Premature ejaculation

Overview

Premature ejaculation occurs in men when semen leave the body (ejaculate) sooner than wanted during sex. Premature ejaculation is a common sexual complaint. As many as 1 out of 3 people say they have it at some time.

Premature ejaculation isn't cause for concern if it doesn't happen often. But you might be diagnosed with premature ejaculation if you:

• Always or nearly always ejaculate within 1 to 3 minutes of penetration
• Are not able to delay ejaculation during sex all or nearly all the time
• Feel distressed and frustrated, and tend to avoid sexual intimacy as a result

Premature ejaculation is a treatable condition. Medications, counseling and techniques that delay ejaculation can help improve sex for you and your partner.

Symptoms

The main symptom of premature ejaculation is not being able to delay ejaculation for more than three minutes after penetration. But it might occur in all sexual situations, even during masturbation.

Premature ejaculation can be classified as:

• Lifelong. Lifelong premature ejaculation occurs all or nearly all the time beginning with the first sexual encounter.
• Acquired. Acquired premature ejaculation develops after having previous sexual experiences without problems with ejaculation.

Many people feel that they have symptoms of premature ejaculation, but the symptoms don't meet the criteria for a diagnosis. It's typical to experience early ejaculation at times.

When to see a doctor

Talk with your health care provider if you ejaculate sooner than you wish during most sexual encounters. It's common to feel embarrassed about discussing sexual health concerns. But don't let that keep you from talking to your provider. Premature ejaculation is common and treatable.

A conversation with a care provider might help lessen concerns. For example, it might be reassuring to hear that it's typical to experience premature ejaculation from time to time. It may also help to know that the average time from the beginning of intercourse to ejaculation is about five minutes.

Causes

The exact cause of premature ejaculation isn't known. It was once thought to be only psychological. But health care providers now know that premature ejaculation involves a complex interaction of psychological and biological factors.

Psychological causes

Psychological factors that might play a role include:

• Early sexual experiences
• Sexual abuse
• Poor body image
• Depression
• Worrying about premature ejaculation
• Guilty feelings that can cause you to rush through sex

Other factors that can play a role include:

• Erectile dysfunction. Being anxious about getting and keeping an erection might form a pattern of rushing to ejaculate. The pattern can be difficult to change.
• Anxiety. It's common for premature ejaculation and anxiety to occur together. The anxiety may be about sexual performance or related to other issues.
• Relationship problems. Relationship issues can contribute to premature ejaculation. This may be true if you've had sexual relationships with other partners in which premature ejaculation didn't happen often.

Biological causes

A number of biological factors might contribute to premature ejaculation. They may include:

• Irregular hormone levels
• Irregular levels of brain chemicals
• Swelling and infection of the prostate or urethra
• Inherited traits

Risk factors

Various factors can increase the risk of premature ejaculation. They may include:

• Erectile dysfunction. You might be at increased risk of premature ejaculation if you have trouble getting or keeping an erection. Fear of losing an erection might cause you to hurry through sex. This may happen whether you're aware of it or not.
• Stress. Emotional or mental strain in any area of life can play a role in premature ejaculation. Stress can limit the ability to relax and focus during sex.

Complications

Premature ejaculation can cause issues in your personal life. They might include:

• Stress and relationship problems. A common complication of premature ejaculation is relationship stress.
• Fertility problems. Premature ejaculation can sometimes make it hard for a partner to get pregnant. This may happen if ejaculation doesn't occur in the vagina.