What is premature ejaculation?

Premature ejaculation is when your ejaculation (orgasm) happens too fast. It may feel uncontrollable.

Premature ejaculation is the most common sexual problem affecting males. Many males ejaculate prematurely ('come' too early) at some point in their lives.

There is no set time that ejaculation should take. Premature ejaculation is usually defined as ejaculating within one minute of penetration.

If premature ejaculation happens sometimes, that is usually not a worry. But if you regularly come earlier than you would like, it may be worth talking to a doctor about.

You may have premature ejaculation all your life, or you may develop it over time. Premature ejaculation can happen at any age, but it is more common in younger males. Ejaculation tends to take longer as you get older.

What are the symptoms related to premature ejaculation?

Symptoms of premature ejaculation vary between people.

Symptoms may include:

• not being able to delay (slow down) ejaculation
• ejaculating during foreplay (sexual acts that come before sex)
• ejaculating when trying to insert the penis during sex
• distress (worry), frustration or embarrassment about ejaculating too soon

Some people may start to avoid sexual intimacy because they worry about ejaculating too early. Over time, this worry can create stress or tension in a relationship and may affect closeness and communication with a partner.

What causes premature ejaculation?

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

• abnormal hormone levels
• genetic causes

Premature ejaculation may also develop later in life. Premature ejaculation that develops later in life is usually due to another problem, such as:

• performance anxiety (anxiety about being good at sex)
• generalised anxiety
• stress
• 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 may also help to talk to your partner. You can include your partner when you talk with a health professional.

It is important to remember that ejaculation problems are common. It is nothing to be embarrassed about.

How is premature ejaculation diagnosed?

Your doctor will ask questions about you and your sexual history. They 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.

Self-care at home

There are some things you can try at home. These include:

• masturbating an hour or 2 before you have sex
• using a condom to help decrease sensation (feeling)
• taking a deep breath in — this may briefly delay the ejaculatory reflex
• trying different positions that you may find less arousing
• taking a break and thinking of something non-sexual
• using the 'second try' trick — you may have delayed ejaculation if you have sex a second time after the first ejaculation

Medicines for premature ejaculation

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

It is 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 decrease in sensation (feeling).

Your doctor may prescribe other medicines to try and help. These medicines can help bring back control over or delay ejaculation.

Other treatment options

It may be helpful to see a psychologist or sex therapist.

Counselling can help you look for underlying issues. These may be psychological, sexual or related to relationships. It can also help with other issues such as anxiety.

You may benefit from couples therapy if you are in a long-term relationship.

There are techniques that can help someone 'unlearn' the habit of premature ejaculation. Sex therapists can advise on the techniques available.

What are the complications of premature ejaculation?

It may be difficult for your partner to fall pregnant if ejaculation does not happen inside the vagina.

Premature ejaculation might also increase:

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

Can premature ejaculation be prevented?

Exercise may improve ejaculation control. Exercise can help strengthen the muscles of the pelvic floor. These are also called Kegel exercises.

Resources and support

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

Family Planning NSW has resources on male sexual health available.

Healthy Male has a series of information pages on male sexual health issues available.

Melbourne Sexual Health Centre has a range of factsheets on sexual health available as well as a telephone triage booking system for people in Melbourne.

Sexual Health Victoria has a range of factsheets on sexual health available in many community languages.

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 you 24 hours a day, 7 days a week.

Information for Aboriginal and/or Torres Strait Islander peoples

VACCHO has a webpage with helpful resources on sexual health available for Aboriginal and/or Torres Strait Islander peoples.

Yarning about Boy's Business is a brochure with information on sexual health for young Aboriginal and/or Torres Strait Islander peoples.

Information for sexually and gender-diverse families

QLife has free LGBTIQ+ peer support and referral, so you can talk about sexuality, gender, bodies, feelings or relationships.

ACON helps sexuality and gender-diverse people by providing information, workshops and a range of support services.