesterase-5 inhibitors, such as sildenafil, tadalafil, and orvardenafil, which are used to treat erectile dysfunction.

Counseling

In cases where a patient’s sexual history or mental health may be a factor, counseling may help. Counseling may ease anxiety or stress associated with premature ejaculation, or may help a patient deal with past sexual experiences or performance anxiety that may be contributing to the problem. Relationship counseling may also help the couple resolve problems or discuss the issue.

Dietary changes 

Some doctors believe that the minerals zinc and magnesium may play a role in sexual health and that a deficiency may contribute to premature ejaculation. Though this has not been proven, some recommend eating foods that are high in these minerals, such as oysters, spinach, almonds, kidney beans, chickpeas, beef, garlic, and peas.