Premature ejaculation

There are many different definitions of premature ejaculation. If you regularly ejaculate sooner than you wish, or with minimal stimulation, and it is a problem for you and your partner, you may have premature ejaculation.

Premature ejaculation can be lifelong or acquired. Lifelong premature ejaculation refers to when it is present from someone’s first sexual experience. Acquired premature ejaculation develops after previously having a longer, satisfactory time to ejaculation.

It might be generalised (occurring in most situations or on most occasions regardless of partner) or situational (only occurring with some types of stimulation or with a particular partner).

Premature ejaculation is the most common sexual problem in the world affecting at least 1 in 3 to 1 in 5 men aged 18-59. However, people are reluctant to talk about the issue so the incidence might be higher.

Symptoms of premature ejaculation are different between individuals. Whether your premature ejaculation is lifelong or acquired, generalised or situational, are important considerations that may influence your diagnosis and treatment.

In some men, premature ejaculation occurs along with erectile dysfunction.

The cause of premature ejaculation is not the same for everyone.

Some people may have:

• Genetic causes related to the molecules that signal between nerves

• Psychological causes

• Other health problems (e.g abnormal hormone levels) that may contribute to premature ejaculation.

About 1 in 3 to 1 in 4 men with premature ejaculation also have erectile dysfunction.

There are no specific tests needed to diagnose premature ejaculation, but your doctor might order some tests so they can be sure of the cause.

If you’re worried about how quickly you ejaculate during sexual activity, your doctor will ask you some questions to understand your concerns and start to understand the cause or problem.

Your doctor may use a questionnaire (e.g. the Premature Ejaculation Diagnostic Tool) to help them understand how premature ejaculation is affecting you.

Treatment for erectile dysfunction depends on what’s causing it.

There are a variety of medications that can be used to treat premature ejaculation.

Talking with a psychologist, sex therapist or other mental health professional may help. Behavioural treatments, like the ‘stop-start’ and ‘squeeze’ techniques, are effective for some people.

Masturbation before sexual activity, wearing condoms, pelvic floor exercises and acupuncture might be effective for some people but there isn’t a lot of evidence to support their use.

If premature ejaculation is related to erectile dysfunction, treating the erection problem might solve the ejaculation problem.

You might want to involve your sexual partner in discussions about how to manage premature ejaculation because the issue may affect their sexual satisfaction, and there may be things they can do to help.

Treatment of premature ejaculation is successful in 30-70% of cases.

Lifelong premature ejaculation cannot be cured but it can be managed with ongoing treatment. Acquired premature ejaculation may be cured by successfully treating the underlying issue.

Premature ejaculation can lead to stress, anxiety, erectile dysfunction and problems with your interpersonal relationships. so it’s important to seek help.

You should be reassured that premature ejaculation is very common and there are effective treatments that can help.

Your doctor can help you identify the reason for your premature ejaculation and find a suitable treatment, so you should see them if your sexual function is a cause of concern for you.