Premature ejaculation is where a man ejaculates too quickly during sexual intercourse.Premature ejaculation (PE) is when ejaculation happens sooner than a man or his partner would like during sex. Occasional PE is also known as rapid ejaculation, premature climax or early ejaculation. PE might not be a cause for worry. It can be frustrating if it makes sex less enjoyable and impacts relationships.
Premature ejaculation is a form of sexual dysfunction that can adversely affect the quality of a man’s sex life. It is when an orgasm or “climax” occurs sooner than wanted.
There may occasionally be complication with reproduction, but premature ejaculation (PE) can also adversely affect sexual satisfaction, both for men and their partners.
How Does Ejaculation Work?
Ejaculation is controlled by the central nervous system. When men are sexually stimulated, signals are sent to your spinal cord and brain. When men reach a certain level of excitement, signals are then sent from your brain to your reproductive organs. This causes semen to be released through the penis (ejaculation).
Ejaculation has 2 phases: emission and expulsion.
Phase 1: Emission
Emission is when sperm moves from the testicles to the prostate and mixes with seminal fluid to make semen. The vasa deferentia are tubes that help move the sperm from the testicles through the prostate to the base of the penis. (When you are talking about just 1 of these tubes, it is called a vas deferens.)
Phase 2: Expulsion
Expulsion is when the muscles at the base of the penis contract. This forces semen out of the penis. Usually, ejaculation and orgasm (climax) happen at the same time. Some men climax without ejaculating. In most cases, erections go away after this step.
Premature Ejaculation and Erectile Dysfunction (ED)
Sometimes PE is a problem for men who have erection problems (erectile dysfunction or ED). This is when men are not able to get or keep an erection that’s firm enough for sex. Since an erection goes away after ejaculation, it can be difficult to know if the problem is PE or ED. ED should be treated first. Premature ejaculation may not be a problem once the ED is treated.
Causes
Serotonin
Though the exact cause of PE is not known, serotonin may play a role. Serotonin is a natural substance made by nerves. High amounts of serotonin in the brain increase the time to ejaculation. Low amounts can shorten the time to ejaculation, and lead to PE.
Psychological Issues
Mental health issues can be involvedd in PE such as:
temporary depression
stress
guilt
unrealistic expectations about sexual performance
history of sexual repression
overall lack of confidence
relationship problems
Managing emotional problems often helps.
Related Issues
PE and Age
Premature ejaculation can happen at any age. Aging is not a direct cause of PE, though aging does cause changes in erections and ejaculation. For older men, erections may not be as firm or as large. Erections may not last as long before ejaculation occurs. The feeling that ejaculation is about to happen may be shorter. These changes can naturally lead to an older man ejaculating earlier.
PE and Your Partner
With PE, you may feel you lose some of the closeness shared with a sexual partner. You might feel angry, ashamed and upset, and turn away from your partner. Premature ejaculation doesn’t only affect you, it also affects your partner. Your partner may be upset with the change in sexual intimacy. PE can cause partners to feel less connected, or feel hurt or distant.
Talking about the problem is an important step. Couples counseling or sex therapy can be helpful. Exercises, such as the squeeze technique, may be helpful for you and your partner to prolong an erection (see the treatment section of this article for details). Most importantly, a couple should learn ways to relax. Worry (such as performance anxiety) only makes PE worse.
Diagnosis
When PE gets in the way of your sexual pleasure, you should see your health care provider. Most often, your health care provider will diagnose PE after a physical exam and talking with you. Some questions he or she may ask are:
How often does PE happen?
How long have you had this problem?
Does this happen with just one partner, or every partner?
Does PE happen with every attempt at sex?
What type of sexual activity (i.e., foreplay, masturbation, intercourse, use of visual cues, etc.) do you engage in and how often?
How has PE affected your sexual activity?
How are your personal relationships?
Is there anything that makes PE worse or better (i.e., drugs, alcohol, etc.)?
Lab testing is only needed if your health care provider finds something during your physical exam.
Treatment
Psychological therapy, behavioral therapy, and drugs are the main treatments for PE. You can talk with your health care provider to decide what will help. More than one type of treatment may be used at the same time.
When to see a doctor
Talk with your doctor if you ejaculate sooner than you wish during most sexual encounters. It’s common for men to feel embarrassed about discussing sexual health concerns, but don’t let that keep you from talking to your doctor. Premature ejaculation is a common and treatable problem.
For some men, a conversation with a doctor might help lessen concerns about premature ejaculation. For example, it might be reassuring to hear that occasional premature ejaculation is normal and that the average time from the beginning of intercourse to ejaculation is about five minutes.
After Treatment
With the simple techniques listed here, about 95 out of 100 men will recover from PE. There is no way to promise recovery, but learning how to relax helps. If the problem remains, continue to work with your health care provider to find solutions.