Coping With Premature Ejaculation

For many, an orgasm is a wonderful experience to share during intimacy and sex with a partner. And while orgasms may be anticipated and enjoyed during intimate moments together, ejaculatory orgasms may sometimes happen earlier than preferred.

Premature ejaculation (PE) occurs when a person with a penis reaches climax and releases semen sooner than expected. This may be a cause of distress to the person dealing with PE and may also cause distress in their partner or partners.

While premature ejaculation can feel like a heavy burden to carry, it is important to be aware that it is one of the most common sexual disorders reported by individuals with penises. Nearly 40% of sexually active men are affected by PE during sex at some point in their life.

In addition to being common, premature ejaculation is also very manageable. This guide will take a dive into PE, its causes, and the different forms of this condition. We will also examine possible treatment options available to manage early ejaculation.

What Counts as Premature Ejaculation?

Because sex is subjective, it’s difficult to place a timeframe for when this act begins and is completed.

On average, it takes five to seven minutes for a person with a penis to have an orgasm and ejaculate while being stimulated. But overall, there is a wide range and the time that it takes to reach orgasm and ejaculate can take less than one minute to over one hour. This time may decrease with age. 

With early ejaculation, certain parameters have been identified to determine what counts as premature. An Ad Hoc Committee for the Definition of Premature Ejaculation listed the following criteria when recognizing this condition:

• Ejaculation that occurs prior to, or within one minute after vaginal penetration from the first sexual experience
• A significant reduction in the length of time it takes to ejaculate
• Difficulty delaying ejaculation during all, or almost all sexual encounters
• Distress following sexual encounters, or the avoidance of intimacy

Causes of Premature Ejaculation

Despite being the most common sexual dysfunction worldwide, it remains difficult to pinpoint an exact cause of premature ejaculation.

Widely, it is believed to be a psychological condition. However, there are several biological and psychological factors that may increase the risk of developing early ejaculation.

Biological Factors

• Low serotonin levels in the brain (this shortens ejaculation time) 
• Abnormal levels of hormones such as prolactin (this chemical helps to regulate arousal)
• Inflammation or an infection of the prostate/urethra
• Genetic traits

Psychological Factors

• Depression
• Anxiety
• Guilt
• Sexual repression
• Performance anxiety
• Body image issues
• Sexual abuse
• Relationship difficulties

Types of Premature Ejaculation

There are different forms of premature ejaculation.

Lifelong

When a penis owner experiences premature ejaculation from their first sexual encounter onward, consistently ejaculating within one minute after vaginal penetration, this is said to be a lifelong condition. In the case of lifelong PE, sexual intercourse has always been marked by unwanted, early ejaculation within seconds.

This condition is usually linked to difficulty in timing erections, detumescence (loss of an erection), and arousal. 

People with lifelong PE may also experience early erections, early ejaculation, and early detumescence. Lifelong premature ejaculation may be traced to neurobiological and genetic factors, including familial history of the condition. 

Acquired Premature Ejaculation

A person with acquired PE has had some experiences with normal ejaculation. Acquired premature ejaculation may develop at some point in an individual's life due to a medical, psychological, or relational origin.

This condition may also be caused by an infection of the prostate, thyroid disorders, erectile dysfunction, or prostatitis.

Generalized Premature Ejaculation

Premature ejaculation is considered generalized when it occurs with every partner, and in any setting. Early ejaculation can happen regardless of the kind of stimulation received. 

Situational Premature Ejaculation

People with situational PE may experience it in identified situational contexts. It may only occur with certain types of stimulation, with a particular partner, or in specific situations or scenarios.

How to Cope With Premature Ejaculation

There are different options available to manage premature ejaculation. Depending on the cause of the condition, treatment may be through behavior therapy, counseling, or medication. 

The first consideration for care is usually behavior therapy. This may, however, be combined with other methods for effective relief.

Behavioral Therapy

This treatment is aimed at teaching the body to control orgasms and their timing. Different methods may be adopted:

• Start and Stop: Using this technique, a penis owner may stimulate the penis alone or with the help of a partner. This usually continues until the point where the urge to ejaculate is felt, at which point stimulation stops until the sensation passes. This technique is repeated several more times before allowing the ejaculation to occur. The start and stop method is also known as "edging." To build control over ejaculation time, this exercise should be practiced often.
• The Stop-Squeeze Technique: Similar to start and stop, this method is meant to teach ejaculation delay tactics. The stop-squeeze or pause-squeeze technique may be practiced alone or with a partner. The goal is to stimulate the penis until the urge to ejaculate is felt. At that point, stimulation is stopped and the top of the penis is squeezed at the point where the head (glans) joins the shaft. Hold the squeeze for several seconds until the urge to ejaculate passes. This process is repeated several times to build resistance to premature ejaculation. 
• Masturbation: You can try to masturbate before engaging in sex to delay ejaculation when you do have intercourse. In younger people, masturbation is employed before intercourse to prevent early ejaculation.This method may be less popular with older individuals because of the longer recovery time that may be required after masturbating. 
• Distracted Thoughts: Another technique suggests allowing the mind to wander to other things when sexually stimulated. By focusing on other thoughts, concentration is focused on something other than an imminent orgasm. Examples of distracted thoughts could be attempting to recall a colleague’s outfits from the past week or considering alternate names for different ice cream flavors.  

Counseling

When premature ejaculation is caused by emotional distress, mental health counseling or sex therapy may be helpful. If relationship difficulties or serious mental health issues like depression or anxiety are affecting sexual performance, therapy can help with healing and recovery.

Medication

Many pharmaceutical options are available to help treat premature ejaculation. A common side effect of certain antidepressants is delayed ejaculation, so selective serotonin reuptake inhibitors (SSRIs) such as Paxil (paroxetine) may be helpful.

When used sporadically, Ultram (tramadol)—a medication commonly used to treat pain with a side effect that delays ejaculation—has been shown to improve the sex lives of patients. It is important to consult with your doctor if you are considering any of these options to help treat premature ejaculation.

Numbing Medication

Another pharmacological option is numbing medication. Anesthetic/desensitizing creams or sprays may be applied to the head and penile shaft to slow ejaculation. These creams should be applied around 20 minutes before expected intercourse. These creams may require condom use to avoid a mess. Condoms also manage the effects of the cream upon penetration. 

Numbing sprays require about five minutes before taking effect. This spray may be wiped off before penetration, and does not require condoms to manage effects.

Other Medications

Erectile dysfunction medication such as Viagra, Levitra, and Avanafil also have benefits for slowing ejaculation.

Before deciding on a pharmaceutical option to manage PE, it is important to consult with your physician or urologist.

For Partners

For partners of those struggling with PE, it's helpful to both you and your partner if you extend as much compassion, patience, acceptance, and kindness as you can.

Do your best to avoid shaming or blaming your partner for their PE, and try to provide them with emotional support on their journey. Remember, there are many ways to explore and enjoy sex and intimacy beyond ejaculation or an orgasm.

A Word From Verywell

Premature ejaculation is a common but distressing sexual challenge. Penis owners with this condition may suffer from self-esteem issues, anxiety, and shame—all of which can affect their interactions with others.

There are many options available for treating PE. Behavioral therapy, medication, counseling, and numbing creams are all possibilities to help with coping and healing. As you consider and explore different options, it is also important to extend grace and compassion to yourself, and to receive support from a partner or partners with grace and compassion in kind.