Book Now

Premature Ejaculation

Picture of Dr Afraz Adam

Dr Afraz Adam

Chief Medical Officer
MBBS. FRNZCUC

Premature ejaculation is when a man ejaculates sooner than he or his partner would like, often leading to stress or frustration. It’s one of the most common sexual concerns for men.

Overview
Symptons
Causes
Risk Factors
Diagnosis
Treatment
Prevention

Overview

Understanding Premature Ejaculation

Premature Ejaculation (PE) is one of the most common sexual concerns for men, affecting up to 1 in 3 at some point in their lives. It happens when ejaculation occurs sooner than you or your partner would like, often with little or no control.

Doctors generally describe PE in two main types:

• Lifelong PE: When ejaculation has always happened too quickly, right from your earliest sexual experiences.

• Acquired PE: When PE develops later in life after a period of normal sexual control.

PE is sometimes called “early ejaculation” or “rapid ejaculation.” While it isn’t physically harmful, it can affect confidence, intimacy, and overall wellbeing. It can also lead to frustration, stress, and relationship difficulties if left untreated.
The good news is that PE is highly manageable. With the right strategies and support, most men can improve control and enjoy a more satisfying sex life.

Symptoms

Symptoms of Premature Ejaculation

PE is less about a strict “time limit” and more about control and satisfaction. The key symptom is ejaculating sooner than desired, usually within a couple of minutes of penetration — and sometimes even before penetration begins.

You may notice:

  • Ejaculation almost immediately after penetration (or before)

  • Feeling unable to delay ejaculation even when you want to

  • Distress, frustration, or loss of confidence linked to your lack of control

  • Avoiding sex due to embarrassment or worry

  • Relationship strain or reduced sexual satisfaction for you or your partner

It’s important to remember occasional quick ejaculation is normal and not the same as PE. To be considered PE, symptoms should occur most of the time and cause ongoing stress or difficulty.

Causes

Causes of Premature Ejaculation

The exact cause isn’t fully understood, but experts agree that both physical and psychological factors can play a role.

Physical & Biological Causes

  • Hormonal changes: Abnormal levels of testosterone, thyroid hormones, or other hormones may shorten ejaculation time.

  • Brain chemistry: Low serotonin levels are linked to quicker ejaculation.

  • Prostate or urethral inflammation: Infections or irritation in this area can affect ejaculatory control.

  • Increased penile sensitivity: Some men naturally have a more sensitive response, which may contribute.

Psychological Causes

  • Performance anxiety: Worrying about lasting long enough can create a cycle of stress and rapid ejaculation.

  • Stress and mental health issues: Everyday stress, depression, or anxiety can make PE more likely.

  • Past experiences: Conditioning from rushed sexual encounters or early sexual trauma can influence current patterns.

  • Confidence and self-image: Low confidence or body image issues can also contribute.

Risk factors

Risk Factors for Premature Ejaculation

Some things may increase the likelihood of PE:

  • Stress, anxiety, or depression

  • Relationship problems or lack of intimacy

  • Erectile Dysfunction (ED) — rushing to climax before losing an erection

  • Prostate inflammation or urological issues

  • Hormonal imbalances

  • Poor sleep or fatigue

Diagnosis

Diagnosis of Premature Ejaculation

There’s no specific test for PE – diagnosis is usually based on your symptoms and experience. Your healthcare provider may:

  • Ask about your sexual history, including how long PE has been an issue

  • Explore whether it is lifelong or acquired later in life

  • Review medical history, stress levels, and relationship factors

  • Check for physical contributors such as hormonal or thyroid problems

  • Rule out other conditions like ED that may be linked


Being open and honest helps your provider give you the right advice and treatment.

Treatment

Treatment for Premature Ejaculation

PE can be successfully treated with a range of approaches. Often, the best results come from a combination of treatments.

Medications

  • SSRIs (antidepressants): Low-dose SSRIs like sertraline, paroxetine, or fluoxetine can delay ejaculation by affecting serotonin.

  • PDE-5 inhibitors: Drugs like Viagra (sildenafil) or Cialis (tadalafil), commonly used for ED, may also help some men with PE.

  • Topical creams or sprays: Local anaesthetics (like lidocaine or benzocaine) reduce penile sensitivity and can increase control.

Behavioural Techniques

  • Stop-start method: Pausing stimulation before climax, then starting again once the urge passes.

  • Squeeze technique: Gently squeezing the base of the penis to reduce arousal and delay ejaculation.

  • Pelvic floor training: Exercises (such as Kegels) can strengthen control of the muscles involved in ejaculation.

Lifestyle Changes

  • Regular exercise

  • Better sleep

  • Stress management

  • Limiting alcohol and avoiding recreational drugs

Therapy & Counselling

Working with a sex therapist or counsellor can address performance anxiety, stress, or relationship issues that contribute to PE.

Prevention

Preventing Premature Ejaculation

Not all cases can be prevented, but healthy habits can reduce risk and improve control:

  • Exercise regularly to boost blood flow and sexual stamina

  • Look after your mental health, addressing stress, anxiety, or depression early

  • Communicate openly with your partner to reduce pressure and increase intimacy

  • Try masturbating a few hours before sex to reduce arousal during intercourse

  • Use condoms designed with desensitising agents to help prolong sex

  • Focus on foreplay and intimacy, not just penetration