Premature Ejaculation

Premature ejaculation is ejaculation that occurs too early, usually before, upon, or shortly after penetration.

Many males, especially adolescents, ejaculate sooner than they or their partners would like. Premature ejaculation is not just ejaculation that occurs before a man wants it to but rather ejaculation that occurs very soon--often within a minute or two--after penetration.

Many experts believe that premature ejaculation almost always results from anxiety or other psychologic causes. Others think that unusually sensitive penile skin may be a cause. Premature ejaculation is rarely caused by a disease, although inflammation of the prostate gland or a nervous system disorder can cause the condition.

Premature ejaculation can distress a man and his partner. If the man ejaculates too early, the partner may be left unsatisfied sexually and may become resentful.

Behavior modification therapy can help most men overcome premature ejaculation. A therapist provides reassurance, explains why premature ejaculation occurs, and teaches the man strategies for delaying ejaculation.

Other methods that can help a man delay ejaculation include drug treatment (with a selective serotonin reuptake inhibitor such as fluoxetine, paroxetine, or sertraline), application of an anesthetic to the penis, and use of condoms, which tend to decrease sensation. Sometimes a combination of drug treatment and behavioral therapy enables a man to delay ejaculation even longer than he might be able to with only one of these treatments. When premature ejaculation is caused by more serious psychologic problems, psychologic therapy may help.

See the sidebar The Stop-and-Start Technique.