Premature ejaculation occurs when a man has an orgasm sooner during intercourse than he or his partner wishes.
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 usually 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.
There usually are no abnormal findings with the condition. The health care provider can get more useful information from interviewing 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:
The "squeeze" method:
Antidepressants such as Prozac and other selective serotonin reuptake inhibitors (SSRIs) may be helpful because one of their side effects is to prolong 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 these distraction techniques cause difficulty maintaining an erection, 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 through education and by practicing the simple techniques outlined. Chronic premature ejaculation may be a sign of anxiety or depression. A psychiatrist or psychologist can help treat these conditions.
Call for an appointment with your health care provider if you are having a problem with premature ejaculation and it does not respond to techniques such as those described above.
There is no way to prevent this disorder. However, relaxation can make it less likely to occur.
Lue TF, Broderick GA. Evaluation and nonsurgical management of erectile dysfunction and premature ejaculation. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 22.
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: Mosby Elsevier; 2008:chap 36.