Premature ejaculation

Many men occasionally ejaculate sooner during sexual intercourse than they or their partner would like. As long as it happens infrequently, it's probably not cause for concern. However, if you regularly ejaculate sooner than you and your partner wish — such as before intercourse begins or shortly afterward — you may have a condition known as premature ejaculation.

Premature ejaculation is a common sexual disorder. Estimates vary, but some experts think it affects as many as one out of three men. Even though it's a common problem that can be treated, many men feel embarrassed to talk to their doctors about it or seek treatment.

Once thought to be purely psychological, experts now know that biological factors also play an important role in premature ejaculation. In some men, premature ejaculation is related to erectile dysfunction.

You don't have to live with premature ejaculation — treatments including medications, psychological counseling and learning sexual techniques to delay ejaculation can improve sex for you and your partner. For many men, a combination of treatments works best.
Symptoms

There's no medical standard for how long it should take a man to ejaculate. The primary sign of premature ejaculation is ejaculation that occurs before both partners wish in the majority of sexual encounters, causing concern or distress. The problem may occur in all sexual situations, including during masturbation — or it may only occur during sexual encounters with another person.

Doctors often classify premature ejaculation as either primary or secondary:

    * You have primary premature ejaculation if you've had the problem for as long as you've been sexually active.
    * You have secondary premature ejaculation if you developed the condition after having had previous, satisfying sexual relationships without ejaculatory problems.

Causes

Experts are still trying to determine exactly what causes premature ejaculation. While it was once thought to be only psychological, we now know premature ejaculation is more complicated and involves a complex interaction of both psychological and biological factors.

Psychological causes
Some doctors believe that early sexual experiences may establish a pattern that can be difficult to change later in life such as:

    * Situations in which you may have hurried to reach climax in order to avoid being discovered
    * Guilty feelings that increase your tendency to rush through sexual encounters

Other factors that can play a role in causing premature ejaculation include:

    * Erectile dysfunction. Men who are anxious about obtaining or maintaining their erection during sexual intercourse may form a pattern of rushing to ejaculate which can be difficult to change.
    * Anxiety. Many men with premature ejaculation also have problems with anxiety — either specifically about sexual performance, or caused by other issues.

Biological causes
Experts believe a number of biological factors may contribute to premature ejaculation, including:

    * Abnormal hormone levels
    * Abnormal levels of brain chemicals called neurotransmitters
    * Abnormal reflex activity of the ejaculatory system
    * Certain thyroid problems
    * Inflammation and infection of the prostate or urethra
    * Inherited traits

Rarely, premature ejaculation is caused by:

    * Nervous system damage resulting from surgery or trauma
    * Withdrawal from narcotics or a drug called trifluoperazine (Stelazine), used to treat anxiety and other mental health problems

Although both biological and psychological factors likely play a role in most cases of premature ejaculation, experts think a primarily biological cause is more likely if it has been a lifelong problem (primary premature ejaculation).