Premature ejaculation: causes and treatment

PE is a complex condition that can have a multitude of causes. In some cases, an exact cause isn’t always clear.

There are two types of PE which have different causes.

Cases of primary PE are more likely caused by psychological trauma, particularly in cases of sexual abuse at a young age.

Cases of secondary PE are usually linked to more acute problems such as recent mental health struggles or physical effects of substance use.

Psychological problems are common risk factors for sexual problems. Below are some of the most common psychological causes of PE.

Mental health

Stress, anxiety and depression can cause an imbalance in your neurochemistry. This can have a significant effect on your physical and sexual well-being.

Serotonin is a chemical messenger linked to your overall mood. Low serotonin levels are believed to cause low mood. It is also linked to ejaculation. Men with high levels of serotonin have been shown to last longer than men with lower levels.

The problem can become cyclical as men with PE feel distressed about their symptoms. Research Trusted source PubMed Government Source Database of Biomedical Research Go to source shows that men with PE are at a greater risk of mental illness because of their condition.

Psychological trauma

The main cause of primary PE is psychological trauma.

A traumatising sexual experience or case of sexual abuse can impact your sexual performance. Negative memories or experiences may persist in your sex life.

For example, a man may ejaculate early out of guilt or fear of being caught during the act stemming from childhood abuse.

Relationship issues

Relationship problems with your partner may affect you in the bedroom. You may not enjoy sex anymore or you may perceive your partner differently.

This can cause anxiety or low mood which can affect your sexual performance. This can be difficult to address, especially if you don’t want to upset your partner.

Performance anxiety

Another common issue for men is sexual performance anxiety. It is a fear of underperforming in the bedroom.

Studies Trusted source National Center for Biotechnology Information (NCBI) Government Source Biomedical Research and Literature Go to source have shown that men experience performance anxiety because of anxiety or marital issues. Both these factors can affect your brain chemistry and affect your sex life.

The problem can also become cyclical. The more anxious you are about PE, the more the symptoms continue.

A lot of sudden cases of premature ejaculation occur due to physical factors or certain medical conditions.

Below are some of the most common culprits.

• prostate problems (e.g. an enlarged prostate or prostatitis)
• alcohol or drug misuse
• medical conditions like hyperthyroidism and diabetes
• low testosterone levels
• sleep deprivation and insomnia
• neurological conditions (e.g. multiple sclerosis)

If nothing else has changed in your mental well-being or your daily life, you may have a medical condition underlying your symptoms.

Does erectile dysfunction cause premature ejaculation?

Erectile dysfunction (ED) is also a common sexual disorder in men. It is characterised by difficulty achieving and maintaining an erection.

Unfortunately, the two conditions often go hand in hand. They share a lot of the same underlying causes. ED can also cause PE. This is because a man may ejaculate early due to the absence of a full erection.

If you’re experiencing both, your doctor will want to get to the bottom of your ED first. Treating the ED may help with your PE.

It’s a common myth that your sexual performance naturally changes as you get older. In fact, there is no direct link between age and PE. Age can have the opposite effect. A lot of older men can lose sensitivity in their penis, we can delay ejaculation.

However, as you get older, you are more susceptible to medical and psychological factors that may affect your sex life. Studies Trusted source National Center for Biotechnology Information (NCBI) Government Source Biomedical Research and Literature Go to source show older men are also more prone to getting ED, which can cause PE.

But, if you are quite healthy, you may be unaffected well into your later years.

Treating PE will depend on the cause.

In simple cases, you may be able to treat it yourself. There are some simple ways of preventing PE:

• trying different sex positions
• masturbating 1 hour or 2 before sex
• using thicker condoms
• deep breathing
• taking breaks during sex

There is also some evidence Trusted source National Center for Biotechnology Information (NCBI) Government Source Biomedical Research and Literature Go to source that exercises to strengthen your pelvic floor muscles, known as Kegels, may improve your PE.

Other causes may require a health professional.

Psychological causes such as trauma or mental health issues may require some kind of psychotherapy. Some cases may require a sex therapist.

Your doctor may recommend various treatment options to delay ejaculation if they think you need it.

If you have low serotonin, they may recommend an SSRI like sertraline or fluoxetine. There is also an SSRI treatment licensed for PE called Priligy.

Your doctor may also recommend a numbing cream. This will help reduce sensitivity and help you last longer.