Premature Ejaculation: Causes, Symptoms, and Treatments

Premature ejaculation (PE) can be a frustrating and sensitive issue for many men. While it’s normal to finish sooner than expected from time to time, when it happens frequently and causes stress or relationship issues, it may be worth exploring treatment options. Let’s break down what PE is, what causes it, and how it can be treated.

What Is Premature Ejaculation?

PE is one of the most common male sexual concerns, affecting about one-third of men aged 18–59. It refers to ejaculating sooner than you or your partner would like during sex. According to the International Society for Sexual Medicine, PE typically involves:

• Ejaculation within one minute of penetration
• Little or no control over ejaculation
• Emotional distress, frustration, or avoidance of sex due to the issue

Types of Premature Ejaculation

There are two main forms:

• Lifelong PE: Has been present since your first sexual experiences.
• Acquired PE: Develops after a period of normal sexual function.

Occasional early ejaculation doesn't usually require treatment, but persistent issues might.

What Causes Premature Ejaculation?

PE can have both psychological and physical causes. Common psychological contributors include:

• Anxiety or performance pressure
• Depression or low self-esteem
• Guilt, stress, or relationship conflicts

Physical or biological factors may include:

• Increased penis sensitivity
• Prostate inflammation
• Hormonal imbalances (e.g., thyroid issues or low testosterone)
• Certain medications or drug use
• Chronic pelvic pain syndrome

While aging can affect erections and stamina, it’s not considered a direct cause of PE.

PE vs. Erectile Dysfunction

PE and erectile dysfunction (ED) are different but can overlap. Some men with ED may rush sex to avoid losing their erection, which can lead to PE. Others develop PE due to anxiety about their erection performance.

Signs and Symptoms

PE isn’t limited to vaginal sex—it can happen during masturbation, oral, or anal sex. The key symptom is ejaculating sooner than you or your partner would like and feeling unable to control it.

Treatment Options for Premature Ejaculation

Treating PE often involves a combination of approaches, tailored to the individual.

Psychological Therapy

Talking to a therapist—alone or with a partner—can help address performance anxiety, relationship issues, or low self-confidence. Sex therapy is particularly helpful when combined with medical treatment.

Behavioral Techniques

These techniques help build better control over ejaculation:

• Stop-Start Method: Pause stimulation when you feel close to climax, then resume once the urge fades.
• Squeeze Technique: Apply pressure to the base of the penis just before climax to delay ejaculation.
• Pelvic Floor Exercises (Kegels): Strengthen the muscles involved in ejaculation. Try contracting the same muscles used to stop urine flow.

Reducing Sensitivity

If you’re highly sensitive, some methods can help you last longer:

• Masturbating before sex to take the edge off
• Topical anesthetics like lidocaine or benzocaine in cream, spray, or wipe form (be sure to wipe off before penetration)
• Fortacin spray (approved in Europe) targets only the head of the penis for numbing without affecting the shaft

Medications

Although no drugs are FDA-approved specifically for PE, several are used off-label:

• SSRIs (like sertraline or paroxetine): Originally for depression, they delay ejaculation when taken daily or before sex
• Tricyclic antidepressants (like clomipramine) may also help
• PDE5 inhibitors (Viagra, Cialis): Especially useful if you have both PE and ED
• Alpha blockers (e.g., tamsulosin): Some evidence suggests they may help
• Tramadol: A pain medication that can delay ejaculation, but it carries a risk of dependence

Always consult your healthcare provider before starting any medication.

Natural Remedies and Supplements

Some research suggests that nutrients like zinc and magnesium may play a role in sexual function:

• Foods rich in zinc: shellfish, seeds, lean meats, beans
• Foods rich in magnesium: leafy greens, whole grains, nuts

Supplements can help if you have a deficiency, but talk to your doctor before taking them. One study also found that a blend of zinc, folic acid, biotin, and Rhodiola rosea may improve PE symptoms and sexual satisfaction.

When to See a Doctor

If PE is affecting your sex life or self-esteem, speak with a healthcare provider. They’ll ask about your symptoms, sexual history, and overall health to find the right treatment plan. With the right support, PE can be managed—improving not just your sex life, but your confidence and relationships as well.