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Climaxing during sex is an amazing feeling. People often describe the things they love as being “better than sex”. This is because the pleasure that we experience during sexual intimacy sets the bar. However, when a man climaxes too early, the fun is usually over before it’s even started. This can lead to feelings of shame and embarrassment, as well as a sexually frustrated partner.

Premature ejaculation (PE) is the most common sexual dysfunction in males and a problem that can affect 30% of men. Ejaculating early now and again can be normal and is sometimes due to overexcitement. However, if you reach climax too soon during the majority of sexual interactions, premature ejaculation could be to blame. PE can damage self-confidence, affect mental health and put pressure on relationships.

Premature ejaculation (PE) is the most common sexual dysfunction in males and a problem that can affect 30% of men.

Despite it being such a common condition, the number of people seeking treatment for premature ejaculation is low. This could be down to the shame associated with PE, with some men believing that their sexual capability is a measurement of their manliness. Another contributing factor could be that many people don’t realize premature ejaculation can be medically treated.

Seeking treatment can be the key to restoring an enjoyment of sex. This article will identify the causes of premature ejaculation and explore the options available for treating the condition.

What is Premature Ejaculation?

Premature ejaculation is when a male reaches climax and expulses semen (i.e ejaculates) sooner than they would like to during sexual activity. The medical definition has called the disorder “the inability to control ejaculation sufficiently for both partners to enjoy sexual interaction”. Premature ejaculation can occur when a man is intimate with a sexual partner, as well as during individual sexual interactions (i.e masturbation). 

There is a term called Intravaginal ejaculation latency time (IELT), which measures the time between the penetration of the vagina and intravaginal ejaculation. If an IELT time of less than a minute is recorded then the subject would be considered to have “definite” premature ejaculation.

Despite the fact that PE is a condition that can be medically treated, doctors don’t diagnose men with the condition. This can create confusion in men and lead to an incorrect self-diagnosis.

Despite the fact that PE is a condition that can be medically treated, doctors don’t diagnose men with the condition. This can create confusion in men and lead to an incorrect self-diagnosis. External influences can lead them to believe they have PE, even when their sexual performance is completely normal.

How PE Happens: The Sexual Response Cycle

The emission stage occurs when sperm makes its way from the testicles to the prostate. The sperm mixes with seminal fluid and creates semen. When the muscles at the base of the penis contract, the expulsion stage begins. 

Expulsion leads to the semen being forced out of the penis and is also known as ejaculation. Typically men reach orgasm while they are ejaculating and usually lose their erection shortly after. For men with premature ejaculation, the expulsion stage occurs too early, putting an abrupt end to their sexual interaction.

Types of Premature Ejaculation

The two main types of premature ejaculation are lifelong (primary) and acquired (secondary). In recent years, a third type was identified which is known as subjective premature ejaculation. This section will break down the different types of premature ejaculation and their causes.

 TYPE
DEFINITION
CAUSES
Lifelong PE
Lifelong premature ejaculation is when the condition has affected someone for their entire life.

This includes the first time they experienced a sexual interaction and ejaculated (including masturbation).
- Sexual experiences at a young age

- Sexual abuse

- Low self-esteem or body image issues

- Erectile dysfunction encouraging rushed ejaculation
    Acquired PE Acquired premature ejaculation affects individuals who have suddenly developed premature ejaculation, despite having had previous sexual experiences with no ejaculation problems. - Development of mental health conditions (e.g. depression)

    - Feelings of stress or guilt 

    - Relationship difficulties

    - Lifestyle habits (e.g. excessive alcohol consumption)
      Subjective PE The third type of premature ejaculation was identified by the International Classification of Diseases (ICD-11) in 2018. This is what’s known as “subjective premature ejaculation”

      This definition describes individuals who believe they suffer from premature ejaculation, despite having a completely normal IELT.

      Often these views are brought on by external influences, leading men to believe they have a problem and that they should last longer than they currently do.
      - Pressure or high expectations from a sexual partner

      - Unrealistic standards from external influences (e.g. media, pornography)

         

          Symptoms of Premature Ejaculation

          • The main symptom of premature ejaculation is not being able to delay ejaculation for more than 3 minutes. Although most individuals that fall within this timeframe are considered to have premature ejaculation, the severity of the condition can affect them very differently.
          • Some men with mild PE will last close to 3 minutes and are able to engage in sexual intercourse with a partner. In more severe cases, men can ejaculate within a matter of seconds, making it almost impossible to participate in sexual activity.
          • Although IELT is a measurement for premature ejaculation based on penetration, PE can also be present without a sexual partner. Rapid climax during masturbation is another symptom of premature ejaculation and if an individual experiences this, there’s a high chance they will also ejaculate early when sexually intimate with a partner.

            Learn about Sexual Performance Anxiety

            Check our related blogs for more insights

            Can Premature Ejaculation be Controlled? Best Techniques and Tips

            Yes, the good news is that premature ejaculation can be controlled. There are plenty of techniques and treatments available for managing premature ejaculation. In this section, we’ve explored a few of the most efficient options for treating premature ejaculation.

            Edging

            Edging is a technique that involves bringing yourself near to orgasm and stopping before you reach the point of climax. By doing so, the time it takes to climax is increased and individuals can practice controlling the release of orgasms. 

            One of the main benefits of this technique is that sexual experiences can feel more enjoyable, as a prolonged orgasm can feel more intense when it’s finally released.

            One of the main benefits of this technique is that sexual experiences can feel more enjoyable, as a prolonged orgasm can feel more intense when it’s finally released.

            Edging can be done with a partner or alone. If you have a severe case of PE, practicing edging alone can help you build up a tolerance to the sensation you will feel from a partner’s touch. 

            One of the challenges of edging successfully with a partner is that poor timing can lead to early ejaculation and a lost erection. A useful tip for effectively edging with a partner is to focus on communication. Setting boundaries or a trigger word can let your partner know that they need to stop stimulation immediately.  

            There are a few different techniques that individuals can use whilst edging and we’ve explored a few of these below.

            Learn more about edging

            Check our related blog for more insights

            Start-stop Technique

            This technique is done by stimulating the penis until the point of orgasm is near, then stopping until the urge to ejaculate is gone. This should be repeated to help identify the feeling of arousal which takes place before an orgasm. Once an individual has learned to recognize when an orgasm is near, they will become far more comfortable controlling its release.

            Ballooning

            Ballooning is a variation of edging, which aims to achieve a full erection without too much stimulation. One of the key differences between this technique and conventional edging is that ballooning doesn’t allow the individual to ejaculate.

            The technique required for ballooning is quite different compared to the standard start-stop technique. Edging encourages stimulation of the most sensitive part of the penis. For many, this is the loose skin under the head of the penis called the frenulum and is sometimes called the “magic spot”. 

            Ballooning involves stimulating the less sensitive parts of the penis without stroking it. This can be achieved by rubbing the lower shaft of the penis and the area between the scrotum and the anus called the perineum.

            Conversely, ballooning involves stimulating the less sensitive parts of the penis without stroking it. This can be achieved by rubbing the lower shaft of the penis and the area between the scrotum and the anus called the perineum. When done correctly a large erection will be achieved, which is where the name ballooning originates.

            This technique requires a high level of self-discipline and can be combined with kegels (which we discuss later) to prevent ejaculation. Ballooning helps individuals get used to penile stimulation without releasing an orgasm.

            Squeezing

            The squeezing technique is similar to the start-stop edging technique. However, instead of withdrawing the stimulation when near to orgasm, the tip of the penis is squeezed as a deterrent to ejaculation. This is a technique that may require some practice and a gentle approach when trying it for the first time.

            If at any point you feel pain or discomfort stop immediately.

            Practice this technique alone so that you get a feeling for it and the pressure that should be applied. Once you are comfortable, you can introduce a partner but make sure that they take a cautious approach.

            This technique allows people to get used to the aroused feeling prior to climax, before squeezing the tip of the penis until the urge to ejaculate has passed. If you have severe PE, you may find that this technique is more effective than standard edging due to the physical squeezing acting as a barrier to ejaculation. 

            The Pros and Cons of Edging

            Kegels

            Kegels are an exercise routine which are designed to strengthen the pelvic floor muscles. This group of muscles affect sexual function and can be used to prevent premature ejaculation and erectile dysfunction.

            By performing kegels, you will strengthen the pubococcygeus (the muscle which controls urination) and be able to contract it to prevent ejaculation the way you do when holding in urine

            Pros and Cons of Kegels

            Pros
            The exercise also helps with erectile dysfunction
            Can be used with edging techniques such as ballooning.
            Cons
            Takes regular practice.

            Decrease Sensitivity

            Premature ejaculation and hypersensitivity go hand in hand. When men feel overly sensitive to the feeling of their penis being stimulated, it often leads to them ejaculating early. So, decreasing penile sensitivity is one strategy to help overcome premature ejaculation. Reducing sensitivity can be achieved in a variety of different ways and we’ve highlighted some below.

            Condoms

            By using condoms you’re placing a layer of latex between the penis and the surface that’s stimulating it. This will reduce penile sensitivity during stimulation and potentially lead to an increased length of time before reaching ejaculation. You can try different types of condoms to find the option which offers the best reduction in sensitivity, while still allowing you to feel pleasure.

            Lubricant

            Using a lubricant can also help reduce penis sensitivity during sexual activity. As with condoms, you are adding a layer (albeit thinner) between the penis and the stimulating surface. There are plenty of lubricants available, but we recommend a water-based lube as they are less likely to trigger an allergic reaction during use.


            Change Technique

            Another way to reduce penile sensitivity is to change the technique used when stimulating the penis. Rather than stroking it up and down in typical fashion, using small rubbing motions could help stimulate the penis without overdoing it. You can find which areas still provide pleasure without feeling too sensitive (such as the base and the perineum). This can allow you to feel sexual pleasure for longer during masturbation and foreplay

            If you are struggling to achieve or maintain an erection after changing technique, you could use accessories such as cock rings and penis pumps to help. You can work with a partner to find a technique that limits penile stimulation during sexual intercourse.

            Pros and Cons of Decreasing Sensitivity

            Pros
            You can enjoy stimulation without the hypersensitivity that causes PE.
            Cons
            You may not experience the pleasure of sexual activity as intensely.
            Using condoms or lubricant costs money.

            Using Selective Serotonin Reuptake Inhibitors (SSRI) or Antidepressants

            An effective method for treating PE is through the use of selective serotonin reuptake inhibitors (SSRIs) or antidepressants. The drugs have been found to effectively increase IELT for individuals with premature ejaculation. 

            A study investigated the effectiveness of four different SSRIs (sertraline 50mg, fluoxetine 20mg, paroxetine 20mg and citalopram 20mg) to treat PE. The study consisted of 480 patients who were considered to have premature ejaculation. Participants were split into four groups, one for each SSRI with 120 participants in each group. 

            The results showed that the ejaculation times significantly increased across all four groups after taking SSRIs.

            The results showed that the ejaculation times significantly increased across all four groups after taking SSRIs.

            Although SSRIs have been shown to effectively treat premature ejaculation, it’s important to be aware of their potential side effects.

            SSRI Side Effects

            The table below shows the side effects identified in the study. The first row shows the percentage of people who took the drug and experienced side effects. The numbers in each column show how many people (out of 120 people) experienced each side effect.

            Frequency Side Effect Sertraline 15% Fluoxetine 20.8% Paroxetine 12.5% Citalopram 10%
            Insomnia 2 2 2 1
            Drowsiness 3 6 3 4
            Dyspepsia 3 2 2 3
            Constipation 2 _ 1 _
            Nausea 2 2 2 1
            Loss of Appetite 1 2 1 1
            Fatigue 2 2 1 _
            Headache 1 2 1 1
            Vertigo 1 1 - 1
            Anxiety 1 2 - -
            Urinary Retention - 2 1 -
            Loss of Sexual Desire - 2 1 -

            Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6909853/

            It’s worth noting that none of the side effects above were deemed severe enough for the study to be discontinued.

            Pros and Cons of Using SSRIs

            Pros
            Effective in increasing the IELT in patients with PE
            Multiple SSRIs are available for finding a suitable option.
            Cons
            Potential side effects associated with using the drugs
            Accessibility depends on health care privileges

            How food and nutrition can help with premature ejaculation

            As PE is heavily influenced by our hormonal system, the activity of the sympathetic nervous system, and the internal system that manages stress, it is possible to eliminate (or at least greatly mitigate) PE by optimizing what we eat.

            Basically, anything that provides the body with useful vitamins and nutrients needed for sex, or which has a calming effect on a person (to engage the parasympathetic nervous system) is good to go.

            However, there a few foods that take this to the next level:

            1. Asparagus: apart from being a generally very healthy vegetable, asparagus also has tons of Iron and Vitamin E, which can act a performance booster by improving testosterone levels and optimizing hormone functioning in men.

            2. Zinc-rich foods: Zinc already plays an important immune-boosting role in our body, but it also greatly helps with the production of testosterone. Zinc-rich foods also happen to be one of the best natural remedies for premature ejaculation. They include seafood, like oyster, crab, and lobster; meat, like beef (chuck roast), chicken and pork chop; nuts, like almonds and cashews; oatmeal, and Swiss cheese.

            3. Foods rich in vitamin D3, especially Eggs: D3 is considered to be a very important vitamin, but people all around the world still have heavy deficiencies of it, especially in places where the sun isn’t shining all the time. Some people even link certain cancers and lowered mood to vitamin D3 deficiency. It just so happens that eating foods rich in vitamin D3 regularly can increase the levels of testosterone as well, and egg yolks especially are considered to be one of the best foods that stop premature ejaculation. 

            Of course, there are dozens of other foods that positively impact PE, or even herbs such as Mucuna pruriens (cowhage), Indian Ginseng, or even Blueberries. But more on these in a later blog post.

            Finally, on an interesting, and somewhat confusing note, according to some research, if some’s having problems with PE, it’s best to avoid heavy-hitting aphrodisiac foods such as oysters, strawberries or beetroot, because they can elevate the already overly-excited mood of someone with PE even higher. More research is needed on the topic though.

            When to see a doctor

            You should seek help from a doctor If you feel that premature ejaculation is damaging your quality of life. Here are a few examples that may indicate it’s time for you to seek help from a medical professional:

            • The condition is putting your relationship under strain
            • Your self-confidence has been damaged
            • Your mental health is suffering
            • You feel ashamed and discouraged from engaging in sexual activity

                It’s important that you feel comfortable enough to come forward and discuss your issues with a doctor. Medical professionals are used to dealing with an array of conditions and offer a safe, judgment-free space. Seeking out professional help is a key step in recovering from PE and your doctor will be able to offer their expertise to help you find a solution.

                Summary

                Premature ejaculation is the most common sexual dysfunction in men. Although some men feel there is a stigma surrounding the disorder, getting treatment is nothing to be ashamed of. By reading this article, you have already been proactive in seeking help.

                There are many solutions out there including edging, kegels, decreasing sensitivity and medication. However, if you feel that premature ejaculation has started to affect your quality of life and you need extra support, always consult your doctor.

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