Premature ejaculation is a condition where ejaculation happens sooner than you or your partner would like, either shortly after penetration or during other sexual stimulation, with little or no control over when it occurs.

Healthcare professionals generally diagnose premature ejaculation when it:

• Happens consistently or most of the time
• Occurs within around two minutes of penetration (lifelong PE) or much sooner than previously (acquired PE)
• Causes frustration, anxiety or relationship difficulties
• Results in a lack of control over ejaculation

There are two main types:

Lifelong premature ejaculation

This type has been present since a man’s first sexual experiences and is thought to be linked to the way the brain and body naturally work.

Acquired premature ejaculation

This develops later in life after previously normal ejaculation. It is often linked to stress, anxiety, erectile dysfunction or underlying medical conditions.

Occasional early ejaculation is common and usually isn’t a cause for concern. Treatment is generally recommended when the problem becomes persistent and starts affecting quality of life.

There isn’t one single cause of premature ejaculation. In many cases, it results from a combination of psychological and physical factors.

Psychological causes

Psychological factors are particularly common in acquired premature ejaculation and may include:

• Performance anxiety
• Relationship problems
• Stress
• Depression
• Low self-esteem
• Previous negative sexual experiences
• Anxiety often creates a cycle where worrying about ejaculating too quickly makes it more likely to happen again.

Physical causes

Some men develop premature ejaculation due to underlying physical factors, including:

• Erectile dysfunction
• Hormonal imbalances
• Prostate inflammation (prostatitis)
• Thyroid disorders
• Increased penile sensitivity
• Differences in serotonin signalling within the brain

Treating any underlying medical condition can often improve symptoms.

The most effective treatment depends on the underlying cause, how long you’ve experienced symptoms and whether you also have erectile dysfunction. 

For most men with persistent premature ejaculation, prescription medication offers the quickest and most reliable improvement, particularly when combined with behavioural techniques.

You should consider seeking treatment if:

• Premature ejaculation happens during most sexual encounters.
• You feel unable to control when you ejaculate.
• It is affecting your confidence, relationships or mental wellbeing.
• The problem has developed suddenly after previously normal sexual function.
• You also experience erectile dysfunction or pelvic pain.

Early assessment can help identify the underlying cause and ensure you receive the most appropriate treatment.