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Overview

Premature ejaculation occurs when a man ejaculates sooner than he or his partner would like during sexual intercourse. Premature ejaculation is a common sexual complaint. As many as 1 out of 3 men say they experience this problem during sexual activity. 

Symptoms

The main symptom of premature ejaculation is the inability to delay ejaculation for more than a minute after penetration during intercourse. This problem can also occur in all sexual situations, even during masturbation. Premature ejaculation can be classified as lifelong or acquired.

Lifelong (primary) premature ejaculation means a person has had this experience always or almost always since their first sexual experience.

Acquired (secondary) premature ejaculation means a person had longer-lasting ejaculations in their life, but has developed premature ejaculation. 

Causes

The exact cause of premature ejaculation may remain unknown. Many psychological and biological factors play a role in premature ejaculation, including:

Psychological causes

Psychological factors that might play a role include:

  • Early sexual experiences
  • History of sexual abuse
  • Poor body image or poor self-esteem
  • Depression 
  • Worrying about ejaculating too early
  • Anxiety
  • Erectile dysfunction

Biological causes

Biological factors that might contribute to premature ejaculation include:

  • Abnormal hormone levels
  • Abnormal levels of neurotransmitters
  • Inflammation and infection of the prostate or urethra
  • Inherited traits

Diagnosis

When premature ejaculation gets in the way of your sexual pleasure, you should talk to your doctor. Your doctor will diagnose premature ejaculation after a physical exam and talking with you about your sex life and health history. Your doctor may also order blood tests to check your male hormone levels. 

Treatment

The treatment options for premature ejaculation include behavioral techniques, topical anesthetics, medications, and counseling. 

Behavioral techniques

Behavioral therapy uses exercises to help build a tolerance to delay ejaculation. A simple exercise is to masturbate an hour or two before intercourse so that you can delay ejaculation during sexual intercourse. Your doctor may also recommend avoiding intercourse for a while and focusing on other types of sexual play.

Medical therapy

Topical anesthetic creams and sprays that contain a numbing agent, such as benzocaine, are sometimes used to treat premature ejaculation. These products are applied to the penis 10 to 15 minutes before sex to reduce sensation which can help delay ejaculation. 

Counseling

This approach involves speaking with a mental health provider about your relationship and experiences. These sessions can help reduce performance anxiety and help you find better ways of coping with stress that relates to your condition.

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