Premature Ejaculation


Ejaculation is the expulsion of semen from the male private part.

Premature ejaculation (PE) on the other hand occurs when ejaculation happens sooner than a man or his partner would like during sex.

Premature ejaculation has also been called called early ejaculation, rapid ejaculation, rapid climax, premature climax and ejaculatio praecox.

A consensus of experts at the International Society for Sexual Medicine endorsed a definition of premature ejaculation as ejaculation occurring around one minute after penetration.

The International Society for Sexual Medicine (ISSM) states that “Premature ejaculation is a male sexual dysfunction characterized by ejaculation which always or nearly always occurs prior to or within about one minute of vaginal penetration; and, inability to delay ejaculation on all or nearly all vaginal penetrations; and, negative personal consequences, such as distress, bother, frustration, and/or the avoidance of sexual intimacy.”

Normally men’s typical ejaculatory latency is approximately 4–8 minutes.

Premature ejaculation causes psychological stress to a male, emotional and relationship distress, can be a cause for worry, and can be frustrating when it makes sex less enjoyable and impacts relationships.

The problem is often thought to be psychological, but biology may also play a role.

Premature Ejaculation and Erectile Dysfunction (ED)

Both Premature Ejaculation (PE) and Erectile Dysfunction (ED) may co-exist. This is when men are not able to get or keep an erection that is firm enough for sex. Since an erection subsides after ejaculation, it can be difficult to know if the primary problem is PE or ED. ED should be treated first. Premature ejaculation may not be a problem once the ED is treated.



Low serotonin levels may play a role in premature ejaculation. Serotonin is a natural substance in the body produced by nerves. High amounts of serotonin in the brain increase the time to ejaculation. Low amounts can shorten the time to ejaculation, and lead to premature ejaculation.

Hence the drug treatment used in premature ejaculation are Selective Serotonin Reuptake Inhibitors (SSRI) and they act by increasing serotonin levels in the brain

Psychological Issues

Psychological, or mental health, issues can be involved in premature ejaculation and may include:

  • depression

  • stress

  • guilt

  • unrealistic expectations about sexual performance

  • history of sexual repression

  • lack of confidence

  • relationship problems

Premature ejaculation and age

Premature ejaculation can happen at any age.

Premature ejaculation may usually be seen when a male just gets engaged or recently married as a result of unrealistic expectations about sexual performance, or 1-2 years after marriage when he undergoes stress exerted to him by family members for producing a child in the family.

Premature ejaculation and the spouse

Talking about the problem is an important step. Couples counseling or sex therapy can be helpful. Exercises, such as the squeeze technique, may be helpful for you and your partner to prolong an erection. Most importantly, a couple should learn ways to relax. Worry (such as performance anxiety) can make premature ejaculation worse.


Psychological therapy, behavioral therapy and drugs are the main treatments for premature ejaculation. More than one type of treatment may be used at the same time.

Psychological Therapy

Psychological therapy is a way to work through the feelings and emotions that may lead to problems with sexual relationships. The goal of this type of therapy is to learn the source of problems and find solutions that may help premature ejaculation. It can also help couples learn to grow closer. Psychological therapy can help you become less nervous about sexual performance. It can also give you greater sexual confidence and understanding to help your partner’s satisfaction.

Behavioral Therapy

Behavioral therapy uses exercises to help build tolerance to delay ejaculation. The goal is to help you train your body away from premature ejaculation. Some choices are the squeeze method and the stop-start method. Exercises work well, but they may not be a lasting answer.

  • The Squeeze Method

    With this method, you or your partner stimulates your penis until you are close to ejaculation. When you are close, you or your partner firmly squeezes your penis so your erection partly goes away. The goal is for you to become aware of the sensations leading to climax. The squeeze method may help you better control and delay climax on your own.

  • The Stop-Start Method

    In this method, you or your partner stimulates your penis until just before ejaculation. When you are about to climax, you or your partner stops until the urge to climax lets up. As you regain control, you and your partner start stimulating your penis again. This process is repeated 3 times. You ejaculate on the fourth time. You repeat this method 3 times a week until you have gained more control.

Medical Therapy

Selective Serotonin Reuptake Inhibitors (SSRI) are used to treat premature ejaculation.

There are also a number of drugs, numbing creams and numbing sprays that may slow ejaculation in men with premature ejaculation.

When to see a doctor

See your doctor if you ejaculate sooner than you wish during most sexual encounters, and it causes distress to you or your partner.

Premature ejaculation is a common and treatable problem.

Sometimes, a conversation with a doctor might help lessen concerns about premature ejaculation.