Lifelong Premature Ejaculation: Symptoms & Treatment

Kristin Hall, FNP

Medically reviewed by Kristin Hall, FNP

Written by Our Editorial Team

Last updated 4/21/2022

Premature ejaculation, or PE, is a common form of sexual dysfunction that affects approximately 30 percent of men worldwide.

If you’re affected by PE, you might find it difficult not to reach orgasm and ejaculate early during penetrative sex or other sexual activity. This may affect your sexual self-confidence, your quality of life and, in some cases, your connection with your partner. 

Some men develop PE at a certain point in life, while for others, it’s a lifelong issue that occurs from the beginning of sexual activity. 

While lifelong premature ejaculation can be frustrating, the good news is that it’s almost always treatable. 

Below, we’ve explained what lifelong premature ejaculation is, as well as the specific symptoms you may notice if you’re affected by this form of PE. We’ve also explained how you treat PE and enjoy better sexual stamina, more satisfying sex and a higher quality of life. 

What Is Lifelong Premature Ejaculation?

Premature ejaculation is a form of sexual dysfunction that involves ejaculating earlier than you or your partner would like during sexual activity. It can happen during penetrative sex, oral sex or other forms of sexual contact.

Like erectile dysfunction (ED) and other male sexual issues, PE is common. In fact, it’s thought of as the most common sexual disorder that affects men.

Precise definitions of premature ejaculation can vary. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), PE is defined as ejaculation that occurs within one minute following vaginal penetration, before the individual wishes, during all or almost all sexual activity.

To qualify as PE, this issue needs to persist for at least six months, cause distress and not have a clear nonsexual explanation, such as a mental disorder, medical condition or medication that’s associated with changes in sexual function.

Premature ejaculation can vary in severity. In some cases, it’s relatively mild and allows at least some time for sexual contact. In others, it can be so severe that the affected person may reach orgasm and ejaculate before any sexual activity takes place.

Like other forms of sexual dysfunction, PE can vary in duration. Premature ejaculation is viewed as “lifelong” when it’s affected someone since their first sexual experience.

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Lifelong Premature Ejaculation Symptoms

The most significant symptom of lifelong premature ejaculation is a shorter average ejaculation time than you and/or your partner would like. This may cause other symptoms, including some that could affect your mental health and the well-being of your sexual relationship.

If you have premature ejaculation, you may experience the following symptoms:

  • Short time to ejaculation. The most common and significant symptom of PE is a short intravaginal ejaculatory latency time, or IELT. This refers to the total amount of time that passes following penetration before ejaculation.
    If you almost always reach orgasm and ejaculate within one minute of penetration, you may be affected by PE.

  • Little or no control over ejaculation. If you have PE, you might feel like you have no voluntary control of ejaculation. You may feel like it’s difficult or impossible to prevent yourself from ejaculating for long enough to satisfy your partner.

  • Less pleasurable sex. Premature ejaculation can potentially make sex less pleasurable for you and your partner, both by preventing you from enjoying the sensation of sex and by making it harder to relax during sexual contact.

  • Psychological distress. Because of its effects on sexual intimacy and pleasure, PE can have a psychological impact. This may affect you and/or your partner and cause issues such as sexual frustration, reduced sexual satisfaction and performance anxiety.

Premature ejaculation can be generalized or situational. For example, some men may ejaculate prematurely in all sexual situations, or with all sexual partners. Others may have situational PE that’s limited to certain situations, partners or types of sexual stimulation.

For some men, premature ejaculation is an acquired problem that begins to develop at a certain period in life. This is referred to as “acquired PE.” Lifelong PE differs in that it occurs right from the start of a person’s sexual life, without a sudden cause or onset.

What Causes Lifelong PE?

Experts aren’t aware of precisely what causes premature ejaculation to develop. However, most research suggests that a combination of biological and psychological risk factors could all play a role in PE. These include:

  • Abnormal hormone levels, including changes in levels of prolactin, luteinizing hormone and thyroid-stimulating hormone.

  • Low levels of serotonin, a neurotransmitter that’s involved in regulating moods, feelings and possibly delaying ejaculation.

  • Infections and/or inflammation that affect the prostate or urethra.

  • Mental health issues, such as depression, anxiety, feelings of guilt or unrealistic beliefs about sexual performance and function.

  • Low self-confidence, a poor body image and/or a personal history of sexual repression or abuse.

  • Problems in your current relationship that affect intimacy, sexual desire or your feelings for each other.

Our guide to the causes of premature ejaculation goes into more detail about common PE risk factors and how they might affect your sexual function.

Lifelong Premature Ejaculation Treatments

A variety of treatments are available for premature ejaculation, including lifelong PE. Treatments for premature ejaculation include over-the-counter products for delaying ejaculation, prescription medications, behavioral techniques and even psychological treatments such as therapy.

Over-the-Counter Sprays and Creams

One effective way to treat premature ejaculation is through the use of topical products that lower the sensitivity level of your penis, helping you to last longer without missing out on the sensation of sex. 

Most topical products for PE contain anesthetic ingredients that reduce sensitivity without overly numbing your penis. For example, our Delay Spray for Men is formulated using lidocaine, while our Clockstopper Climax Delay Wipes use benzocaine for fast-acting relief from PE. 

Research shows that when applied shortly before sex, these ingredients can help to slow down ejaculation and increase sexual stamina. 

For example, a study published in the International Journal of Impotence Research found that a spray containing lidocaine significantly improved intravaginal ejaculation latency time (time after penetration before ejaculation) in men with lifelong PE.

Similar research has found that benzocaine wipes produce a significant increase in ejaculatory latency time for men with PE.

Our guide to how lidocaine spray works for premature ejaculation goes into greater detail about using topical products to treat PE.

Prescription Medication for PE

Currently, there’s no FDA-approved prescription medication specifically for treating premature ejaculation. However, several common antidepressants are prescribed off-label as treatments for PE, including sertraline (the active ingredient in (Zoloft®).

Sertraline belongs to a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs). It works by increasing serotonin levels, which can reduce the severity of depression symptoms.

In addition to potentially causing depression, low levels of serotonin are associated with rapid ejaculation. Experts think that the increase in serotonin levels from sertraline inhibits orgasm and ejaculation, treating PE and improving sexual stamina.

Research largely backs this up. For example, one systematic review and meta-analysis from 2019 found that sertraline helps to prolong intravaginal ejaculation latency time and improve sexual satisfaction for their partners.

Other research suggests that some treatments for erectile dysfunction, such as sildenafil (the active ingredient in Viagra®), may also help to delay ejaculation and improve performance.

For example, severalstudies have found that sildenafil appears to increase time to ejaculation, improve sexual satisfaction and increase self-confidence and frequency of sex in men affected by premature ejaculation.

We offer sildenafil for PE online as part of our range of evidence-based premature ejaculation treatments

Behavioral Techniques

Sometimes, premature ejaculation gets better with simple behavioral techniques that you can use during sex to delay orgasm and ejaculation. These include the stop-start method and the squeeze technique

The stop-start method involves stopping sexual activity before you feel you’re about to reach orgasm and ejaculate, waiting for the level of sexual arousal to decrease, then starting again once you feel more comfortable.

The squeeze technique involves either you or your partner squeezing your penis at the point where the glans (the head of your penis) meets the shaft. Like the stop-start method, this is something that you can do as you feel you’re approaching orgasm and ejaculation. 

These methods are repeatable during sex, meaning they can be used several times to delay orgasm and improve your sexual stamina.

Other behavioral approaches to treating PE include sensate focus, pelvic floor exercises and the use of stimulation devices.

Research is mixed on the effects of behavioral techniques for PE. A 2015 systematic review found that some studies of these techniques show large improvements in ejaculation latency, while others show little or no changes.

In other words, your mileage may vary. However, since these techniques are easy to do and cost nothing, they might be worth giving a try, either on their own or in combination with other medical treatments for PE.

Psychotherapy

When premature ejaculation is caused by a psychological issue such as depression or anxiety, psychotherapy can often help.

Also referred to as talk therapy, psychotherapyinvolves talking with a mental health provider to identify and change problematic emotions, thoughts and patterns of behavior. As a treatment for PE, this may involve changing negative thoughts and behaviors related to sex. 

Research largely suggests that a combination of pharmacotherapy (treatment with medication) and behavioral treatment is the most effective option for treating PE. Your provider might give you medication to use in combination with therapy and other techniques. 

We offer online talk therapy with licensed counselors as part of our full range of mental health services

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Learn More About Dealing With Premature Ejaculation

Premature ejaculation can take a major toll on your sex life, especially if it’s something you’ve struggled with for as long as you’ve been sexually active. 

The good news is that premature ejaculation, whether lifelong or acquired, is almost always a treatable issue. With the right combination of behavioral techniques, medication and therapy, you can delay ejaculation and enjoy longer-lasting, more pleasurable sex.

If you’re one of the tens of millions of men affected by PE, you can access help with our range of premature ejaculation treatments, including over-the-counter products and prescription PE medications available following a consultation with a licensed healthcare provider. 

You can also learn more about dealing with PE and improving your sexual performance in our guide to lasting longer in bed.

9 Sources

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.

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  2. Crowdis, M. & Nazir, S. (2021, July 1). Premature Ejaculation. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK546701/
  3. El-Hamd, M.A. (2021). Effectiveness and tolerability of lidocaine 5% spray in the treatment of lifelong premature ejaculation patients: a randomized single-blind placebo-controlled clinical trial. International Journal of Impotence Research. 33, 96-101. Retrieved from https://www.nature.com/articles/s41443-019-0225-9
  4. Shabsigh, R., et al. (2019, July). Randomized, Placebo-Controlled Study to Evaluate the Efficacy, Safety and Tolerability of Benzocaine Wipes in Subjects With Premature Ejaculation. Journal of Men’s Health. 15 (3), 80-88. Retrieved from https://jomh.org/articles/10.22374/jomh.v15i3.156
  5. Yi, Z.-M., Chen, S.-D., Tang, Q.-Y., Tang, H.-L. & Zhai, S.-D. (2019, June). Efficacy and safety of sertraline for the treatment of premature ejaculation. Medicine (Baltimore). 98 (23), e15989. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6571276/
  6. Wang, W.-F., Wang, Y., Minhas, S. & Ralph, D.J. (2007, April). Can sildenafil treat primary premature ejaculation? A prospective clinical study. International Journal of Urology: Official Journal of the Japanese Urological Association. 14 (4), 331-335. Retrieved from https://pubmed.ncbi.nlm.nih.gov/17470165/
  7. McMahon, C.G., et al. (2005, May). Efficacy of sildenafil citrate (Viagra) in men with premature ejaculation. The Journal of Sexual Medicine. 2 (3), 368-375. Retrieved from https://pubmed.ncbi.nlm.nih.gov/16422868/
  8. Cooper, K., et al. (2015, September). Behavioral Therapies for Management of Premature Ejaculation: A Systematic Review. Sexual Medicine. 3 (3), 174-188. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4599555/
  9. Psychotherapies. (2021, June). Retrieved from https://www.nimh.nih.gov/health/topics/psychotherapies

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.