Managing Premature Ejaculation: Causes, Strategies and Treatment Options
Premature ejaculation (PE) is when ejaculation happens sooner than you would like during sex and feels hard to control. Healthdirect describes it as the most common sexual problem affecting males.
This article is general information, not medical advice. It explains what premature ejaculation is, what can cause it, the techniques people use to manage it, and when it is worth talking to a practitioner. Results vary between individuals.
On this page
- What Is Premature Ejaculation?
- Types of Premature Ejaculation
- How Common Is Premature Ejaculation?
- Common Causes of Premature Ejaculation
- Premature Ejaculation and Erectile Dysfunction
- How to Control Premature Ejaculation: Techniques You Can Try
- Psychological Approaches
- Treatment Options From a Practitioner
- Does Premature Ejaculation Go Away?
- When to See a Practitioner
- Frequently Asked Questions
What Is Premature Ejaculation?
Premature ejaculation is when ejaculation (orgasm) happens too soon and may feel uncontrollable. There is no set time that ejaculation should take. Healthdirect notes that premature ejaculation is usually defined as ejaculating within one minute of penetration. Healthy Male describes it as regularly ejaculating sooner than you wish, or with minimal stimulation, in a way that is a problem for you and your partner.
Healthdirect lists these signs:
You are not able to delay ejaculation.
You ejaculate during foreplay, or while trying to insert the penis during sex.
You feel distress, frustration or embarrassment about ejaculating too soon.
Many males ejaculate prematurely at some point in their lives. If it happens sometimes, that is usually not a worry. If you regularly ejaculate earlier than you would like, it may be worth talking to a doctor.
Types of Premature Ejaculation
Premature ejaculation can be lifelong or acquired (Healthy Male):
Lifelong premature ejaculation is present from a person's first sexual experience.
Acquired premature ejaculation develops after a period of having a longer, satisfactory time to ejaculation.
It can also be generalised, meaning it happens in most situations regardless of partner, or situational, meaning it happens only with some types of stimulation or with a particular partner. Whether your premature ejaculation is lifelong or acquired, generalised or situational, matters, because it can influence how a practitioner approaches assessment and treatment.
How Common Is Premature Ejaculation?
Premature ejaculation is the most common sexual problem in the world. Healthy Male reports that it affects at least 1 in 3 to 1 in 5 men aged 18 to 59, and notes that the true figure might be higher because people are reluctant to talk about it. It can happen at any age, but it is more common in younger males, and ejaculation tends to take longer as you get older.
Common Causes of Premature Ejaculation
The exact cause of premature ejaculation is unknown. Healthy Male describes it as a complex interaction between psychological and biological factors, and the cause is not the same for everyone. The causes also tend to differ between lifelong and acquired premature ejaculation.
Psychological causes
Healthdirect notes that premature ejaculation that develops later in life is usually due to another problem. Common examples are:
Performance anxiety, meaning anxiety about being good at sex. This is often the cause of acquired premature ejaculation, and it can relate to shame around sex or worry about a specific situation, such as a new partner.
Generalised anxiety and stress.
Psychological or relationship problems. Depression and low self-esteem may also contribute.
Biological causes
Lifelong premature ejaculation may be linked to:
Genetic causes related to the molecules that signal between nerves.
A chemical imbalance in the brain that lowers the threshold for ejaculation.
Abnormal hormone levels or other health problems.
Erectile dysfunction
Erectile dysfunction (ED) is a recognised cause of acquired premature ejaculation. The next section covers this link in more detail.
Lifestyle factors
Alcohol and drug abuse can make premature ejaculation worse. Stress is also on the list above, so pressure at work or at home can play a part.
Premature Ejaculation and Erectile Dysfunction
The two conditions often overlap. Healthy Male reports that about 1 in 3 to 1 in 4 men with premature ejaculation also have erectile dysfunction. Acquired premature ejaculation may also be caused by erectile dysfunction and the anxiety that surrounds it.
The order of treatment matters here. Healthy Male notes that when premature ejaculation is related to erectile dysfunction, treating the erection problem might resolve the ejaculation problem as well. This is one reason a practitioner asks about erections during an assessment. If erections are part of the picture for you, our guides to the causes of erectile dysfunction and to erectile dysfunction symptoms, causes and treatments explain what is involved.
How to Control Premature Ejaculation: Techniques You Can Try
Several techniques help some people manage premature ejaculation. Suitability and results vary between individuals, and a practitioner can help you work out which approach fits your situation.
Behavioural methods
Two exercises can be practised alone or with a partner. They do not promise a lasting fix, but they may help in the short term.
The stop-start method. You or your partner stimulate the penis until you are about to orgasm, then stop until the urge to climax lessens. Once the urge has passed, you repeat the process three more times and allow yourself to ejaculate on the fourth.
The squeeze method. You or your partner stimulate the penis until you are close to ejaculating, then firmly squeeze the penis to decrease the erection. The squeeze method helps you become aware of the sensations in the lead-up to ejaculating, so you can slow down.
Sex therapists can also advise on techniques that help someone unlearn the habit of premature ejaculation.
Self-care at home
Healthdirect lists these things you can try at home:
masturbating an hour or two before you have sex
using a condom to help decrease sensation
taking a deep breath in, which may briefly delay the ejaculatory reflex
trying different positions that you may find less arousing
taking a break and thinking of something non-sexual
the "second try", because you may have delayed ejaculation if you have sex a second time after the first ejaculation.
Pelvic floor exercises
Pelvic floor exercises, sometimes called Kegel exercises, may improve ejaculation control by strengthening the muscles of the pelvic floor, according to healthdirect. Healthy Male points to a link between weak pelvic floor muscles and premature ejaculation, and says the exercises can help give you better control.
To find the right muscles, sit or lie down with your thighs, buttocks and stomach relaxed, then squeeze the muscles around your anus as if you are trying to stop passing wind. Contract, hold and relax, and over time try to hold the contraction harder and for longer. You can do them anywhere, in any position, and aim for every day. Healthy Male notes that the evidence for pelvic floor exercises, condoms and masturbation before sex is limited, so results vary.
Lifestyle adjustments
Because alcohol and drug use can make premature ejaculation worse, cutting back is a reasonable place to start. Managing stress and anxiety also matters, since both sit on the list of causes.
Psychological Approaches
It may help to see a psychologist or sex therapist. Counselling can help you look for underlying issues, which may be psychological, sexual or related to relationships, and it can also help with anxiety. If you are in a long-term relationship, you may benefit from couples therapy. A couples counsellor can listen to both parties objectively and offer exercises that help build trust and improve communication.
Healthy Male also points out that the relationship between premature ejaculation and mental health goes both ways. Depression, low self-esteem and anxiety may cause it, and it can in turn be a source of embarrassment, low mood and anxiety. That is one reason to raise it rather than wait.
Treatment Options From a Practitioner
Treatment for premature ejaculation depends on the cause. A registered practitioner decides whether treatment is suitable after assessing your history, your symptoms and whether erectile dysfunction is also present. The practitioner explains the treatment options that apply to your situation during the assessment. Treatment is sometimes a combination of approaches, and lifelong and acquired premature ejaculation may be treated differently. Outcomes vary between individuals.
Does Premature Ejaculation Go Away?
It depends on the type. Healthy Male explains that lifelong premature ejaculation does not go away on its own, but it can be managed with ongoing treatment. Acquired premature ejaculation may resolve when the underlying issue, such as anxiety or erectile dysfunction, is treated. Results vary between individuals, and a practitioner can help you find an approach that suits you.
Premature ejaculation does not directly affect sperm quality or fertility. It can make it harder for a partner to fall pregnant if ejaculation happens before penetration. Left unaddressed, it might also increase stress, anxiety, depression, low self-esteem and relationship issues.
When to See a Practitioner
You should talk to a doctor if premature ejaculation is affecting you. They can help work out the cause and offer you treatment options. Ejaculation problems are common, and there is nothing to be embarrassed about.
In a consultation, the practitioner will ask questions about you and your sexual history. There is no specific test to diagnose premature ejaculation, but they may order some tests to help work out the cause. Your practitioner may also use a questionnaire, such as the Premature Ejaculation Diagnostic Tool, to understand how it is affecting you. It may help to involve your partner in the conversation, because the issue may affect their sexual satisfaction and there may be things they can do to help.
Healthy Male suggests questions worth asking:
What do you think could be the cause of my premature ejaculation?
Can we include my partner in discussions about causes and treatment?
Which treatment do you think would suit me?
How long after starting treatment might I notice a change?
Burst Health connects you with an Australian-registered doctor or nurse practitioner who reviews your answers and decides whether treatment is suitable for you. You can check whether you are eligible through a discreet online assessment.
When behavioural methods alone have not been enough, Burst Health provides premature ejaculation treatment online after review by an Australian-registered doctor or nurse practitioner, and you can check whether you are eligible.
Frequently Asked Questions
What is the definition of ejaculation?
Ejaculation is the release of semen from the penis at orgasm. Premature ejaculation is when this happens sooner than you would like and feels hard to control. Healthdirect notes it is usually defined as ejaculating within one minute of penetration, although there is no set time that ejaculation should take.
What are the treatment options for premature ejaculation?
Treatment depends on the cause. Options include behavioural techniques such as the stop-start and squeeze methods, self-care steps at home, pelvic floor exercises, counselling or sex therapy, and treatment options a registered practitioner may consider after assessment. Suitability and results vary between individuals, so an assessment is the starting point.
What treatments can help me last longer in bed?
No single approach works for everyone. Self-care steps include masturbating an hour or two before sex, using a condom to decrease sensation, and trying less arousing positions. Behavioural methods, pelvic floor exercises and treatment options from a practitioner may also help some people. Results vary between individuals.
What are some natural remedies for premature ejaculation?
There is no remedy with strong evidence behind it. Healthy Male notes that masturbation before sex, condoms, pelvic floor exercises and acupuncture might help some people, but there is not a lot of evidence to support their use. Simple self-care steps, such as a condom or a less arousing position, cost nothing to try. A practitioner can advise you before you rely on any product.
What are the treatment options for erectile dysfunction?
Treatment depends on the cause, and a practitioner first treats any underlying condition. Options include lifestyle changes, counselling or sex therapy, and treatment options a practitioner may consider after assessment. Because premature ejaculation and erectile dysfunction often overlap, you can also read about erectile dysfunction treatment at Burst Health.
Premature ejaculation treatment, online
In three steps.
- 1Answer a quick questionnaireOnline, no appointment, no in-person visit.
- 2A practitioner reviews itAn Australian-registered doctor or nurse practitioner decides whether treatment is suitable for you.
- 3Start your planIf treatment is suitable, you start your plan with the practitioner supporting you throughout.
References
This article is general information only and does not replace medical advice. Speak with a registered Australian healthcare practitioner about your own situation.