Premature ejaculation occurs when a guy achieves orgasm and releases semen sooner than he or his partner would prefer.
Premature ejaculation can be a source of frustration for both you and your spouse. Worse, most of the time it can be fixed!
Cleveland Clinic is a not-for-profit medical center. Our advertising helps us achieve our goals. Not all Cleveland Clinic products or services are endorsed Policy
Premature ejaculation occurs in 30-40% of males. Premature ejaculation is the most frequent sexual problem in men, according to the AUA. Premature ejaculation is reported by one in five men aged 18 to 59.
When is a man’s ejaculation considered premature?
Premature ejaculation is defined as occurring sooner than anticipated, either before or immediately after penetration, causing distress to one or both partners. Severity is defined by the time until ejaculation, with light being under one minute.
Many clinicians describe prematurity as ejaculation within a minute of starting intercourse. However, your thoughts about what is premature are also taken into account.
SIGNS AND CAUSES
Why do I ejaculate too early?
There are many variables that trigger premature ejaculation.
- A diagnosis of erectile dysfunction.
- A biological issue with oxytocin levels that affect male sexual function. LH, prolactin, and thyroid-stimulating hormone (TSH) are all involved in sexual activity (TSH)
- Low levels of serotonin or dopamine, brain chemicals involved in sexual desire and excitement.
- A penis that is especially sensitive.
Psychological causes include:
- Anxiety before a The fear of having sex again after a lengthy period of abstinence, lack of confidence, guilt, being extremely excited or stimulated, or other reasons.
- Relationship issues
Symptoms of premature ejaculation
No. Premature ejaculation has no symptoms.
How to diagnose premature ejaculation?
Make an appointment with a urologist if you suffer regular premature ejaculations, or if they cause you distress or despair.
Pre-exam questions from your urologist include sexual history. You’ll be asked:
- How long has this issue been?
- How did it happen?
- How often is it?
- Is premature ejaculation a sexual norm?
- Is it true for all partners?
- Does masturbation cause premature ejaculation?
- Do you struggle to keep an erection?
While the questions are personal, it is critical that you answer honestly so your urologist can properly diagnose your issue.
Your urologist will also inquire about any other medical issues and drugs, including OTC, vitamins, and herbal products. You will also be quizzed on your alcohol and drug use.
Does lab testing help diagnose premature ejaculation?
Lab testing is normally not required unless your doctor feels an underlying health issue is at play.
Care and Treatment
Early ejaculation treatment
Early ejaculation can be treated in several ways depending on the cause. Medication and behavioral therapy are examples.
Premature ejaculation is usually addressed with behavior therapy and/or counseling to address underlying emotional issues, performance anxiety, and stressors. Often, multiple therapy approaches are explored concurrently.
Behavioral treatment entails delaying your orgasm. It teaches you how to regulate your body and emotions. Among them:
When you or your partner stimulates your penis to the point of climax, stop for 30 seconds to regain control of your response. Start and stop three or four times before letting yourself orgasm. Keep practicing until you have solid control.
Squeeze treatment involves gently squeezing the head of your penis for around 30 seconds, causing you to lose your erection.
Repetition is key before allowing oneself to climax. Practice this approach until you can control your orgasm.
Distracted thinking: The goal is to focus on nonsexual activities while being sexually stimulated. Naming sequences help you focus.
Imagine name all the businesses you pass on your way to the gym, all the players on your favorite sports team, or all the products in your favorite store’s aisles.
Psychological, emotional, or relational concerns (performance anxiety, melancholy, stress, guilt, or a dysfunctional relationship) might cause premature ejaculation. Your urologist can help you find these specialists.
Various drugs may be tested.
Some antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa®), escitalopram (Lexapro®), fluoxetine (Prozac®), paroxetine (Paxil®), and sertraline (Zoloft®), can help prevent premature ejaculation.
Off-label use (not approved by the Food and Drug Administration for this use). Discuss the medication’s adverse effects with your urologist to ensure it’s right for you.
Numbing creams and sprays for the penis’ head and shaft are other alternatives for delaying ejaculation. After applying the anesthetic cream or spray, let it soak in for 10-30 minutes until the penis feels less sensitive.
Wash your penis before intercourse to avoid numbing your partner’s vagina or losing your erection.
Premature ejaculation has been treated with erectile dysfunction drugs such sildenafil (Viagra®), tadalafil (Cialis®), vardenafil (Levitra®), and Avanafil (Stendra®).
Can a condom help prevent early ejaculation?
Yes. Wearing a condom can help reduce penile sensitivity and delay ejaculation.
Early ejaculation: detrimental or a symptom of a health issue?
Premature ejaculation is harmless in itself, but other health issues might cause it. These health issues are:
- Difficulty maintaining an erection for intercourse.
- Chronic pelvic pain (long-term pain and cramping in the pelvic area plus long-term urinary tract symptoms and sexual dysfunction).
- Drunken fun.
What is the difference between ED and pre-ejaculation?
You can’t get or keep an erection if you have ED. You have an erection but reach climax and ejaculate earlier than you or your spouse would want.
However, erectile dysfunction might cause premature ejaculation. This happens when a man realizes he can’t hold an erection for long, therefore he develops the practice of ejaculating quickly after arousal.
Because these two disorders are linked, your urologist will first check for erectile dysfunction and treat it if it exists.
Can alcohol delay ejaculation?
While alcohol might postpone orgasm, it is not a cure for premature ejaculation.
Your urologist and healthcare team will devise a treatment plan for your prematu ejaculation. To find out how to manage premature ejaculation, consult your urologist or other doctors.
Although discussing sexual issues with your doctor may be unpleasant, remember that they are experts who want you and your partner to be happy. Remember, you are not alone in this!