Premature Ejaculation: It Could Happen To You


Men who experience premature ejaculation have an orgasm sooner than they and their partners find desirable or sexually satisfying. Typically, this means men ejaculate either before or soon after penetration. Has this happened to you?

If you are experiencing premature ejaculation, you have lots of company. This challenge is the most common sexual disorder among men younger than 40, although it also affects older men. It is estimated that 30 percent to 70 percent of males in the United States will experience premature ejaculation at least sometime during their lives. [1]

Types Of Premature Ejaculation

There are two main types of premature ejaculation: primary and secondary. Primary premature ejaculation is said to occur when a male has experienced the condition since his first attempts at sexual intercourse. Men with secondary premature ejaculation are those who have had successful penetration and satisfying sexual encounters but then develop the problem either occasionally or more frequently.

Risk Factors And Causes

Causes of premature ejaculation and its risk factors are closely related. Premature ejaculation usually is caused by an emotional or psychological factor, although physical or biological issues also can have a role.

Among men with primary premature ejaculation, risk factors and causes typically include psychiatric conditions or a history of severe trauma, such as sexual assault or incest.

Secondary premature ejaculation is usually associated with erectile dysfunction, feelings of guilt or anxiety about one’s sexual performance, or relationship problems that may or may not be associated with sex, financial matters, children and other stressful issues.

In a new study from Italy involving more than 3,700 men with sexual dysfunction, for example, investigators set out to identify the risk factors for reduced libido (sex drive). They found that 28.2 percent of men with reduced sex drive also reported experiencing premature ejaculation. [2]

Infrequently, premature ejaculation is associated with a biological issue, such as hormone imbalance, thyroid problems, prostatitis (inflammation of the prostate), damage to the nervous system associated with surgery or injury, or withdrawal from drugs used to treat mental health conditions.

Treatment Of Premature Ejaculation

Premature ejaculation can be treated successfully. According to a review published in the January 2013 issue of the Journal of Sexual Medicine, “… all men seeking treatment for PE [premature ejaculation] should receive basic psychosexual education.” In addition, “behavioral therapy is indicated” when couples are dealing with relationship or psychological challenges, and it “is often best combined with PE pharmacotherapy in an integrated treatment program.” [3]

Therefore, to help resolve relationship issues or reduce the anxiety of premature ejaculation, couples can seek marital or sexual therapy. Professional sex therapists also can help couples learn techniques advocated by William H. Masters and Virginia E. Johnson called stop-and-start and squeeze-and-pause. These are exercises couples can do together to help resolve premature ejaculation. Kegel exercises also may help men strengthen and better control their pubococcygeus (PC) muscles and, thus, gain better control over ejaculation. [4]

Pharmacotherapy may include use of selective serotonin reuptake inhibitors (SSRIs; e.g., escitalopram, fluoxetine, paroxetine), a class of antidepressants that can cause delayed orgasm. Although considered to be a downside in some cases, men with premature ejaculation may benefit from this side effect. Other options include anesthetic creams (e.g., lidocaine, prilocaine), which desensitize the penis and may allow men to delay ejaculation. Use of drugs prescribed for erectile dysfunction (e.g., sildenafil, vardenafil) as treatment for premature ejaculation is controversial. [5]

Men who experience erectile dysfunction along with premature ejaculation (which is a common occurrence) may need to treat both conditions at the same time. A medical professional can help men and couples make those treatment decisions.

Premature ejaculation is a common sexual challenge, but it can be remedied. Men and couples who are dealing with premature ejaculation should seek the assistance of a knowledgeable urologist and therapist.

For more information about men’s health and prostate health, see

[1] Premature ejaculation.

[2] Risk Factors Associated with Primary and Secondary Reduced Libido in Male Patients with Sexual Dysfunction.

[3]Standard operating procedures in the disorders of orgasm and ejaculation.

[4] Sexual dysfunction, Part II: diagnosis, management and prognosis.

[5]Medical therapy for premature ejaculation.

Dr. Geo Espinosa

By Dr. Geo Espinosa

Dr. Geo Espinosa is a naturopathic doctor, licensed acupuncturist and certified functional medicine practitioner recognized as an authority in holistic urology and men’s health. He is Clinical Assistant Professor and holistic clinician in Urology at New York University Langone Medical Center. As an avid researcher and writer, Dr. Geo has authored numerous scientific papers and books including co-editing the Integrative Sexual Health book, and author of the best selling prostate cancer book: Thrive, Don't Only Survive.