Premature Ejaculation: Why Does It Happen?

By Dennis Thompson Jr
Medically Reviewed by Pat F. Bass III, MD, MPH


Whatever the cause, premature ejaculation can be very frustrating. Anxiety is often at the root of this common problem.

Premature ejaculation is, as its name suggests, a tendency for a man to ejaculate with little sexual stimulation, usually prior to the commencement of sexual intercourse or just after it begins.

Premature ejaculation is considered the most common type of male sexual dysfunction. Doctors estimate between 20 percent and 30 percent of men experience premature ejaculation at some point during their lives.

Men living with premature ejaculation face a great deal of emotional turmoil. They feel distress, embarrassment, and a lack of control.

Reasons for Premature Ejaculation

There are both psychological and biological reasons for premature ejaculation. The psychological causes include:

• Early sexual experiences that establish a pattern in which sex is linked to excitement, anxiety, and a demand to perform quickly for fear of being caught. Men find themselves hypersensitive and unable to slow down and enjoy the pleasure of sex.

• Anxiety about sexual performance or about other life issues. This anxiety can create overstimulation that leads to premature ejaculation.

• Worry over erectile dysfunction. Men anxious about achieving or maintaining erection might begin rushing to ejaculate, then have trouble getting their bodies out of that habit.

Biological and other causes for premature ejaculation include:

• Abnormal hormone levels

• Low levels of the neurotransmitterserotonin

• Abnormal condition affecting the ejaculatory system

• Thyroid problems

• Inflammation or infection of the reproductive organs, specifically the prostate or the urethra

• Damage to the nervous system, which could have been caused by trauma or surgery

• The use of drugs

• Diabetes and/or cardiovascular disease

Premature Ejaculation: Treatment and Coping

Men experiencing premature ejaculation caused by psychological issues should consider behavioral therapy. Such therapy might involve masturbating an hour or two before sex to give yourself a better chance of delaying ejaculation, or arousing your partner prior to sex so that your orgasms can take place at the same time.

A man also might choose to avoid intercourse for a while, focusing instead on other forms of sexual play and giving himself a chance to work through the anxiety and pressure that is affecting his performance.

Other ways to treat or cope with premature ejaculation include:

The stop-and-start method. The man slows down or reduces stimulation when he feels himself nearing climax. This might involve removing his penis, or simply becoming very still. Once the moment has passed, he then resumes intercourse.

The squeeze. The man's partner squeezes the tip of his penis when he feels himself about to climax. The partner maintains the squeeze for several seconds, until the urge to ejaculate passes. After another 30 seconds, the man and his partner can go back to sex. Repeating this can help the man train his body away from premature ejaculation.

Condom use. Condoms reduce the amount of stimulation the man is receiving and can help him last longer.

Desensitizing lubricants. These contain a mild anesthetic that temporarily numbs the skin of the penis.

Medication. Antidepressants can be prescribed to help delay a man's orgasm.

And, of course, there's the old joke about "thinking of baseball stats" when the urge to climax approaches. Focusing his thoughts on something non-sexual can help a man last longer.

Originally Published: