Sexual Health Q&A

Q&A
Premature Ejaculation
What is premature ejaculation? What causes it?

In general terms, premature ejaculation (PE) occurs when a man ejaculates earlier than he intends to. More specifically, three criteria are used to define PE:

  • The time period between penetration and ejaculation (also called the latency period) is shorter than desired.
  • Men feel they cannot control when they ejaculate.
  • Men feel distressed about their situation.

When considering PE, it is helpful to have realistic expectations. Typically, the normal time to ejaculation is between 5 and 7 minutes.

PE is sometimes classified as lifelong or acquired.

As the term suggests, men with lifelong PE have struggled with early ejaculation since their first sexual experience.

The International Society for Sexual Medicine (ISSM) defines lifelong PE in this way:

A male sexual dysfunction characterized by

          (i) ejaculation which always or nearly always occurs prior to or within about one minute of vaginal penetration, and

          (ii) the inability to delay ejaculation on all or nearly all vaginal penetrations, and

          (iii) negative personal consequences, such as distress, bother, frustration and/or the avoidance of sexual intimacy.

In contrast, men with acquired PE develop PE after a period of normal sexual functioning. The ISSM describes acquired PE as follows:

A clinically significant reduction in latency time, often to about 3 minutes or less (acquired premature ejaculation), and negative personal consequences, such as distress, bother frustration and/or the avoidance of sexual intimacy.

The most severe type of PE is called ante portas ejaculation, which occurs before any penetration.

Researchers are not sure what causes premature ejaculation, but PE has been linked to health conditions like prostatitis (inflammation of the prostate gland), anxiety and other psychological issues, and (rarely) hyperthyroidism.  In addition, men with erectile dysfunction (ED) may experience PE because they have “learned” to ejaculate before losing their erection.

Some experts theorize that PE could be genetic in some men. Others believe that a chemical imbalance or receptor sensitivity changes in the brain are involved, at least for some men.

Many men with PE feel embarrassed, anxious, depressed, and worried about pleasing a partner. Single men sometimes avoid new relationships because of the stress of PE.

Men who are concerned about PE are urged to see a healthcare provider. There are several strategies and treatments available that might help men last longer.

Resources

International Society for Sexual Medicine

“ISSM Patient Information Sheet on Premature Ejaculation”
(August 2014)
http://www.issm.info/images/uploads/ISSM_Patient_Information_Sheet_on_PE_-_website.pdf

“ISSM Patient Information Sheet on Premature Ejaculation”
(January 2015)
http://www.issm.info/images/uploads/ISSM_Patient_Information_Sheet_on_PE_-_website_JAN_2015.pdf

SexHealthMatters.org

“Causes - Premature Ejaculation”
http://www.sexhealthmatters.org/premature-ejaculation/causes-premature-ejaculation

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