What is premature ejaculation?

Premature ejaculation is characterized by orgasm and ejaculation occurring more quickly than desired, often with minimal stimulation. It is the most common s*xual dysfunction in men and can occur during intercourse, foreplay, or even before penetration.

There is no precise time frame defining premature ejaculation, but doctors generally consider it as such when it occurs within the first minute after penetration or before the man desires it. It is normal for many men to experience it occasionally due to arousal or stress, but it becomes problematic when it occurs frequently.

Some men experience premature ejaculation throughout their lives, while others develop it later, after years of normal functioning. This disorder can occur at any age, but it is more common in younger men. With age, experience, and emotional maturity, ejaculatory control generally improves. However, stress and health problems can lead to recurrences.

Symptoms of Premature Ejaculation

The most common symptom is the inability to control or delay ejaculation for more than a few minutes during s*xual intercourse. This can occur even with minimal stimulation or during foreplay.

Premature ejaculation is generally divided into two categories:

• Continuous (always present): the problem is present from the first s*xual encounters and persists throughout life.
• Acquired: it develops later, after a period of normal s*xual activity.

Occasional premature ejaculation is not a medical problem. However, when it becomes persistent and causes distress, frustration, or relationship problems, it is important to consult a professional. Some men may also experience decreased s*xual self-esteem, anxiety, or avoidance of intimacy because of this condition.

What are the causes of premature ejaculation?

Premature ejaculation can have both psychological and biological causes, and often the two are linked.

Psychological factors play a significant role. Men experiencing stress, performance anxiety, or relationship problems are more likely to have difficulty controlling their ejaculation. Depression, low self-esteem, and unresolved emotional tension can also trigger or worsen this problem. Early s*xual conditioning, such as learning to ejaculate quickly during adolescence out of fear of being caught, can influence s*xual behavior in adulthood.

Biological causes are equally important. Hormonal imbalances, particularly low testosterone levels, or abnormal serotonin activity in the brain can affect ejaculation control. Medical conditions such as prostate inflammation, thyroid disorders, or erectile dysfunction can also lead to premature ejaculation. Additionally, nerve sensitivity, genetics, and even certain medications can contribute to the problem.

Lifestyle factors, such as smoking, alcohol consumption, lack of sleep, and a poor diet, can worsen premature ejaculation by affecting blood flow, hormonal balance, and energy levels. Identifying the cause is essential for choosing the appropriate treatment.

Diagnosis of Premature Ejaculation

Diagnosis begins with a thorough consultation with a doctor, usually a urologist or s*xologist. The doctor will ask whether the premature ejaculation is a long-standing or recent problem and may ask about your s*x life, emotional state, and medical history. A physical examination may be performed to rule out other conditions, such as prostate problems or hormonal imbalances. In some cases, blood or urine tests may be ordered.

If emotional or psychological factors are suspected, your doctor may refer you to a psychologist or s*xologist specializing in s*xual disorders. Open communication about your s*x life and lifestyle habits is essential for an accurate diagnosis and effective treatment.

How is premature ejaculation treated?

Treatment for premature ejaculation depends on its underlying cause and severity. Most men experience significant improvement with a suitable combination of self-care, medication, and therapy.

1. Self-care and home techniques

You can try some simple strategies at home to improve your ejaculation control:

• Masquerade for one or two hours before s*x to reduce sensitivity.
• Use condoms to decrease stimulation and delay arousal.
• Practice deep breathing during s*x to delay orgasm.
• Try new, less stimulating positions or positions that allow you to easily pause.
• Take breaks and mentally distract yourself when you feel you are about to ejaculate.
• Use the "second attempt" technique: after ejaculating once, try again later; most men last longer the second time.

2. Medications for Premature Ejaculation

Over-the-counter topical sprays or creams containing mild anesthetics (such as lidocaine or benzocaine) can reduce penile sensitivity and help prolong intercourse.

For more persistent cases, doctors may prescribe:

• Selective serotonin reuptake inhibitors (SSRIs), such as sertraline or paroxetine, which delay orgasm.
• PDE5 inhibitors, such as sildenafil (Viagra) or tadalafil (Cialis), especially in cases of associated erectile dysfunction.

It is important to use these medications under medical supervision to avoid side effects or drug interactions.

3. Psychological and Couples Therapy

If premature ejaculation is related to anxiety, stress, or relationship problems, therapy can be very helpful. A s*x therapist or psychologist can teach behavioral techniques, such as the start-stop method or the squeeze technique, to delay ejaculation.

Couples therapy helps identify emotional triggers, reduce anxiety, and strengthen communication between partners. It can also improve trust, comfort, and understanding, which often leads to greater control over s*xuality.

4. Pelvic Floor Exercises

Strengthening the pelvic floor muscles (through Kegel exercises) has been shown to help men delay ejaculation. In one clinical study, men performed pelvic floor exercises three times a week for 12 weeks, and more than 80% of them experienced improved ejaculatory control.

At the start of the study, the average time to ejaculation was 32 seconds; after regular training, it decreased to nearly 2.5 minutes. These exercises are safe, natural and inexpensive, making them one of the best long-term treatments for premature ejaculation.

Is Premature Ejaculation Preventable?

While prevention isn't always possible, adopting healthy s*xual habits can reduce the risk of premature ejaculation. Focus on relaxation, foreplay, and emotional intimacy rather than performance. Avoid rushing during s*x: slowing down and paying attention to your sensations can help prolong pleasure.

A healthy lifestyle, including regular physical activity, a balanced diet, and restful sleep, improves the body's natural regulatory mechanisms. Open communication with your partner about your needs and limits also creates an atmosphere of trust, reducing pressure and anxiety.

If premature ejaculation persists, consulting a doctor as soon as possible can prevent it from becoming chronic. With consistent effort and appropriate care, you can regain full control of your ejaculation and enjoy a fulfilling s*x life.

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