Premature ejaculation is when a man has an orgasm sooner during intercourse than desired.
Premature ejaculation is a common complaint. It is only rarely caused by a physical problem.
Premature ejaculation early in a relationship is most often caused by anxiety and too much stimulation. Guilt and other psychological factors may also be involved. The condition often improves without treatment.
The man ejaculates before he or his partner would like (prematurely). This may range from before penetration to a point just after penetration. It may leave the couple feeling unsatisfied.
Exams and Tests
In most cases, there are no abnormalities that can be detected. The health care provider can get more information by talking to the person or couple.
Practice and relaxation should help you deal with the problem. Some men try to distract themselves by thinking nonsexual thoughts (such as naming baseball players and records) to avoid getting excited too fast.
There are several helpful techniques you can try.
The "stop and start" method:
- This technique involves sexually stimulating the man until he feels like he is about to reach orgasm. Stop the stimulation for about 30 seconds and then start it again. Repeat this pattern until the man wants to ejaculate. The last time, continue stimulation until the man reaches orgasm.
The "squeeze" method:
- This technique involves sexually stimulating the man until he recognizes that he is about to ejaculate. At that point, the man or his partner gently squeezes the end of the penis (where the glans meets the shaft) for several seconds. Stop sexual stimulation for about 30 seconds, and then start it again. The person or couple may repeat this pattern until the man wants to ejaculate. The last time, continue stimulation until the man reaches orgasm.
Antidepressants such as Prozac and other selective serotonin reuptake inhibitors (SSRIs) are often prescribed. These medicines can increase the time it takes to reach ejaculation.
You can apply a local anesthetic cream to the penis to reduce stimulation. Decreased feeling in the penis may delay ejaculation. Condom use may also have this effect for some men.
If distraction techniques and antidepressants do not help you keep an erection, other medications used for erectile dysfunction may help.
Evaluation by a sex therapist, psychologist, or psychiatrist may help some couples.
In most cases, the man is able to learn how to control ejaculation. Education and practicing simple techniques are often successful. Chronic premature ejaculation may be a sign of anxiety or depression. A psychiatrist or psychologist can help treat these conditions.
If a man ejaculates very early, before entering the vagina, it may prevent a couple from getting pregnant.
A continued lack of control over ejaculation may cause one or both partners to feel sexually dissatisfied. It may lead to sexual tension or other problems in the relationship.
When to Contact a Medical Professional
Call your health care provider if you are having a problem with premature ejaculation and it does not get better using the methods described above.
There is no way to prevent this disorder. However, relaxation can make it less likely to occur.
Mulhall JP. Premature ejaculation. In: Wein AJ, ed. Campbell-Walsh Urology. 10th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 26.
Shafer LC. Sexual disorders and sexual dysfunction. In: Stern TA, Rosenbaum JF, Fava M, Biederman J, Rauch SL, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, PA: Elsevier Mosby; 2008:chap 36.
Update Date 1/21/2015
Updated by: Scott Miller, MD, urologist in private practice in Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.