What Is Premature Ejaculation?

Timing can be everything in the bedroom.

If you’re climaxing sooner than you and your partner would like, sex may not be satisfying for either of you.

It’s a problem called premature ejaculation (PE). It can be frustrating and even embarrassing. It can hurt your relationship too.

You don’t have to live with it. There are things you can do to last longer in bed.

What Is Premature Ejaculation?

There is no set time when a man should ejaculate during sex. But it’s probably too soon if you have an orgasm before intercourse or less than a minute after you start.

It’s a problem because when you ejaculate you lose your erection and can’t continue having sex. You and your partner may feel there’s not enough time to enjoy it.

It’s a common issue for men. Between 30%-40% have it at some time in their life. So, keep in mind -- it’s not something to worry about if it happens only occasionally.

What Causes It?

It’s not really known. But your brain chemistry could be at least partly to blame. Men who have low levels of the chemical serotonin in their brains tend to take a shorter time to ejaculate.

Emotional factors can play a role:

Sometimes PE can be a problem for men with erectile dysfunction (ED). That’s when the penis does not remain firm enough for sex. Men who are worried they could lose their erection may develop a pattern of rushing to ejaculate. It can be a hard habit to break.

Treating the erectile dysfunction may make the premature ejaculation go away. There are many options including drugs like sildenafil citrate (Viagra), tadalafil (Cialis) or vardenafil HCI (Levitra). All of these help men maintain an erection.

When Should I See the Doctor?

Make an appointment if PE is bothering you or your partner. The doctor probably will ask if you’ve always had the problem or if it’s a new thing. He may ask about your sex life or your relationships. You’ll probably get a physical exam, too.

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How Is It Treated?

Ninety-five percent of men are helped by behavioral techniques that help control ejaculation.

Stop and start: You or your partner stimulate your penis until your feel like you’re going to have an orgasm. Stop the arousal for about 30 seconds or until the feeling passes. Start the stimulation again and repeat three or four more times before you actually ejaculate.

The Squeeze: It works the same way as the start and stop method. But, when you feel like you’re reaching orgasm, you or your partner squeezes the head of your penis until you lose the erection. Repeat this a few times before ejaculating.

Some men find that if they think of something else during sex they can last longer.

What Medications Can Treat PE?

There aren’t any medications specifically approved to treat it. But sometimes, doctors find that medications used to treat other things can help. This is called an off-label use.

These include:

Antidepressants: A side effect of some selective serotonin reuptake inhibitors (SSRIs) is delayed orgasm. But these medications also have side effects that include nausea and drowsiness. They also can throw a wet blanket on your desire to have sex. So, it’s possible you’re trading one problem for another. You and your doctor will decide what’s right for you.

Tramadol: This is a pain reliever that can delay ejaculation. It may be prescribed if antidepressants don’t help. This medicine is addictive, so it may not be an option for you.

Anesthetic creams or sprays: You put these on the head of your penis to make it less sensitive. Leave it on for about 30 minutes. It must be washed off before sex so you don’t lose your erection or cause loss of sensation for your partner.

Can Anything Else Help?

Strengthen your muscles: Weak pelvic floor muscles sometimes contribute to PE. Kegel exercises may help strengthen them. Find the right muscles to tighten by stopping your urine in midstream. Hold them tight for 3 seconds and then release them for 3 seconds. Do this 10 times, at least 3 times a day.

Wear a condom: It may desensitize you enough so you can last longer.

Get busy before you “get busy”: Some men find that masturbating a few hours before sex helps them stay in control during intercourse.

Seek counseling: A psychologist or psychiatrist can help you work through problems like depression, anxiety, or stress that may be contributing to your PE.

If your relationship is affected, talking about the problem is an important first step. A relationship counselor or sex therapist may be able to help.

WebMD Medical Reference Reviewed by Melinda Ratini, DO, MS on March 27, 2017

Sources

SOURCES:

American Academy of Family Physicians: “Premature Ejaculation.”

Sexual Medicine Society of North America: “Conditions: Premature Ejaculation.”

Mayo Clinic: “Premature Ejaculation.”

Urology Care Foundation: “How Is ED Treated?” “What is Premature Ejaculation?”

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