During sexual intercourse, when a man ejaculates sooner than he or his partner will like, it is called premature ejaculation. It is very common among the sexual problems in men. When it occurs occasionally, it is called as rapid ejaculation, premature climax or early ejaculation. If it occurs, sex becomes less enjoyable and the relationship is also affected. There are various psychological and biological factors that can cause premature ejaculation. Premature ejaculation is a common sexual problem and can be treated, but many men feel embarrassed to talk about it. The sexual life of you and your partner can be improved by medications, counseling and sexual techniques that delay ejaculation, or a combination of all these.

Symptoms

The inability to delay ejaculation for more than one minute after penetration is the main symptom of premature ejaculation. However, in all sexual situations including masturbation, this problem may occur.

Premature ejaculation can be classified as:

  • Lifelong (primary). Nearly all of the time beginning with your first sexual encounters, lifelong premature ejaculation occurs.

  • Acquired (secondary). After you’ve had previous sexual experiences without ejaculatory problems, acquired premature ejaculation develops.

Causes

What exactly causes premature ejaculation is unknown. It was once thought that the cause is only psychological, but now sexologist doctors have the knowledge that a complex interaction of psychological and biological factors is involved in premature ejaculation.

Psychological causes

The following psychological causes play an important role:

  • Early sexual experiences

  • Sexual abuse

  • Poor body image

  • Depression

  • Worrying about premature ejaculation

  • Guilty feelings that increase your tendency to rush through sexual encounters

There are also many other factors which play a role in it. They are:

  • Erectile dysfunction. There is a tendency among many men who are anxious about maintaining an erection during sexual intercourse. This tendency is to form a pattern of rushing to ejaculate, which can be difficult to change.

  • Anxiety. There are problems also with anxiety among many men with premature ejaculation. These problems may either be specifically about sexual performance or related to other issues.

  • Relationship problems. If premature ejaculation happened infrequently or not at all during satisfying sexual relationships with other partners, it may be possible that the problem is caused because of interpersonal issues between you and your current partner.

Biological causes

There are a number of biological factors that might contribute to premature ejaculation. They include:

  • Abnormal hormone levels

  • Abnormal levels of brain chemicals called neurotransmitters

  • Inflammation and infection of the prostate or urethra

  • Inherited traits

Diagnosis

Your doctor will ask you about your health history, your sex life and might do a physical exam. Your doctor might order blood tests to check your male hormone (testosterone) levels or other tests if you have both premature ejaculation and trouble getting or maintaining an erection. You might also be suggested by your doctor to go to a urologist or a mental health professional in some cases.

Treatment

Behavioral techniques, topical anesthetics, medications and counseling are some common options for premature ejaculation treatment. It must be kept in mind that finding the treatment or combination of treatments that will work for you may take time. The most effective course may be behavioral treatment along with drug therapy.

Behavioral techniques

Some simple steps such as masturbating an hour or two before intercourse so that you can delay ejaculation during sex may be involved in therapy for premature ejaculation, which is a common sexual problem, in some cases. Avoiding intercourse for a period of time and focusing on other types of sexual play may be recommended by your doctor to remove pressure from your sexual encounters.

Pelvic floor exercises

Your ability to delay ejaculation might be decreased by weak pelvic floor muscles. These muscles can be strengthened by pelvic floor exercises.
To perform these exercises:

  • Find the right muscles

  • Perfect your technique

  • Maintain your focus

  • Repeat 3 times a day

The pause-squeeze technique

In the course of normal sexual activity, when you feel the urge to ejaculate, make your partner to squeeze the end of your penis at the joining point of the head (glans) and the shaft for several seconds until the urge to ejaculate go away. You can reach the point of entering your partner without ejaculating by repeating as many times as necessary. If pain or discomfort is caused by this technique, there is the stop-start technique which involves stopping of sexual stimulation just prior to ejaculation, waiting until the decrease of arousal and again begin.

Condoms

Penis sensitivity might be decreased by condoms and this can help in the delay of ejaculation.

Medications

Topical anesthetics

To treat premature ejaculation, a common sexual problem, anesthetic creams and sprays containing a numbing agent such as benzocaine, lidocaine or prilocaine, are sometimes used. To reduce sensation and help delay ejaculation, these products are applied to the penis 10 to 15 minutes before sex.

Oral medications

  • Antidepressants. Delayed orgasm is a side effect of certain antidepressants

  • Analgesics. Delayed ejaculation is a side effect of Tramadol (Ultram), a medication commonly used to treat pain.

  • Phosphodiesterase-5 inhibitors. Premature ejaculation might be decreased by the help of some medications used in the treatment of erectile dysfunction

Counseling

Talking with a mental health provider about your relationships and experiences is involved in counseling. It is more likely to help when used in combination with drug therapy.