Premature ejaculation (PE) is the inability to delay ejaculation. Self-reporting surveys indicate that anywhere from 20 to 30 percent of men experience premature ejaculation, according to a study published in Sexual Medicine; however, the researchers indicate that this is likely a high number, as some men might “have concerns” about their sexual function without meeting a clinical definition of the condition.
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (2013), indicates that PE indicates the man consistently ejaculates within one minute of vaginal penetration and that this:
- Has persisted for at least six months
- Results in emotional distress, sexual frustration and dissatisfaction of sexual partners
The researchers believe that no more than four percent of men meet this definition. However, many men who experience PE, whether ejaculating within one minute or quick enough to interfere with their sexual satisfaction, have higher levels of personal distress and experience more problems in relationships.
Causes of premature ejaculation
Historically, PE was thought to be caused by psychological factors. Nervousness, fear of rejection or intimacy, performance anxiety, external stressors, or eagerness can all contribute to PE. There are also some physical conditions that can cause PE. According to the Cleveland Clinic, injury, infection, and hormonal problems are sometimes to blame. A study published in The Journal of Sexual Medicine found that men with PE had an increased level of a certain protein in their seminal plasma, which can cause neuronal dysfunction. Another study found that regular exercise helped to alleviate symptoms of PE.
Based on the many unknowns that come with diagnosing PE, the best course of action is to talk to your doctor if you are consistently experiencing problems. If it is believed to be caused by nervousness or lack of sexual experience, then education, patience, and practice usually help. A psychologist, psychiatrist, or sexual therapist might also be helpful.
- Increasing the time before ejaculation is sometimes a matter of understanding your own body and the sensations during sex. Pay attention to how you feel when you reach “the point of no return.” Once you do that, you might be able to control the timing of your ejaculation by stopping for 30 seconds and then starting again. You might also be able to squeeze the end of your penis for a few seconds to stop the feeling and then begin again. As you are learning to control your ejaculation, you might need to do this repeatedly until you are ready to orgasm. You can try this alone or ask your partner to work with you.
- Use Kegel exercises to help build up muscles in your pelvic floor. A study published in Therapeutic Advances in Urology found that performing Kegel exercises was a “viable, therapeutic option for the treatment of premature ejaculation.”
- Use condoms to reduce sensitivity during intercourse. Thick condoms will work better.
- Use a lubricant to help reduce friction. This might help you last longer.
- Try different positions to see if you can reduce or increase sensitivity and friction.
- Use a numbing on anesthetic cream to reduce stimulation and sensitivity.
Experiment with your partner to find out what works. You might find that extended foreplay helps you relax, or it might do the opposite and get you so stimulated that you ejaculate immediately after penetration. You might find that having a no-penetration night helps you to better understand your body without the added pressure. Work together with your partner to find out what is best for you.
If, despite trying different at-home methods, you are still experiencing PE, talk to your doctor. There are some medical interventions that could help.
SSRI medications: Serotonin reuptake inhibitors are antidepressant medications that often have a side effect of increasing the time to reach ejaculation. While you might not need the medication for depression, you might benefit from the side effect.
Erectile dysfunction medications might help.
- Alternative medicine: A review of 10 studies on alternative medicine found that acupuncture, Chinese herbal medicine, and Ayurvedic herbal medicine show some success in improving PE symptoms. The researchers indicated these methods worked better than placebos in the studies; however, they believe that further studies are needed before reaching any conclusions.
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Eileen Bailey is a freelance health writer. She is the author of What Went Right: Reframe Your Thinking for a Happier Now, Idiot's Guide to Adult ADHD, Idiot's Guide to Cognitive Behavioral Therapy, Essential Guide to Overcoming Obsessive Love, and Essential Guide to Asperger's Syndrome. She can be found on Twitter @eileenmbailey and on Facebook at eileenmbailey.