What Causes Premature Ejaculation?

Dr. Babak Ashrafi

Medically reviewed by

Dr Babak Ashrafi

Last reviewed: 22 Apr 2022

Premature ejaculation happens when you ejaculate too soon during sex. You may occasionally experience episodes of premature ejaculation, but this is common and often nothing to worry about.

Man sat on couch researching the causes of premature ejaculation on his mobile

If you find you’re ejaculating too early during sex on a regular basis, you may consider speaking to your doctor about treatment.

Premature ejaculation is also known as early ejaculation or rapid ejaculation.

What is premature ejaculation?

Premature ejaculation happens when you ejaculate too early during sex. While there’s no definition of how long sex should last, you might find yourself unhappy with the amount of time taken.

There are 2 types of premature ejaculation: acquired and lifelong. Acquired premature ejaculation happens if you’ve previously been able to ejaculate normally. Lifelong premature ejaculation occurs from your first sexual experience.

Premature ejaculation is different to erectile dysfunction, which is when you have trouble getting or maintaining an erection. The two conditions can be linked, so it’s important to get erectile dysfunction treated first. Erectile dysfunction can be treated with PDE5 inhibitors, a group of medications that include sildenafil (Viagra), tadalafil (Cilais), vardenafil (Levitra), and avanafil (Stendra).

Who does it affect the most?

Premature ejaculation is one of the most common sexual dysfunction problems that men face. Premature ejaculation is reported to affect nearly a third of men worldwide, so you’re not alone in facing this problem.

Premature ejaculation can affect men of all different ages at various stages of their life. Your mental health can affect premature ejaculation and, in turn, your sex life. As your mental state can change when you get older, it’s important to take care of your mental health to avoid the psychological causes of premature ejaculation. This includes performance anxiety, which can have an impact on your ability to have satisfying sex.

What are the main causes of premature ejaculation?

Premature ejaculation can happen due to psychological factors. You might find yourself having premature ejaculation more often if you:

  • have depression or poor self esteem
  • have a history of negative sexual experiences
  • have anxiety about your sexual performance

Having relationship problems can also impact your sexual function, and if this is the case, you may want to consider couple therapy or see a sex therapist.

If you have low moods that affect your sex life, your doctor may recommend therapy or antidepressants. These include medications like sertraline or fluoxetine.

Premature ejaculation can also occur when there is a physical change, such as:

  • your penis being more sensitive
  • inflammation or infections on your penis or urethra (where you pee)
  • abnormal hormone levels, such as thyroid hormones
  • low serotonin levels
  • developing medical conditions, such as heart disease
  • if you’re taking other medication

Your doctor may ask you to do some blood tests to check if premature ejaculation is happening due to a physical cause.

Can premature ejaculation be prevented or avoided?

There are a few things you can try to prevent or avoid getting premature ejaculation. Try not to be discouraged if they do not work at first. It can take time to figure out what works best for you.

You can try:

  • using a thicker condom which helps reduce penis sensitivity
  • masturbating an hour or so before you have sex
  • taking breaks during sex to distract yourself

If these self help tips are not effective, there are some premature ejaculation treatment options you can try. These medicines are often used in the treatment of premature ejaculation and are available to request from ZAVA.

Emla cream is a topical treatment that you apply to your penis skin and it contains 2 different anaesthetics. These are lidocaine and prilocaine. Anaesthetics are medications that reduce sensation and make a certain area of your body feel numb.

You can use Emla cream around 20 minutes before you plan on having sex. This is an off label use of Emla, meaning Emla is not designed to be used for premature ejaculation but can be used in this way if your doctor suggests it is suitable.

Priligy is another common treatment for premature ejaculation. Each Priligy tablet contains 30mg of dapoxetine, a selective serotonin reuptake inhibitor (SSRI). SSRIs are medications that increase your levels of serotonin. Serotonin is a neurotransmitter needed for many functions in your body. These include your digestive system and nervous system.

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Tips to delay ejaculation

You can try to delay ejaculation by using the squeeze method or the stop-go technique.

In the squeeze method, your partner should help you masturbate and stop just before you ejaculate. They should then squeeze the head of the penis for around 10 to 20 seconds and let go, waiting for 30 seconds before continuing masturbation. This should happen a few times before you allow ejaculation to happen.

The stop-go technique works in the same way but without squeezing your penis. Both these techniques allow you to practice control of ejaculation and increase your confidence during sex. By practising these techniques often, you can delay ejaculation.

Medically reviewed by:
Dr Babak Ashrafi Clinical Lead for Service Expansion
Accreditations: BSc, MBBS, MRCGP (2008)

Babak studied medicine at King’s College London and graduated in 2003, having also gained a bachelor’s degree in Physiology during his time there. He completed his general practice (GP) training in East London, where he worked for a number of years as a partner at a large inner-city GP practice. He completed the Royal College of GPs membership exam in 2007.

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Last reviewed: 22 Apr 2022

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If you are finding that you ejaculate during sex earlier than you’d like to, premature ejaculation treatment might help. ZAVA offers oral tablets and topical creams to help you delay ejaculation.

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