Premature ejaculation (PE) occurs when a man ejaculates before he or his partner would like. It can happen before intercourse or immediately upon penetration. Most men experience premature ejaculation at some point in their life. It usually isn’t a problem unless it happens on a chronic basis.

PE is classified as either lifelong or acquired.

Lifelong premature ejaculation typically occurs within one minute of vaginal penetration during all or nearly all sexual encounters. Lifelong premature ejaculation is a source of stress and frustration. Men who grapple with it can suffer from anxiety and depression, and often avoid sexual intimacy.

Acquired premature ejaculation carries all of the same symptoms of lifelong PE, except men in this category have previously enjoyed satisfactory sex without premature ejaculation.

Biological causes of premature ejaculation include erectile dysfunction and underlying health issues that contribute to erectile dysfunction. Other physical causes can include abnormal hormone and neurotransmitter levels, thyroid problems, inflammation and infections of the prostate or urethra. Certain medications can also play a role.

Psychological causes can include unpleasant or traumatic early sexual experiences, guilt associated with religious or cultural beliefs, performance anxiety and relationship difficulties. 

Treatment options for premature ejaculation include sexual therapy, psychotherapy and medications. Antidepressants such as Prozac, Zoloft, Paxil and other selective serotonin-reuptake inhibitors are often prescribed because delayed ejaculation is a side effect of antidepressants.

Topical anesthetic creams containing lidocaine or prilocaine may be prescribed to dull feeling in the penis and help delay ejaculation. Applied a short time before intercourse, the cream is wiped off once sensation to the penis has been dulled enough to help delay ejaculation.

Tactics for delaying ejaculation such as the stop-and-start technique and squeeze technique may also be recommended.

For men whose PE is not attributed to physical or medical conditions, sexual therapy, talk therapy and psychotherapy may be helpful.