30 Jan 2020

Causes, Treatment & Tips of Premature Ejaculation



As a couples and sex therapist in private practice, I am often astonished at how many men and couples come to see me trying to fix premature ejaculation. Many men suffer with shame and embarrassment about feeling that they ejaculate too quickly, leading them to have anxiety about sex and their performance.


What is premature ejaculation?


Premature ejaculation is the most common ejaculation-related health condition. Premature ejaculation is when a person ejaculates or ‘comes’ too quickly during sex. There are a few ways to try and improve premature ejaculation, including medical treatments, techniques, and lifestyle changes.


Premature ejaculation is a condition where a person ejaculates (comes) too quickly during sex. Premature ejaculation can affect up to 30% of men, and is split into 2 different kinds, lifelong (primary) or acquired (secondary):


* Lifelong/primary – where the problem has existed since the first time a person has had sex.

* Acquired/secondary – where premature ejaculation is intermittent or starts later in life


International guidelines on premature ejaculation define it as when a man ejaculates within one minute of entering their partner. But, the average ejaculation time is around 5 ½ minutes. So, if you ejaculate much faster than this, you could think about ways to improve it if it’s a problem for you


What counts as having premature ejaculation?

Ejaculation can be called ‘premature’ if it happens less than 2 minutes into having penetrative sex. But, the official times for what’s classed as ‘premature’ ejaculation can change between different countries, cultures, and healthcare experts. Still, most experts agree that if sex lasts less than 2 minutes, and ejaculation occurs, then it can be called a premature ejaculation.


Whether or not you decide to look for medical treatment for premature ejaculation is a personal choice. If your ejaculation time is causing you or your partner distress, you could look into treatment or techniques to improve it.


How common is it?

Premature ejaculation is the most common ejaculation problem and can affect up to 30% of men at some point during their lifetime.


There are several ‘risk factors’ which make getting premature ejaculation more likely. Men who are most at risk of developing premature ejaculation might:


* Be under a lot of stress

* Have erectile dysfunction

* Have depression

* Be overweight

* Drink too much alcohol

* Smoke


There are treatments available for premature ejaculation specifically. But, if it’s caused by another underlying health condition, you may need other medical treatments as well.


What causes different types of premature ejaculation?

There are two types of premature ejaculation, primary and secondary.

1) Lifelong (primary) premature ejaculation

Primary premature ejaculation will happen the very first time a person have sex, and will happen every time afterwards. Psychological factors are often common causes of lifelong premature ejaculation. This is compared to men who have secondary premature ejaculation, where the causes can sometimes be physical.


Causes of primary premature ejaculation include:


* Psychological issues: some men who have experienced childhood trauma related to sex can cause them to become overly anxious about sex

* Culture: an individual’s culture can cause lifelong premature ejaculation, particularly if sex is taught to be inappropriate or shameful

* Conditioning: some men become conditioned when ejaculating, which can cause lifelong premature ejaculation. For example, some men condition themselves to ejaculate quickly during adolescence to avoid being caught, which leads to ejaculating too quickly with a partner


2) Acquired (secondary) premature ejaculation


Secondary premature ejaculation is often caused by stress, anxiety, and/or depression. Psychological factors like these are all strongly linked with sexual dysfunctions, including premature ejaculation. Research has shown that in men who ejaculate prematurely, there is a strong link with depression. Other factors include relationship issues, personal conflicts, and performance-related anxiety.


There are also physical causes of secondary premature ejaculation, including:

* Thyroid problems

* High blood pressure

* Prostate disease

* Binge drinking

* Conditions like multiple sclerosis or nerve damage


Relationship issues are also seen as a common cause of premature ejaculation. Relationship causes of premature ejaculation can be a ‘vicious circle’, particularly if the partner is not supportive. This can lead to an even higher level of anxiety and fear of failure. If relationship problems are a cause of premature ejaculation, it may be due to:

* Different sexual needs

* Anxiety around sexual satisfaction

* Lack of communication

* Fear of sex


How Is It Treated?

Ninety-five percent of men are helped by behavioral techniques that help control ejaculation.


Stop and start: 

You or your partner stimulate your penis until your feel like you’re going to have an orgasm. Stop the arousal for about 30 seconds or until the feeling passes. Start the stimulation again and repeat three or four more times before you actually ejaculate.


The Squeeze

It works the same way as the start and stop method. But, when you feel like you’re reaching orgasm, you or your partner squeezes the head of your penis until you lose the erection. Repeat this a few times before ejaculating.


Some men find that if they think of something else during sex they can last longer.



Strengthen your muscles: Weak pelvic floor muscles sometimes contribute to PE. Kegel exercises may help strengthen them. Find the right muscles to tighten by stopping your urine in midstream. Hold them tight for 3 seconds and then release them for 3 seconds. Do this 10 times, at least 3 times a day.


Wear a condom: It may desensitize you enough so you can last longer.



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