Premature ejaculation is ejaculation that occurs too early, usually before, upon, or shortly after penetration.
The cause is most likely to be anxiety, other psychological factors, or very sensitive penile skin.
Behavior modification therapy, including strategies to delay ejaculation, helps most men.
(See also Overview of Sexual Function and Dysfunction in Men.)
Premature ejaculation often causes distress to couples.
Many experts believe that premature ejaculation almost always results from anxiety or other psychological causes. Others think that oversensitive penile skin may be a cause. Having intercourse less frequently than desired may worsen the problem by making the man even more sensitive. Premature ejaculation is rarely caused by a disease, although inflammation of the prostate gland, overactivity of the thyroid gland, or a nervous system disorder can cause the condition.
Treatment of Premature Ejaculation
Behavior modification therapy
Behavior modification therapy can help most men overcome premature ejaculation. A therapist provides reassurance, explains why premature ejaculation occurs, and teaches the man strategies for delaying ejaculation.
Learning to delay ejaculation
Two techniques are commonly used to treat premature ejaculation. They also help reduce the anxiety that often aggravates the problem. Each technique trains the man to experience high levels of excitement without ejaculating. Both involve self-stimulation of the penis (while masturbating) or stimulation by a partner until the man feels that he will soon ejaculate. When done with a partner, stimulation is at first by hand and later before or during intercourse.
In the stop-and-start technique, stimulation is stopped. With the squeeze technique, the man or his partner squeezes for 10 to 20 seconds the part of the penis where the head (glans) meets the shaft, preventing ejaculation and decreasing the strength of the erection. In both techniques, stimulation can resume after about 30 seconds. With practice, more than 95% of men learn to delay ejaculation for 5 to 10 minutes or even longer.
When delayed ejaculation is the problem
Delayed ejaculation (sometimes called impaired ejaculation) is another abnormality in the timing of ejaculation. A man with this condition needs prolonged stimulation in order to achieve ejaculation. Some men may need 30 minutes or more of stimulation. Others may abandon the pursuit of ejaculation due to fatigue, frustration, irritation of the penile skin, or pain. Still others experience an inability to ejaculate at all. In many cases, delayed ejaculation is related to psychological factors. However, factors such as erectile dysfunction and certain medications (eg, serotonin reuptake inhibitors) can contribute to this as well.
