What is premature ejaculation?

Premature ejaculation is when you have trouble controlling when you orgasm, and it happens too fast.

Premature ejaculation is the most common sexual problem to affect males. Many people ejaculate prematurely, or 'come too early', at some point in their lives.

There is no fixed time that you take to ejaculate. Premature ejaculation is normally considered when you ejaculate within one minute of your penis entering your partner. Premature ejaculation can also happen during foreplay, or when you are trying to insert your penis during sex.

If premature ejaculation happens occasionally, that's usually not a worry. But if you regularly come earlier than you would like, then it is an issue to think about.

Some people have premature ejaculation all their life, and some develop it. Premature ejaculation can happen at any age, but it's more common in younger males. This is because ejaculation tends to take longer as you get older.

What are the symptoms related to premature ejaculation?

Symptoms of premature ejaculation vary between people. The main symptom is not being able to delay ejaculation.

What causes premature ejaculation?

Sometimes premature ejaculation is a lifelong problem that starts the first time you have sex. This may be due to:

• abnormal hormone levels
• genetic causes that affect the signalling between nerves

Premature ejaculation can also develop after a period of normal ejaculation. It's usually due to another problem like:

• performance anxiety
• generalised anxiety
• stress
• erectile dysfunction — about 1 in 3 people with premature ejaculation also have erectile dysfunction
• psychological or relationship problems

Alcohol and drug abuse can make premature ejaculation worse.

When should I see my doctor?

You should talk to your doctor if you are experiencing premature ejaculation. They can help work out the cause and offer you treatment options.

It can also help to talk to your partner and include your partner when you talk to a health professional. Most people with premature ejaculation can be helped, which can help with developing and maintaining intimate relationships.

It's important to remember that ejaculation problems are common and nothing to be embarrassed about.

How is premature ejaculation diagnosed?

Your doctor will ask questions about your sexual history and details about the premature ejaculation. Your doctor may also order some tests to help work out the cause.

There is no specific test to diagnose premature ejaculation.

How is premature ejaculation treated?

The treatment for premature ejaculation depends on the cause. There are some things you can try at home.

Self-care at home

There are some things you may wish to try at home. These include:

• Masturbating an hour or 2 before you have sex.
• Using a condom to help decrease sensation.
• Taking a deep breath in — this briefly shuts down the ejaculatory reflex.
• Trying different positions that you may find less arousing.
• Taking a break and thinking of something other than sex.
• Using the "second try" trick — you may have delayed ejaculation when having sex a second time after the first ejaculation.

Medicines for premature ejaculation

You can buy a local anaesthetic spray at your pharmacy without prescription. You spray it on the head of your penis 10 minutes before having sex.

It's important that you follow the instructions for use. You should also be aware that the spray may rub off on your partner. This can cause a short-term reduction in sensation.

Your doctor may prescribe other medicines that can be used to treat premature ejaculation.

Medicines to treat erectile dysfunction can help bring back the normal control over ejaculation.

Other treatment options

You may benefit from seeing a sex therapist or psychologist for help with premature ejaculation and other sexual problems.

Counselling can help you identify any underlying psychological, sexual or relationship issues. It can also help improve other problems related to premature ejaculation, such as anxiety.

If you are in a long-term relationship, you may benefit from couples therapy.

There are techniques that can help someone 'unlearn' the habit of premature ejaculation. Sex therapists can advise on the techniques available to do this. They include the 'stop-start' technique and the 'squeeze' technique.

Can premature ejaculation be prevented?

Exercise has been reported to help prevent premature ejaculation. Kegel exercises are exercises to strengthen your pelvic floor muscles. These can also help to improve your control over ejaculation.

Complications of premature ejaculation

Premature ejaculation might make it difficult for your partner to conceive (fall pregnant) if ejaculation does not happen inside the vagina.

Premature ejaculation might also increase:

• stress
• anxiety
• depression
• low self-esteem
• relationship issues

Resources and support

Speak to your doctor if you are worried about premature ejaculation.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.