Medically reviewed by Katelyn Hagerty, FNP
Written by Our Editorial Team
Last updated 5/4/2021
Depending on who you ask, premature ejaculation is either the worst, or the second worst sexual dysfunction you can have. Erectile dysfunction may ice things over before they get a chance to heat up, but an abrupt end to activity might cause just as many confidence and intimacy issues as if things never got started.
Premature ejaculation can make intimacy a source of concern or even worry, leading to anxiety and panic issues if it’s not addressed. But before you can treat a condition, you need to understand where it comes from.
You might have some ideas already about what causes your PE. Maybe you’ve always had low self esteem, or suffered from body issues. Maybe you’ve had bouts of depression or always worried about pleasing a partner. If you’ve felt any of these things in the past, you may have a start on your recovery journal. But just because you checked the “yes” box, doesn’t mean your PE issue is going to be wrapped up so easily.
Premature ejaculation isn’t a simple condition, and science hasn’t had much luck defining exactly what causes it, or exactly how to treat it.
Here’s what we know.
Premature ejaculation is one of the most common conditions affecting men alongside erectile dysfunction. As many as 39 percent of men suffer from some degree of it, according to estimates.
You might assume you’ll know if you have PE, but to be diagnosed, premature ejaculation suffers have to meet several requirements.
According to the World Health Organization, PE consists of “… persistent or recurrent ejaculation with minimal stimulation before, on or shortly after penetration and before the person wishes it, over which the sufferer has little or no voluntary control which causes the sufferer and / or his partner bother or distress…” If that sounds familiar, you’re probably suffering from premature ejaculation.
With a fairly direct set of diagnostic symptoms, it’s fair to say that diagnosing PE is the easy part. Figuring out how and why you have it—that’s more complicated.
There is no one central cause of premature ejaculation unfortunately. Many things have been linked or correlated, but science is still unsure of an exact mechanism or mechanisms behind the issue. Instead, there are several categories of risk factors the medical community tends to agree on, most of which fit either into the biological or psychological categories.
Biological issues associated with premature ejaculation, for instance, include inflammation of the prostate or urethra, abnormal levels of certain hormones, or abnormal serotonin levels. Serotonin levels are thought to shorten the time to ejaculation, according to some experts.
Psychological factors might also contribute to your or someone else’s particular premature ejaculation issues. They might include depression, anxiety, stress, unrealistic performance expectations or an overall lack of confidence.
Body image issues, relationship problems, guilt, a history of sexual abuse or a history of sexual repression might also contribute to ongoing issues with premature ejaculation (and other sexual conditions like ED, for that matter).
As you can see, the possible causes create a wide and complex net of possible factors some acquired, some lifelong, some chemical, some social. As such, the process of finding the root cause of your PE issue and treating it can be difficult.
There are several premature ejaculation treatment options available if you’re suffering from premature ejaculation. Unfortunately, none of these are ultimately cures for the condition—we’re likely years away from that.
What we do have though are some techniques for handling the problem, as well as some recommendations for handling it as a chronic condition.
One of the first things you might try emploring is the start-stop technique, which is what you think it is: stopping before you orgasm and starting again when the urge to orgasm goes away.
Pelvic floor exercises (yes, kegels for men), are an exercise for outside-the-bedroom time.The goal of this exercise is strengthening pelvic floor muscles.
The squeeze technique, meanwhile, is squeezing at the other end of the mechanics. Just before orgasm, you pull out and press down on the tip of your penis with thumb and index finger to decrease arousal levels (typically about 30 seconds). You do this for 30 seconds or so, and may have to repeat it several times before continuing.
There are other ways to address PE alongside exercises, including gels, creams, and other products designed to dull your sensitivity. You can read more about other treatments for PE in our guide.
A 2007 study also recommended prescribing antidepressant SSRIs (Selective Serotonin Reuptake Inhibitors), which 100 percent of men said improved the condition over a four week period.
If you’re suffering from PE, there are a lot of things you can do for yourself, and most of them start with speaking to a healthcare provider. Your next steps may be complicated, and you may try several solutions before finding one that works, so a good medical professional in your corner will be your best asset in hunting down the right one for you.
They’ll also take a look at other lifestyle factors that might contribute to your issues (diet, exercise, stress, anxiety) and potentially refer you to a specialist or therapist for further guidance.
Some of these things may sound scary, but remember that uncertainty can be scarier than facing your problems, especially when facing them will put so many more assets in your hands for solving the problem.
If you’re just learning about premature ejaculation, read our 101 guide to premature ejaculation for information on causes, statistics, and more.
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