Premature ejaculation is a type of sexual dysfunction that occurs when a man has an orgasm and releases (ejaculates) semen sooner than he or his partner would like. It often happens before or shortly after penetration during intercourse. Premature ejaculation can be a frustrating experience for both you and your sexual partner and makes your sex lives less enjoyable. However, the good news is that it’s usually fixable!
Between 30% and 40% of men experience premature ejaculation at some point in their life. According to the American Urological Association, premature ejaculation is the most common type of sexual dysfunction in men. About one in five men between the ages of 18 and 59 report incidences of premature ejaculation.
Although the definition of premature ejaculation varies, the American Urological Association defines ejaculation as “premature” if it occurs sooner than desired, either before or shortly after penetration, causing distress to either one or both partners. The American Psychiatric Association defines three levels of severity (mild, moderate, severe), based on time to ejaculation, with mild being under one minute. If pressed for a time frame, many doctors would define prematurity as ejaculation within a minute of beginning intercourse. Despite professional opinions, your feelings as to what is premature are also considered.
Physical, chemical and emotional/psychological factors cause premature ejaculation.
Physical and chemical problems include:
Emotional or psychological causes include:
No. The only symptom of premature ejaculation is the condition itself.
If you have frequent premature ejaculations, or if premature ejaculation is causing you anxiety or depression and affecting your relationship, make an appointment to see a urologist.
Your urologist will begin an exam by asking about your sexual experiences. You will likely be asked:
While the questions are personal, it is important that you answer your urologist honestly so they can best diagnose the source of your problem.
Your urologist will also ask about any other medical conditions you may have and any medications including over-the-counter medications, supplements and herbal products you are taking. You will also be asked about any alcohol and illegal drug use.
Lab tests are usually not needed unless your healthcare provider suspects that an underlying health problem is contributing to the problem.
There are many different treatments options for premature ejaculation depending on the cause. These include behavioral therapy, counseling and medications. Most causes of premature ejaculation are usually treated first with behavior therapy and/or counseling to help with emotional concerns, performance anxiety or stressors that may be contributing. Often more than one treatment approach may be tried at the same time.
Behavioral therapy
Behavioral therapy involves trying different methods to delay your orgasm. Its goal is to teach you how to control your body and your feelings. Methods include:
Counseling
If the cause of your premature ejaculation is psychological, emotional, or due to relationship issues – due to performance anxiety, depression, stress, guilt, or a troubled relationship – seek the help of a psychologist, psychiatrist, couples therapist or sex therapist. Your urologist can help direct you to these health professionals.
Medications
Several types of medications may be tried.
Antidepressants, especially selective serotonin reuptake inhibitors like citalopram (Celexa®), escitalopram (Lexapro®), fluoxetine (Prozac®), paroxetine (Paxil®) and sertraline (Zoloft®) or the tricyclic antidepressant clomipramine (Anafranil®), can help delay premature ejaculation. This is an “off-label” use (not approved by the Food and Drug Administration for this use). Be sure to discuss the side effects of this medication with your urologist to be sure it’s appropriate for you.
Anesthetic (numbing) creams and sprays applied to the head and shaft of the penis is another medication option to delay ejaculation. The anesthetic cream or spray is applied to the penis, absorbed for 10 to 30 minutes or until you feel less sensitivity in your penis. It’s important to wash your penis before sex to prevent numbness to your partner’s vagina or loss of your erection.
Erectile dysfunction medications, which include sildenafil (Viagra®), tadalafil (Cialis®), vardenafil (Levitra®) and Avanafil (Stendra®), have also been used to treat premature ejaculation, particularly in men with underlying erectile dysfunction.
Lab tests are usually not needed unless your healthcare provider suspects that an underlying health problem is contributing to the problem.
Yes, you likely can! By following the techniques described in this article to delay ejaculation, taking any prescribed medications, and seeking counseling if needed, premature ejaculation can become a problem of your past.
There are several treatment methods that can help prevent premature ejaculation. By involving your partner and seeing the appropriate healthcare professionals – a urologist for initial assessment plus other health care professionals (psychologists, psychiatrists, counselors) as needed for underlying contributing problems, you will likely be able to control your ejaculation and enjoy your sex life once again.
Yes. Wearing a condom can decrease sensitivity to your penis and help delay ejaculation.
Premature ejaculation itself is not harmful but other health problems may contribute to the development of premature ejaculation. These health problems include:
If you have erectile dysfunction, you can’t attain or maintain your erection. If you have premature ejaculation, you have an erection but you reach orgasm and ejaculate earlier than you or your partner would have liked.
However, erectile dysfunction can actually lead to the development of premature ejaculation. This happens when a man knows his ability to sustain an erection is poor, so he develops the habit of ejaculating soon after erection before he loses his erection.
Because of this connection between these two conditions, your urology will want to figure out if you have erectile dysfunction and, if so, treat that first.
While it’s true that drinking alcohol can delay orgasm, it’s not a treatment for premature ejaculation.
A note from Cleveland Clinic
Your urologist and team of healthcare providers will come up with a plan to treat your premature ejaculation. Premature ejaculation is often easily treated with a few simple steps, so it is important to see your urologist or other doctors if you are experiencing premature ejaculation. Although it may be uncomfortable to talk with your doctors about sexual problems, know that they are professionals and want you and your partner to have a satisfying sex life. Remember, this is a common problem and you are not alone!
