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Causes, Symptoms, and Treatment Of Premature Ejaculation

With inputs from Dr. Vidhi Modi

Updated on: November 2023

With inputs from Dr. Vidhi Modi

Updated on: November 2023

Reviewed by Dr Raja Indana

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Table of contents

Premature ejaculation can be a frustrating and demoralizing condition that affects many men. It can have a significant impact on both their self-esteem and their relationships. Understanding what causes premature ejaculation, recognizing the symptoms, and knowing the treatment options available are essential for those seeking relief.

Premature ejaculation occurs when a man ejaculates sooner than he or his partner would like during sexual activity. While the exact cause is still unknown, several factors are believed to contribute to this condition. These may include psychological issues, such as stress, anxiety, or guilt, as well as physical factors, like hormonal imbalances or certain medical conditions.

Symptoms of premature ejaculation can vary from person to person but commonly include ejaculation within one minute of penetration, an inability to delay ejaculation, and feelings of frustration or embarrassment.

Thankfully, there are several treatment options available for premature ejaculation. These may involve psychological counseling, medications, or various techniques to help delay ejaculation.

By understanding the causes, recognizing the symptoms, and exploring treatment options, men with premature ejaculation can take steps towards improving their sexual health and overall well-being.

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Chapter 1: What Is Premature Ejaculation?

Premature ejaculation is defined as the condition in which a man ejaculates sooner than he or his partner would like during sexual activity. It is one of the most common sexual problems experienced by men and can occur at any age.

While occasional instances of premature ejaculation are not uncommon and may not require treatment, persistent and recurrent episodes can be distressing for both partners and may affect their sexual satisfaction and overall quality of life. Men who struggle with premature ejaculation may also experience feelings of anxiety, shame, and low self-esteem.

Premature ejaculation can be classified into two types: lifelong (primary) and acquired (secondary).

Lifelong premature ejaculation is a condition that occurs from the first sexual encounter. It is often attributed to psychological factors such as anxiety, guilt, or depression. In some cases, it may also be caused by genetic or biological factors. Men with lifelong premature ejaculation typically ejaculate within 1 to 2 minutes of penetration, making sexual intercourse difficult or impossible.
Acquired premature ejaculation, on the other hand, develops later in life and can be linked to both psychological and physical causes. For example, it may be caused by stress, relationship problems, or a medical condition such as prostate problems or low testosterone levels.

Men with acquired premature ejaculation may experience a sudden onset of the condition, or it may develop gradually over time. It is important to note that both types of premature ejaculation can be treated.

The treatment options include medication, psychological therapy, or a combination of both. Seeking help from a healthcare professional is recommended to determine the underlying cause and develop an appropriate treatment plan.

Chapter 2: What Are The Causes Of Premature Ejaculation?

The exact cause of premature ejaculation is still unknown. However, several factors are believed to contribute to this condition. These factors can be broadly categorized into psychological and physical causes.

(1) Psychological Factors:

Anxiety: Performance anxiety, stress, or fear of sexual failure can trigger early ejaculation. Anxiety can create a cycle of worry, making it difficult to relax and enjoy sexual activity. Here’s a closer look at how anxiety contributes to PE:

Performance Anxiety: Feeling pressure to perform well in bed can lead to anxiety about sexual performance. The fear of not satisfying a partner or meeting unrealistic expectations can create a heightened state of tension, potentially leading to premature ejaculation.
Stress: High levels of stress, whether related to work, personal life, or other factors, can negatively affect sexual function. Stress hormones can interfere with the body’s natural processes, including those involved in ejaculation control.
Fear of Sexual Failure: A history of previous early ejaculation episodes or concerns about experiencing it again can instill fear. This fear can become a self-fulfilling prophecy, causing further instances of premature ejaculation.

Relationship Issues: Problems within a relationship, lack of emotional connection, or communication problems can contribute to premature ejaculation. A healthy relationship can significantly impact sexual satisfaction and performance:

Problems Within a Relationship: Ongoing conflicts, unresolved issues, or feelings of resentment between partners can create a hostile or unsupportive environment. This emotional strain can carry over into the bedroom, leading to performance issues, including PE.
Lack of Emotional Connection: Emotional intimacy and a strong emotional bond are essential components of a fulfilling sexual relationship. When emotional connection is lacking, the physical aspect of sex may become less satisfying, potentially contributing to PE.
Communication Problems: Effective communication is vital for understanding each partner’s needs, desires, and concerns. If communication is hindered, it can lead to misunderstandings, unmet expectations, and increased anxiety during sexual encounters.

Past Sexual Experiences: Negative sexual experiences or early conditioning may lead to premature ejaculation. Early sexual encounters and conditioning can shape one’s sexual responses and behaviors:

Negative Sexual Experiences: Traumatic or negative sexual experiences in the past, such as sexual abuse, assault, or coercive encounters, can result in psychological trauma. This trauma may manifest as sexual dysfunction, including premature ejaculation.
Early Conditioning: Early sexual experiences can set the stage for future sexual performance. If an individual learned to ejaculate quickly during early sexual encounters, it could become a pattern that persists into adulthood.

Depression: Mental health issues, particularly depression, can affect sexual function in various ways, potentially contributing to premature ejaculation:

Altered Neurotransmitter Levels: Depression can lead to imbalances in neurotransmitters like serotonin and dopamine, which play a role in regulating mood and sexual function. These imbalances may affect ejaculatory control, leading to PE.
Low Libido: Depression often diminishes one’s interest in sexual activity, leading to infrequent or less satisfying sexual encounters. In some cases, individuals with depression may rush through sexual activity, inadvertently causing early ejaculation.
Fatigue and Low Energy: Depression can result in persistent fatigue and low energy levels, which can negatively impact sexual endurance and performance. This physical fatigue can contribute to PE.

(2) Biological Factors:

Abnormal Hormone Levels: Imbalances in serotonin, dopamine, or other neurotransmitters can impact ejaculation control. Neurotransmitters are chemicals in the brain that play a crucial role in regulating various bodily functions, including mood and sexual response. When there are abnormalities in these neurotransmitters, it can affect ejaculation control:

Serotonin Imbalance: Serotonin is a neurotransmitter associated with feelings of well-being and mood stability. An imbalance in serotonin levels may lead to a reduction in the brain’s ability to delay ejaculation. This imbalance can result from factors such as genetics, medication side effects, or other underlying health conditions.
Dopamine Imbalance: Dopamine is another neurotransmitter that influences mood, motivation, and pleasure. Imbalances in dopamine levels can affect the brain’s reward system and, in some cases, contribute to premature ejaculation.

(3) Genetics:

A genetic predisposition to premature ejaculation may play a role in some cases. Genetic factors can influence various aspects of sexual function, including the duration of sexual intercourse. While not the sole determinant, genetics can make some individuals more susceptible to PE. It’s important to note that genetic factors often interact with other environmental and psychological factors.

(4) Prostate Issues:

Conditions affecting the prostate gland, such as prostatitis, may contribute to premature ejaculation. The prostate is a small gland located below the bladder, and it plays a role in producing seminal fluid. Prostate issues can interfere with normal ejaculation processes:

Prostatitis: Prostatitis is an inflammation of the prostate gland, which can be caused by infection or other factors. Inflammation and discomfort in the prostate region may lead to heightened sensitivity and, consequently, early ejaculation.
Prostate Surgery: Some surgical procedures involving the prostate, such as a prostatectomy to treat prostate cancer, can result in changes to the normal ejaculatory process. This can lead to PE in some cases.

(5) Nervous System Abnormalities:

Problems with the nervous system can affect ejaculatory control. The nervous system plays a central role in transmitting signals between the brain and the body, including those related to sexual function:

Neurological Disorders: Conditions like multiple sclerosis, stroke, or spinal cord injuries can disrupt the normal functioning of the nervous system. These disruptions can interfere with the brain’s ability to regulate the timing of ejaculation.

Nerve Damage or Dysfunction: In some cases, nerve damage or dysfunction in the genital area or along the neural pathways involved in sexual response can lead to premature ejaculation. This damage can result from injuries, infections, or other medical conditions.

Chapter 3: Contributing Factors of Premature Ejaculation

Several factors can contribute to the development or exacerbation of premature ejaculation. Recognizing these factors can help tailor treatment approaches. Some contributing factors include:

(1) Age:

Premature ejaculation is more common in younger men but can affect men of all ages. Age-related factors can influence PE in various ways:

Inexperience: Younger men may have less sexual experience, which can contribute to performance anxiety and early ejaculation. As individuals gain more experience and confidence, they may be better able to control ejaculation.
Hormonal Changes: Age-related hormonal changes can impact sexual function. In some older men, reduced testosterone levels may lead to changes in ejaculation patterns, potentially resulting in PE.

(2) Inexperience:

Lack of sexual experience or infrequent sexual activity can contribute to early ejaculation. Inexperience can lead to heightened anxiety and uncertainty during sexual encounters, making it challenging to control ejaculation. Here are some key points to consider:

Anxiety and Uncertainty: Individuals with limited sexual experience may feel more anxious about their performance and their ability to satisfy a partner. This anxiety can trigger PE.
Learning Curve: Sexual performance often improves with practice and experience. As individuals become more familiar with their bodies and their partners’ preferences, they can develop better ejaculatory control.

(3) Performance Pressure:

Pressure to perform well in bed can lead to anxiety and premature ejaculation. Performance pressure can come from various sources, including societal expectations, personal goals, or partner expectations:

Societal Expectations: Societal norms and portrayals of sexual prowess can create unrealistic expectations, putting pressure on individuals to meet these standards. This pressure can lead to anxiety and PE.
Partner Expectations: Concerns about satisfying a partner’s sexual desires or meeting their expectations can lead to performance anxiety and contribute to early ejaculation.

(4) Health Conditions:

Certain medical conditions, such as diabetes or hypertension, can increase the risk of premature ejaculation. These health conditions can affect various aspects of sexual function:

Diabetes: Diabetes can lead to nerve damage and reduced blood flow, affecting the genitals’ sensitivity and function. These changes may contribute to PE.
Hypertension (High Blood Pressure): Hypertension and medications used to treat it can affect blood flow and blood pressure regulation. These factors may influence ejaculatory control.

(5) Medications:

Some medications, like antidepressants or drugs used to treat high blood pressure, may affect ejaculation. Medications can have a wide range of side effects, including changes in sexual function:

Antidepressants (SSRIs): Selective serotonin reuptake inhibitors (SSRIs), commonly prescribed to treat depression and anxiety, can have sexual side effects, including delayed ejaculation or, paradoxically, premature ejaculation.
Alpha-Blockers and Beta-Blockers: Medications used to manage conditions like high blood pressure can sometimes interfere with normal ejaculation, leading to PE.

(6) Substance Abuse:

Alcohol, drugs, or tobacco can negatively impact sexual function and contribute to premature ejaculation:

Alcohol: Excessive alcohol consumption can impair judgment, increase anxiety, and affect sexual performance. It can also desensitize the genital area, potentially leading to PE.
Drugs: Illicit drugs can have a range of effects on sexual function, including impairing ejaculatory control.
Tobacco: Smoking can lead to reduced blood flow and vascular problems, which may impact erectile function and ejaculation control.

(7) Sensitivity:

Increased penile sensitivity can make it challenging to delay ejaculation. Penile sensitivity varies among individuals and can be influenced by factors such as genetics and circumcision status. Highly sensitive genitalia can lead to quicker ejaculation, as the threshold for stimulation required to ejaculate is lower.

Chapter 4: What Are The Symptoms Of Premature Ejaculation?

Symptoms of premature ejaculation can vary from person to person. However, common indicators include

Ejaculation within one minute of penetration
An inability to delay ejaculation, and
Feelings of frustration or embarrassment.

It’s important to note that premature ejaculation is a subjective experience, and what may be considered premature for one person may not be for another.

Aside from the physical symptoms, premature ejaculation can have a significant impact on an individual’s mental and emotional well-being. It can lead to decreased self-esteem, anxiety about sexual performance, and even avoidance of sexual intimacy.

Chapter 5: Treatment of Premature Ejaculations

Thankfully, there are several treatment options available for premature ejaculation. These options can range from psychological counseling to medical interventions. It’s important to note that treatment plans should be tailored to each individual’s specific needs and circumstances.

Natural Premature Ejaculation Treatments

Lifestyle Modifications:

(1) Healthy Diet:

A balanced diet rich in nutrients is essential for overall sexual health. Nutrients such as vitamins, minerals, and antioxidants support various bodily functions, including those related to sexual function.
Specific nutrients, such as zinc, selenium, and omega-3 fatty acids, are thought to have a positive impact on sexual health and performance.
A diet that promotes cardiovascular health can improve blood flow to the genitals, potentially enhancing sexual function.

(2) Regular Exercise:

Engaging in regular physical activity offers several benefits for managing premature ejaculation.
Exercise helps reduce stress and anxiety, which are common contributors to PE. It stimulates the release of endorphins, which promote a sense of well-being and relaxation.
Improved cardiovascular fitness from exercise can enhance blood circulation, potentially aiding in erectile function and ejaculatory control.
Incorporating kegel exercises (pelvic floor exercises) into a fitness routine can target specific muscles involved in ejaculation control.

(3) Stress Management:

Stress is a significant factor that can exacerbate premature ejaculation. Managing stress effectively can lead to better ejaculatory control.
Stress management techniques such as yoga, meditation, and deep breathing exercises promote relaxation and reduce anxiety.
Mindfulness practices can help individuals stay present during sexual encounters, allowing them to focus on sensations and control their arousal.

(4) Pelvic Floor Exercises (Kegels):

Pelvic floor exercises, commonly known as Kegels, target the muscles that surround the base of the penis and the pelvic area. These exercises can be particularly beneficial for those seeking to improve ejaculatory control. Here’s a more detailed look at Kegel exercises:

Locating the Pelvic Floor Muscles: To perform Kegels, it’s essential to first identify the pelvic floor muscles. One way to do this is by stopping the flow of urine midstream during urination. The muscles used to accomplish this are the pelvic floor muscles.
How to Perform Kegels:
- Begin by emptying your bladder.
- Find a comfortable and quiet place to practice.
- Contract your pelvic floor muscles by squeezing and lifting them. Imagine trying to stop the flow of urine or prevent passing gas.
- Hold the contraction for about 3-5 seconds initially and then release.
- Repeat the contraction and release cycle 10-15 times in a row.
- Aim to do at least three sets of Kegel exercises each day.
Progressive Training: As you become more accustomed to Kegels, you can gradually increase the duration of each contraction and the number of repetitions. Over time, work up to holding each contraction for 10 seconds or longer.
Consistency Is Key: To see lasting benefits, it’s important to practice Kegels consistently. Like any muscle, the pelvic floor muscles require regular exercise to strengthen and maintain their function.
Benefits of Kegels: Strengthening the pelvic floor muscles can lead to improved ejaculatory control. These exercises can help delay ejaculation by providing better muscle control over the ejaculatory reflex. Additionally, stronger pelvic floor muscles can enhance overall sexual performance.

Behavioral techniques for managing premature ejaculation:

Behavioral techniques are often considered the first line of treatment for premature ejaculation (PE). These techniques focus on improving ejaculatory control and delaying ejaculation to enhance sexual satisfaction. They can be practiced individually or with the support of a partner. Here are some common behavioral strategies:

(1) Start-Stop Method (Pause-Start Technique):

The start-stop method involves temporarily pausing sexual activity when a person feels they are approaching the point of no return, just before ejaculation.
Once paused, the individual or their partner can engage in non-penetrative activities or simply wait until the urge to ejaculate subsides.
After a brief pause, sexual activity can resume, allowing the person to gain better control over their arousal and delay ejaculation.
This technique helps individuals become more aware of their arousal levels and learn to recognize when they are nearing ejaculation.

(2) Squeeze Technique:

Similar to the start-stop method, the squeeze technique aims to delay ejaculation by interrupting sexual activity when nearing climax.
Instead of pausing, the partner applies pressure or squeezes the base of the penis for about 30 seconds, effectively preventing ejaculation.
After the squeeze, sexual activity can resume, allowing for a longer duration of intercourse.
This technique can help individuals gain control over their ejaculatory reflex and extend the time to ejaculation.

(3) Use of Condoms or Topical Anesthetics:

Condoms can be employed to decrease penile sensitivity and prolong the time it takes to ejaculate. Condoms with thicker latex or those specifically designed to delay ejaculation are available.
Some individuals use topical anesthetics (numbing creams or sprays) to reduce penile sensitivity. These products are applied to the penis before sexual activity to help delay ejaculation.
It’s essential to follow product instructions and consult a healthcare provider if considering the use of topical anesthetics to ensure safety and effectiveness.

(4) Behavioral Exercises and Masturbation Techniques:

Behavioral exercises, such as edging, involve intentionally delaying orgasm during solo sexual activity (masturbation). This practice can help individuals become more in tune with their arousal levels and gain control over the timing of ejaculation.
Masturbation techniques that encourage slower and deliberate arousal, such as the “stop and go” method, can also be beneficial for improving ejaculatory control.

(5) Partner Involvement:

Partners can play a crucial role in supporting individuals with PE. Their involvement in practicing behavioral techniques can enhance intimacy and communication.
Partners can actively participate in implementing the start-stop or squeeze techniques, providing physical support and feedback.
Open and supportive communication between partners about their sexual experiences and desires is essential for a successful outcome.

Chapter 6: Medical Interventions for Premature Ejaculation

In some cases, medical interventions may be recommended to manage premature ejaculation. These interventions can include the use of

(1) Topical anesthetics:

This includes creams, such as lidocaine or sprays, to desensitize the penis and delay ejaculation. Antidepressant medications, specifically selective serotonin reuptake inhibitors (SSRIs), can also be prescribed to help increase serotonin levels and prolong ejaculation time.

(2) Hormone therapy:

Hormonal imbalances can contribute to premature ejaculation. In such cases, hormone therapy may be recommended to restore the balance and improve ejaculatory control. This therapy involves the use of medications or injections to regulate hormone levels.

(3) Nerve block injections:

Nerve block injections involve the injection of an anesthetic into specific nerves in the pelvic region. This temporary numbing effect can help delay ejaculation and alleviate symptoms of premature ejaculation. However, it is essential to note that this intervention is not suitable for everyone and should be discussed with a healthcare professional.

(4) Surgery:

In rare cases, surgical intervention may be considered for severe cases of premature ejaculation that do not respond to other treatments. Surgical procedures aim to modify the nerves and tissues involved in the ejaculatory process to improve control. However, surgery is typically considered a last resort due to the potential risks and complications involved.

Chapter 7: MFine Sexual Wellness Program

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Don’t let sexual health concerns affect your quality of life any longer. Take the first step towards improving your sexual wellness by consulting with us today. Reach out to our sexologists for guidance or request a callback – your journey to a healthier, more fulfilling sex life starts here.

Chapter 8: Effect Of Premature Ejaculation On Relationships

Premature ejaculation can have a profound effect on romantic relationships. It goes beyond being a mere physical issue and extends into the emotional and psychological realms. Here are some ways in which PE can affect relationships:

Feelings of Dissatisfaction: For both partners, premature ejaculation can lead to feelings of dissatisfaction with their sexual experiences. The shortened duration of intercourse may leave both individuals longing for more intimacy and pleasure.
Frustration: The person experiencing PE often feels frustrated and disappointed in their ability to satisfy their partner fully. This frustration can lead to self-esteem issues and performance anxiety, further exacerbating the problem.
Neglected or Sexually Unfulfilled Partner: The partner of someone with PE may feel neglected or sexually unfulfilled. They might wonder whether their partner is truly interested in their sexual needs and desires. This can create emotional distance and dissatisfaction within the relationship.
Compromised Intimacy: Premature ejaculation can disrupt the natural flow of intimacy and connection between partners. The anticipation of early ejaculation may prevent couples from fully enjoying the emotional and physical closeness that comes with sexual activity.

Strained Communication: Couples often find it challenging to discuss sexual issues openly, especially when one partner is experiencing PE. The fear of hurting each other’s feelings or making the problem worse can lead to avoidance and strained communication.

Chapter 9: The Role of Open and Honest Communication

Addressing premature ejaculation within a relationship requires open and honest communication. Here’s why it’s crucial:

Fostering Understanding: Open communication allows both partners to express their feelings, concerns, and needs. It fosters empathy by helping each partner understand the other’s perspective and challenges.
Empathy and Support: When partners communicate openly about premature ejaculation, they can provide emotional support to each other. They can work together to find solutions and offer reassurance that the issue is not a reflection of their love or attraction.
Exploring Solutions Together: Discussing the issue openly enables couples to explore potential solutions collaboratively. They can research treatment options, consider lifestyle changes, or seek guidance from healthcare professionals as a team.
Reducing Anxiety and Tension: Keeping the issue hidden or avoiding conversations about it can create tension within the relationship. Open communication reduces anxiety, allows for problem-solving, and strengthens the emotional connection between partners.

Enhancing Intimacy: As partners work together to address premature ejaculation, their emotional intimacy can deepen. The trust and vulnerability required for these conversations can lead to a stronger bond.

Chapter 10: Tips for Effective Communication About Premature Ejaculation:

Choose an appropriate time and setting for the conversation, ensuring both partners feel comfortable and relaxed.
Use “I” statements to express feelings and needs without placing blame. For example, “I feel concerned about our sexual intimacy” rather than “You always finish too quickly.”
Listen actively to your partner’s perspective, demonstrating empathy and understanding.
Be patient and compassionate with each other. Solving the issue may take time and experimentation.
Consider seeking the guidance of a therapist or counselor who specializes in sexual issues if communication becomes challenging.

Chapter 11: Frequently Asked Questions

How can I stop premature ejaculation fast?

Fast relief from PE may involve techniques like the pause-squeeze method or topical anesthetics. Long-term solutions may require lifestyle changes, exercises, or medications.

What causes quick ejaculation?

Quick ejaculation can be caused by psychological factors (anxiety, performance pressure) or biological factors (hormone imbalances, prostate issues). Identifying the specific cause is essential for effective treatment.

Why do I last only 30 seconds in bed?

Premature ejaculation can lead to very short-lasting sexual encounters. Addressing the root causes through treatments like exercises, therapy, or medication can help improve duration.

Is 5 minutes good for ejaculation?

The ideal duration of sexual intercourse varies from person to person. Five minutes may be satisfactory for some couples, while others may desire longer-lasting intimacy. Communication with your partner is key.

Is it normal to last 40 minutes in bed?

The definition of “normal” duration in bed is subjective. Some individuals naturally have longer endurance, while others find shorter encounters satisfying. What matters most is mutual satisfaction and communication with your partner.

How to stop ejaculation for 30 minutes?

Achieving a specific duration can be challenging, but techniques like the pause-squeeze method, pelvic floor exercises, and desensitizing sprays can help extend ejaculatory control.

Why do I last 2 hours in bed?

Extended durations in bed are not common and may not be necessary for most couples. If this causes discomfort or dissatisfaction, consult a healthcare provider to explore potential causes and solutions.

References

Premature ejaculation is a common sexual concern that can impact relationships and self-esteem. Understanding its causes and treatment options is crucial for those affected. Whether through natural remedies, exercises, medications, or therapy, effective solutions exist to help manage premature ejaculation and improve the overall quality of one’s sexual experiences. It’s essential to consult with a healthcare professional to determine the most suitable treatment plan based on individual needs and circumstances.

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