premature ejaculation

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Premature Ejaculation: Symptoms, Causes, Diagnosis, Treatment and Myths

Imagine you’re playing your favorite video game, and just when you’re about to win, the game ends unexpectedly. Frustrating, right? This is what it can feel like for someone dealing with premature ejaculation (PE). It’s a condition where a man ejaculates too quickly during sex, often leaving both partners feeling unsatisfied and upset.

You might think this is embarrassing to talk about, but you’re not alone. Many men experience premature ejaculation, and it’s nothing to be ashamed of. This condition is more common than you might think, and understanding it is the first step toward finding a solution.

You may be skeptical about treatments or worried about medication side effects. That’s okay. This article will provide clear, evidence-based information on various treatment options, including behavioral techniques, medications, and natural remedies. You’ll learn that there are many ways to manage premature ejaculation, and finding the right one for you can take some time and patience.

What is Premature Ejaculation?

Premature ejaculation is when a man ejaculates sooner than he or his partner would like during sexual activity. It’s a common condition, and it can be distressing. But understanding what it is can help.

When we talk about premature ejaculation, we mean ejaculating with minimal sexual stimulation, usually within one minute of penetration. This can be frustrating and can cause problems in relationships. It’s not just about the time; it’s also about not feeling in control over when you ejaculate.

Types of Premature Ejaculation

There are two types of premature ejaculation:

  1. Lifelong (primary) premature ejaculation: This happens nearly all the time, starting with the man’s first sexual encounters.
  2. Acquired (secondary) premature ejaculation: This develops after having previous sexual experiences without ejaculation problems.

It’s important to know that premature ejaculation is not the same as erectile dysfunction, which is trouble getting or keeping an erection. However, the two conditions can occur together.

Statistics show that about 1 in 3 men say they have experienced this problem at some time. It’s a lot more common than many think. And while people consider it embarrassing to talk about, it’s a treatable condition. [1]

Understanding that PE is a medical condition can help reduce the stigma. It’s not just in your head, and it’s not your fault. There are real, physical reasons behind it, and you can get help.

Causes and Risks of Premature Ejaculation

Understanding why premature ejaculation happens is the first step in finding a solution. While there are many factors believed to contribute to premature ejaculation, it’s important to know that the primary causes are often physical. Psychological issues can also play a role, but they are usually a result of dealing with PE rather than the initial cause.

Physical Causes

  1. Hormonal Imbalances: Your body’s hormones can significantly impact ejaculation. Imbalances in hormones like testosterone can cause premature ejaculation.
  2. Infections: Some infections, especially in the prostate or urethra, can cause inflammation and lead to PE.
  3. Genetic Factors: If your father or grandfather had premature ejaculation, you might be more likely to experience it too. There seems to be a genetic component to this condition.
  4. Abnormal Reflex Activity: Your body’s reflexes play a role in ejaculation. Some men may have heightened reflexes that make them ejaculate quicker.
  5. Neurobiological Factors: Differences in the levels of brain chemicals called neurotransmitters can affect the timing of ejaculation. Low levels of serotonin, for example, have been linked to premature ejaculation. [2]
  6. Erectile Dysfunction: Men who have erectile dysfunction might develop a pattern of rushing to ejaculate before losing their erection, which can lead to PE.

Psychological Factors (A Myth)

Many people believe that psychological issues like stress, anxiety, or relationship problems are primary causes of premature ejaculation. However, these issues often develop after the onset of PE rather than causing it. It’s understandable to feel anxious or stressed if you’re worried about ejaculating too soon. This anxiety can make the problem worse, creating a cycle that’s hard to break. But it’s important to remember that these psychological issues are usually a result of experiencing premature ejaculation, not the root cause.

Lifestyle Factors

  1. Stress: High levels of stress can affect your sexual performance and might make PE worse.
  2. Substance Abuse: Using drugs or alcohol can interfere with your sexual function, potentially leading to premature ejaculation. [3]

Understanding the true causes of PE can help you and your healthcare provider find the most effective treatment. It’s not about blaming yourself or your mental state; it’s about addressing the physical reasons and finding ways to manage the condition.

Symptoms and Diagnosis

As we have already said, recognizing the symptoms of premature ejaculation is the first step toward seeking help and finding a solution. It’s important to remember that this condition is common and treatable.

Symptoms of Premature Ejaculation

  1. Quick Ejaculation: The primary symptom is ejaculating within one minute of penetration, often before you or your partner want it to happen.
  2. Lack of Control: Feeling unable to delay ejaculation almost every time during sexual activity.
  3. Distress: Feeling frustrated, embarrassed, or distressed about your sexual performance, which can lead to avoiding intimacy altogether.
  4. Impact on Relationships: The condition can cause stress and tension in relationships, affecting emotional intimacy and satisfaction for both partners.

These symptoms can vary in severity. Some men might experience premature ejaculation occasionally, while for others, it can be a frequent problem. If these symptoms are affecting your life and relationships, it’s time to seek help.

How is Premature Ejaculation Diagnosed?

Diagnosing premature ejaculation typically involves the following steps:

  1. Medical History: Your doctor will ask about your sexual history, including when the problem started, how often it occurs, and how it impacts your life.
  2. Physical Examination: A physical exam can help rule out other health issues that might be causing or contributing to PE.
  3. Questionnaires: You might be asked to fill out questionnaires that help assess the severity of your symptoms and their impact on your well-being.
  4. Discussion of Sexual Health: Open and honest communication with your healthcare provider about your sexual health, any other symptoms, and your mental and emotional state is crucial.

There’s no need to feel embarrassed about discussing these issues with your doctor. They are trained to help and will handle your concerns with sensitivity and confidentiality. [4]

Premature Ejaculation Treatment Options

Once premature ejaculation is diagnosed, there are several treatment options available. The goal is to find the right approach that works for you, which might include a combination of methods.

Behavioral Techniques

  1. The Stop-Start Method: This involves stimulating the penis until you feel close to ejaculation, then stopping until the feeling subsides, and starting again. This can help you gain control over ejaculation.
  2. The Squeeze Technique: Similar to the stop-start method, but this involves gently squeezing the base of the penis until the urge to ejaculate passes, then resuming stimulation.

Premature Ejaculation Therapy

  1. Cognitive-Behavioral Therapy (CBT): CBT can help you address any anxiety or stress related to PE. It focuses on changing negative thoughts and behaviors.
  2. Counseling: Talking to a certified counselor or therapist can help you and your partner improve communication and reduce anxiety about sexual performance.

Medical Treatments

  1. Medications: There are various premature ejaculation meds available that can help delay ejaculation.
    • Dapoxetine: This is a medication specifically approved for premature ejaculation treatment. It belongs to a class of drugs called selective serotonin reuptake inhibitors (SSRIs). [5]
    • Other SSRIs: Medications like sertraline, fluoxetine, and paroxetine can also be effective in delaying ejaculation.
    • Topical Anesthetics: Creams or sprays containing numbing agents can be applied to the penis to reduce sensation and help delay ejaculation.\

These medications, however, should never be taken without consulting with your doctor as it may lead to worsening of your condition.

Natural Remedies and Lifestyle Changes

  1. Exercise: Regular physical exercises, including pelvic floor muscle strengthening exercises like kegels, can improve overall health and reduce stress, which might help with premature ejaculation.
  2. Healthy Diet: Eating a balanced diet can improve your overall well-being and sexual health.
  3. Avoiding Alcohol and Drugs: Reducing or eliminating alcohol and drug use can improve sexual performance.
  4. Stress Management: Techniques like meditation, yoga, and deep breathing can help manage stress and anxiety.

These treatments can be very effective, and combining different approaches often yields the best results. It’s important to work with your healthcare provider to find the right treatment plan for you.

Medications for Premature Ejaculation

Medications can be an effective way to manage PE. They help by delaying ejaculation and improving control. Here are some commonly used medications:


  • Dapoxetine is specifically designed for premature ejaculation treatment.
  • Dapoxetine works by increasing serotonin levels in the brain, which can improve control over ejaculation.
  • It is usually taken 1-3 hours before sexual activity and has been shown to be effective for many men.

Other SSRIs

  • Medications like sertraline, fluoxetine, and paroxetine are also SSRIs used off-label for premature ejaculation.
  • These medications are typically used for depression and anxiety but can help delay ejaculation when taken daily.
  • They may take a few weeks to start working and can have side effects such as nausea, dizziness, and fatigue.

Topical Anesthetics

  • Creams or sprays containing numbing agents like lidocaine or prilocaine can be applied to the penis.
  • These anesthetics reduce sensation, helping to delay ejaculation.
  • They are used shortly before sexual activity and can be very effective.
  • It’s important to use them as directed to avoid excessive numbness.


  • Tramadol is a pain medication that has been found to delay ejaculation.
  • It’s used off-label for PE but should be used with caution due to the risk of dependency and side effects.

Phosphodiesterase-5 Inhibitors (PDE5 Inhibitors)

  • Medications like sildenafil (Viagra) and tadalafil (Cialis) are primarily used for erectile dysfunction but can also help with premature ejaculation.
  • They work by increasing blood flow to the penis and can help men maintain control during sex.

It’s essential to talk to a healthcare provider before starting any medication. They can help determine the best treatment plan and monitor for potential side effects.

Advanced Treatments for Severe Cases

In some cases, premature ejaculation may be severe and not respond well to standard treatments. For these situations, advanced treatments might be necessary.

Hormonal Therapy

  • Hormonal imbalances can contribute to premature ejaculation.
  • Testosterone replacement therapy might be used if low testosterone levels are identified.
  • Hormonal treatments should be carefully managed by a healthcare provider due to potential side effects.

Surgical Options

  • Surgery is rarely needed for PE, but in some cases, it might be considered.
  • One surgical option is selective dorsal neurotomy (SDN), which involves cutting some of the penile nerves to reduce sensitivity.
  • This procedure is still experimental and not widely available.

Innovative Therapies and Research

  • Ongoing research is exploring new treatments for premature ejaculation.
  • Gene therapy, stem cell therapy, and new medications are being studied.
  • Innovative therapies hold promise for the future but are not yet widely accessible.

For severe cases of PE, it’s crucial to work with a specialist who can offer tailored treatment options. These advanced treatments should be considered when other methods have not been effective.

Complications of Premature Ejaculation

Premature ejaculation can lead to several complications that affect both physical and emotional well-being:

  1. Relationship Issues: PE can cause strain in relationships due to dissatisfaction and frustration for both partners.
  2. Stress and Anxiety: Men suffering from PE might experience increased stress and anxiety, which can further impact their sexual performance.
  3. Low Self-Esteem: Persistent PE can lead to feelings of embarrassment and low self-esteem.
  4. Reduced Sexual Satisfaction: Both partners might experience reduced sexual satisfaction, leading to less frequent and enjoyable sexual activity.

Myths and Facts about Premature Ejaculation

There are many misconceptions about premature ejaculation that can make it harder for men to seek help. Let’s debunk some common myths and present the facts.

Myth 1: Premature ejaculation is always caused by psychological issues.

Fact: While stress and anxiety can contribute to premature ejaculation, the primary causes are often physical. Hormonal imbalances, infections, and genetic factors play significant roles. Psychological issues usually develop as a result of premature ejaculation rather than being the initial cause.

Myth 2: Only young or inexperienced men experience premature ejaculation.

Fact: Premature ejaculation can affect men of all ages, regardless of sexual experience. Both lifelong and acquired forms of PE can occur at any stage of life.

Myth 3: Premature ejaculation cannot be treated.

Fact: There are several effective treatments for premature ejaculation, including behavioral techniques, medications, therapy, and counseling. Many men find significant improvement with the right treatment plan.

Myth 4: Premature ejaculation means you have a low sex drive.

Fact: Premature ejaculation is not related to the level of sexual desire. Men with a high sex drive can also experience PE. It’s more about control over ejaculation rather than desire.

Myth 5: Masturbation before sex can cure premature ejaculation.

Fact: While some men find temporary relief, this is not a long-term solution. Proper treatment strategies are more effective and sustainable.

Understanding the facts can help reduce the stigma and embarrassment around premature ejaculation. It’s important to approach this condition with accurate information and a compassionate perspective.

Living with Premature Ejaculation

Living with premature ejaculation can be challenging, but there are ways to manage it and lead a fulfilling life. Here are some tips to help you cope with PE:

Communication with Your Partner

  • Open Discussion: Talk openly with your partner about premature ejaculation. Sharing your feelings and concerns can strengthen your relationship and reduce anxiety.
  • Mutual Support: Work together to find solutions. Understanding and support from your partner can make a big difference.

Techniques to Manage Premature Ejaculation

  • Relaxation Techniques: Practicing relaxation methods such as deep breathing, meditation, or yoga can help reduce stress and improve control over ejaculation.
  • Behavioral Methods: Techniques like the stop-start method and the squeeze technique can help delay ejaculation and improve control.
  • Exercise: Regular physical activity can improve overall health and reduce stress, which may help with premature ejaculation.
  • Pelvic Floor Muscle Exercise: Pelvic floor muscles, located at the base of the pelvis, are crucial for sexual health and performance. Strengthening these muscles through targeted exercises can significantly help in managing premature ejaculation. Kegel exercises, which involve contracting and relaxing the pelvic floor muscles, are particularly effective. By improving muscle control, men can gain better command over ejaculation, potentially delaying it and enhancing overall sexual experience. Regular practice of Kegel exercises can lead to stronger, more toned pelvic floor muscles, contributing to increased endurance and control during intercourse. Incorporating these exercises into daily routines can offer a non-invasive, natural method to combat premature ejaculation, promoting sexual confidence and satisfaction. It, however, is absolutely critical to do these exercises the right way, otherwise you may not reap any benefits out of it.

Professional Help

  • Therapy: Seeing a certified therapist or counselor can help address any anxiety or stress related to premature ejaculation. Cognitive-behavioral therapy (CBT) is particularly effective.
  • Medical Consultation: Regular check-ups with your healthcare provider can help monitor your condition and adjust treatments as needed.

Healthy Lifestyle Choices

  • Balanced Diet: Eating a nutritious diet can improve your overall health and well-being.
  • Avoiding Substances: Reducing or eliminating alcohol and drug use can enhance sexual performance and control.
  • Sleep: Getting enough sleep is crucial for overall health and can bring positive results in your sexual function.

Positive Outlook

  • Patience and Persistence: Treating premature ejaculation can take time. Be patient with yourself and persistent in following your treatment plan.
  • Focus on Pleasure: Remember that sexual activity is about intimacy and pleasure, not just performance. Enjoying the moment can help reduce anxiety and improve your experience.

Living with premature ejaculation requires understanding, communication, and the right strategies to manage it. By taking proactive steps and seeking appropriate help, you can improve your sexual health and enjoy a fulfilling life. Remember, you are not alone, and effective treatments are available.

Seeking Professional Help

If you’re dealing with premature ejaculation, seeking professional help is a positive and proactive step towards finding a solution. It can be daunting to talk about such a personal issue, but healthcare providers are trained to handle these conversations with sensitivity and confidentiality. Here’s how you can approach seeking professional help:

When to Seek Help

  • Persistent Symptoms: If premature ejaculation happens frequently and causes distress for you or your partner, it’s time to seek help.
  • Impact on Relationships: If the condition is affecting your relationship or causing significant emotional distress, professional guidance can be beneficial.
  • Ineffective Self-Treatment: If you’ve tried self-help techniques without success, a healthcare provider can offer more effective treatments.

How to Talk to a Healthcare Provider

  • Be Honest: When discussing your symptoms, be open and honest about what you’re experiencing. Detailed information helps the provider understand your situation better.
  • Prepare Questions: Write down any questions or concerns you have beforehand. This can help ensure you cover everything you want to discuss.
  • Discuss All Symptoms: Mention all related symptoms, even if they seem minor. This includes emotional symptoms like anxiety or depression.
  • Talk About Your History: Provide a full medical history, including any medications you’re taking and past experiences with premature ejaculation.

What to Expect During a Consultation

  1. Medical History Review: The doctor will review your medical and sexual history to identify any underlying causes.
  2. Physical Examination: A physical exam may be conducted to check for any physical conditions that might be contributing to premature ejaculation.
  3. Discussion of Treatment Options: The healthcare provider will discuss various treatment options with you, which may include behavioral techniques, medications, or therapy.
  4. Follow-Up Plan: A follow-up plan will be established to monitor your progress and adjust treatments as necessary.

Finding the Right Specialist

  • Sex Therapist: A sex therapist can provide counseling and therapy to help address any psychological aspects of premature ejaculation.
  • General Practitioner: Your primary care doctor can also provide initial advice and refer you to specialists if needed.
  • Urologist: A urologist too holds specialization in men’s reproductive health and can offer specific treatments for PE.

Seeking professional help is a crucial step in managing premature ejaculation effectively. With the right support, you can find treatments that work and improve your sexual health and quality of life.


Premature ejaculation is a common and treatable condition that affects many men. It can be frustrating and impact both your self-esteem and your relationships, but there is hope. Understanding premature ejaculation, its causes, and the available treatments can empower you to take control of your sexual health.

Remember, you are not alone in this journey. Many men experience premature ejaculation, and effective treatments are available. By taking the initiative to learn about the condition and seek appropriate help, you can improve your sexual health and overall well-being. Don’t let premature ejaculation hold you back from enjoying a fulfilling and happy life. Reach out for help, explore your treatment options, and take control of your health.

Dr Monga’s is a trusted clinic located across Delhi NCR having several certified sexual wellness experts who have years of experience in treating patients of premature ejaculation. So, if you are also experiencing any of the symptoms of PE, do not hesitate and get in touch with Dr Monga’s to embark on your healing journey.


Premature ejaculation is primarily caused by physical factors such as hormonal imbalances, infections, and genetic predispositions. Psychological issues like stress and anxiety often develop as a result of experiencing PE rather than being the initial cause.

There is no specific drink that can guarantee longer lasting during sexual activity. However, maintaining a healthy diet and staying hydrated can improve overall health and stamina. Green tea, which is rich in antioxidants, and drinks with amino acids like L-citrulline or L-arginine might help improve circulation and stamina.

Men do not stop ejaculating at a specific age. As men age, they may experience changes in sexual function, including reduced semen volume and ejaculation force, but they can continue to ejaculate well into their later years.

After 7 days of not ejaculating, some men may notice increased energy levels, heightened sexual desire, and potentially improved sperm quality. There is no significant harm in not ejaculating for a week; it varies based on individual health and lifestyle.

Releasing sperm daily is generally considered healthy and normal for men. It can help reduce the risk of prostate cancer, improve mood, and maintain the reproductive system’s health. However, excessive ejaculation can lead to temporary fatigue or soreness.

Men’s mood changes after ejaculating due to the release of various chemicals in the brain, including oxytocin, prolactin, and serotonin. These chemicals can promote relaxation and a sense of well-being, but they can also cause temporary mood changes.

Masturbation can positively affect sleep for many men. The release of endorphins and other relaxing hormones during and after ejaculation can promote relaxation and help improve sleep quality.

The time to wait for round 2, medically known as refractory period, varies from person to person. On average, it might take a few minutes to an hour. Factors like age, overall health, and individual refractory period influence this duration.

The second round often lasts longer due to a reduced level of sexual arousal and sensitivity after the first ejaculation. This period allows the body to partially recover, making it easier to control ejaculation.

Females do not have a refractory period like men do. While men need time to recover after ejaculation, women can often experience multiple orgasms without the need for a recovery period. However, sensitivity and arousal levels can vary, affecting their ability to continue sexual activity immediately.

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  2. Changing paradigms from a historical DSM-III and DSM-IV view toward an evidence-based definition of premature ejaculation. Part I–validity of DSM-IV-TR (
  3. International Society for Sexual Medicine’s guidelines for the diagnosis and treatment of premature ejaculation (
  4. Serotonin and Premature Ejaculation: From Physiology to Patient Management (
  5. Premature ejaculation – current concepts in the management: A narrative review (
  6. Disorders of Male Orgasm and Ejaculation (!/content/book/3-s2.0-B9780323546423000719?scrollTo=%23hl0001640)
  7. Disorders of Ejaculation: An AUA/SMSNA Guideline (
  8. Premature Ejaculation: Aetiology and Treatment Strategies (
  9. Pelvic floor muscle training improves erectile dysfunction and premature ejaculation: a systematic review (
  10. Diagnostic and Statistical Manual of Mental Disorders (
  11. Kegel Exercises (
  12. Medical Treatment of Disorders of Ejaculation (

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