What are the Causes, Symptoms & Treatments Premature Ejaculation?

NOTICE: This article is for educational and medical purposes only. It does not contain explicit or adult content.

Premature ejaculation is one of the most common and misunderstood intimate health disorders in men. Although it affects millions worldwide, many men hesitate to talk about it or seek help. Yet understanding what causes it, how to recognize it, and what treatments exist can greatly improve sexual confidence and overall well-being.

Premature Ejaculation: Causes, Symptoms & Treatments

This article explains the different types of premature ejaculation, its psychological and physical causes, its impact on relationships and fertility, and the most effective medical and behavioral treatments available today.

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Everything You Need to Know About Premature Ejaculation: Causes, Symptoms & Treatments

Premature ejaculation is the most common sexual concern among young men. It affects 20–30% of men under 30, compared with 22% of men aged 40–50 and 23% of men aged 50–60.

What exactly is premature ejaculation? How is it different from anejaculation? Can it cause infertility? Are there effective treatments? How can you prevent it? Here is a complete, easy-to-understand guide.

What Is Premature Ejaculation?

Premature ejaculation is defined as the inability to control when ejaculation happens. It occurs when a man ejaculates earlier than he or his partner would like—so quickly that sexual intercourse becomes difficult or nearly impossible.
In more severe cases, ejaculation happens before penetration or within a few seconds or minutes after it begins.

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This condition can affect male sexual health, self-esteem, relationships, and overall emotional well-being.

Premature ejaculation can be either:

• Primary premature ejaculation

• Secondary (acquired) premature ejaculation

Primary Premature Ejaculation

According to the DSM-V (Diagnostic and Statistical Manual of Mental Disorders), primary premature ejaculation is diagnosed when ejaculation occurs:

• Before vaginal penetration, or

• Within less than one minute after penetration and has been present since the very first sexual experiences.

This condition creates an inability to control what becomes a reflex response. It often leads to emotional distress, frustration, lowered self-esteem, and relationship difficulties.

Secondary or Acquired Premature Ejaculation

Acquired premature ejaculation occurs when a man who previously had normal control begins experiencing symptoms—either suddenly or gradually.

Causes of Premature Ejaculation

Premature ejaculation may have psychological or physical origins. Here are the most common causes.

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Psychological Causes

Often, the anxiety caused by the problem becomes a cause itself. Guilt, shame, and emotional tension also play a major role. Other contributing psychological factors include:

• Anxiety and stress – They prevent relaxation and keep the body in a constant state of alert, influencing ejaculation directly.

• Depression – Affects libido, sexual desire, and motivation.

• Low sexual activity – Lack of regular sexual practice can increase pressure, anxiety, and arousal.

• Relationship conflicts – Couples’ issues, especially those involving intimacy, can create emotional blocks.

• Early conditioning or poor sexual education – Early sexual experiences involving shame, fear, or pressure can limit long-term control.

Physical Causes

Certain medical factors may also contribute:

• Leptin abnormalities and serotonin receptor dysfunction – These can disrupt sexual desire and hormonal control, affecting ejaculation timing.

• Chronic prostatitis – Inflammation of the prostate may harm libido and erectile function, increasing sexual performance anxiety.

• Erectile difficulties – Erectile problems and premature ejaculation are different conditions, but they often coexist.

Consequences of Premature Ejaculation

Premature ejaculation can reduce quality of life by causing:

• low self-confidence

• anxiety and stress

• depression

• relationship problems

• avoidance of intimacy

It may also lead to secondary erectile dysfunction, triggered by fear or insecurity.

Impact on Fertility

In rare cases, infertility may occur when ejaculation never happens inside the vagina.
If pregnancy does not happen after one year of attempts, a specialist may recommend assisted reproductive techniques (ART).

How to Know If You Have Premature Ejaculation?

Here are the main signs:

1. Very Rapid Ejaculation

Ejaculation typically occurs in under one minute after penetration and earlier than desired by both partners.

2. Lack of Control

The man cannot delay ejaculation despite efforts to do so, often feeling an urgent need to climax.

3. Discomfort During Sex

This leads to frustration, anxiety, insecurity, and reduced sexual satisfaction.

4. Difficulty Maintaining an Erection

Anxiety caused by premature ejaculation can make it harder to stay erect.

Premature Ejaculation vs. Anejaculation

Before distinguishing them, here’s how ejaculation normally works:

Ejaculation occurs after puberty and is usually triggered by orgasm. During orgasm, 2–5 ml of semen are expelled from the urethra.

This reflex involves both the nervous and hormonal systems and includes four stages:

• desire
• erection
• orgasm
• ejaculation (sperm expulsion)

Two phases coordinate the process:

Emission phase – Seminal fluids and sperm accumulate in the urethra.

Expulsion phase – Pelvic muscles contract, pushing semen out.

A key measurement is the Intravaginal Ejaculatory Latency Time (IELT)—the time between penetration and ejaculation.

Research shows:

• Average IELT across five countries: about 5 minutes
• Ages 18–30: slightly above 6 minutes
• Men over 50: about 4.3 minutes.