Premature Ejaculation: Symptoms, Causes, and Treatments

You may feel embarrassed if you’ve ever experienced premature ejaculation. But you’re not alone. Research shows premature ejaculation is the most common sexual complaint of men — affecting about 30% of those having sex. And this can also cause distress for the man or his partner.

Premature ejaculation is very common, and there are several treatment options available. But, in order to find the right treatment option for you, you’ll first need to understand what’s causing your premature ejaculation. Let’s take a look at the potential causes and discuss what can be done to treat it.

What is premature ejaculation?

Premature ejaculation is when a man climaxes and releases semen sooner than he wants to, usually within 1 to 2 minutes after penetration. But premature ejaculation isn’t just about the clock. Experts also look at whether it leads to frustration, embarrassment, or relationship stress. If it doesn’t bother you or your partner, it may not be considered a medical problem.

Premature ejaculation can be broken down into two main types: 

• Primary (lifelong): If you've had symptoms since you started having sex, you probably have primary premature ejaculation.

• Acquired: If your symptoms developed later in life, you may have acquired premature ejaculation. In these cases, there's often an underlying medical or mental health reason behind it.

Knowing the different types of premature ejaculation is helpful for finding a possible cause and the right treatment. 

What are the symptoms of premature ejaculation?

The American Urological Association has identified certain symptoms as criteria to diagnose premature ejaculation. These criteria include:

• Ejaculation that occurs in 2 minutes or less

• A shorter time to ejaculation than in the past

• Inability to delay ejaculation (always or almost always)

• Emotional distress and/or other negative consequences from premature ejaculation

If one or more of these criteria apply to you, you may have premature ejaculation.

What causes premature ejaculation?

Although there are ideas about what may cause premature ejaculation, none of them have been confirmed. There are several physical and psychological causes that have been proposed by researchers. Let’s review them here.

Physical causes

Physical causes of premature ejaculation could include:

• Urologic conditions: These include conditions such as chronic prostatitis and varicocele, which can affect how the penis functions.

• Hypersensitive penis: Research shows that an increased sensitivity of the penis can cause some people to ejaculate faster.

• Medical conditions: Certain conditions, such as thyroid conditions and diabetes, can lead to hormonal changes that affect sexual function. 

• Low serotonin levels: People with lifelong premature ejaculation may have genetic differences in a serotonin receptor that can lead to premature ejaculation.

• Nerve damage: Neurologic conditions, such as spinal cord injuries or multiple sclerosis, can also lead to premature ejaculation.

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Risk factors of premature ejaculation

Anyone can experience premature ejaculation, but certain factors can make it more likely. Some of these overlap with the causes discussed above. Understanding your personal risk factors can help guide your conversation with a healthcare professional.

Risk factors for premature ejaculation include:

• Age: Premature ejaculation can happen at any age, but it tends to be more common in younger men. As men get older and gain more sexual experience, ejaculatory control often improves.

• Anxiety and depression: Mental health conditions, particularly anxiety, are strongly linked to premature ejaculation. Performance anxiety (worrying about how you'll do during sex) can create a cycle that's hard to break.

• Erectile dysfunction (ED): Men who have trouble getting or keeping an erection may rush through sex out of fear of losing it, which can contribute to premature ejaculation.

• Relationship stress: Tension or conflict with a partner, or feeling emotionally disconnected, can make premature ejaculation more likely.

If you recognize any of these risk factors in yourself, it's worth bringing them up with a healthcare professional.

Treatments for premature ejaculation

There are both medication and non-medication treatments for premature ejaculation. But, if another medical condition is causing your premature ejaculation, it’s important to treat that first. Not only can this improve your overall health, but it may also improve your ejaculation time.

Here are some techniques and medications to help treat premature ejaculation.

How to prevent premature ejaculation

There’s no way to predict or prevent the first episode of premature ejaculation. It’s likely to happen to most men at least once in their lifetime. But, if premature ejaculation continues to happen on a regular basis, there are a few tips you can try:

• Masturbation: Masturbating 1 to 2 hours before sex may help prevent you from ejaculating too quickly the next time. 

• Distracting yourself: It may be helpful to think about other things during sex to try and prevent premature ejaculation.

• Taking a break: If you feel yourself about to have an orgasm, stop and take a short break until the sensation goes away. It may also help to extend foreplay to delay sex and the opportunity to climax.

• Planning ahead: If you’re using medications, numbing creams, or condoms, make sure they’re on hand and available to use. 

Does Viagra help premature ejaculation?

Viagra (sildenafil citrate) may offer some benefits as a treatment for premature ejaculation, but the evidence isn’t strong. In one study, researchers found no significant improvement in ejaculation time. But participants in the study reported feeling more confident and had greater sexual satisfaction. And they were able to achieve a second erection more quickly after ejaculating.

Other studies showed that medications, like Viagra, could be a more promising treatment for premature ejaculation — but only in cases where erectile dysfunction was also present. It doesn’t seem to work as well in those with premature ejaculation alone. Keep in mind, if you do have erectile dysfunction, with GoodRx Care Direct, you can get sildenafil citrate (the generic version of Viagra) delivered directly to your home.

When treating premature ejaculation, Viagra seems to work better in combination with certain medications than when it’s taken alone. Specifically, when paired with an SSRI or tramadol, sildenafil citrate (Viagra) increased the time before ejaculation and led to more sexual satisfaction.

When to seek medical attention

If you and your partner are happy with how long it takes you to ejaculate, there’s probably no need to see a healthcare professional about it. But, if premature ejaculation is causing you or your partner distress, a medical professional can help. 

Some other reasons you should seek care include:

• You have other medical symptoms, like trouble urinating, changes in your weight, or loss of sensation.

• You’ve started a new medication, like medications to treat Parkinson’s disease or lithium.

• You’re feeling anxious, depressed, or hopeless.

• You’ve experienced sexual abuse in the past. 

Remember, there’s no magic cure for premature ejaculation. But a healthcare professional can diagnose and treat underlying medical conditions. They can also help you find the right combination of treatments to make your sexual experiences more satisfying.

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Written by:

Frank Schwalbe, MD

Frank Schwalbe, MD, is an assistant professor of anesthesiology at the Yale School of Medicine. He has practiced anesthesiology for 30 years.

Edited by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

Reviewed by:

Farzon A. Nahvi, MD

Farzon Nahvi, MD, is an emergency medicine physician and author of “Code Gray: Death, Life, and Uncertainty in the ER.” He works at Concord Hospital in Concord, New Hampshire, and teaches at the Geisel School of Medicine at Dartmouth.

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