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Premature ejaculation

Contents of this page:

Illustrations

Male reproductive system
Male reproductive system

Definition    Return to top

Premature ejaculation occurs when a man has an orgasm sooner during intercourse than he or his partner wishes.

Causes    Return to top

Premature ejaculation is a common complaint. It is only rarely caused by a physical problem.

Premature ejaculation early in a relationship is most often caused by anxiety and too much stimulation. Guilt and other psychological factors may also be involved. The condition usually improves without treatment.

Symptoms    Return to top

The man ejaculates before he or his partner would like (prematurely). This may range from before penetration to a point just after penetration. It may leave the couple feeling unsatisfied.

Exams and Tests    Return to top

There usually are no abnormal findings with the condition. The health care provider can get more useful information from interviewing the person or couple.

Treatment    Return to top

Practice and relaxation should help you deal with the problem. Some men try to distract themselves by thinking non-sexual thoughts (such as naming baseball players and records) to avoid getting excited too fast.

There are several helpful techniques you can try.

The "stop and start" method:

The "squeeze" method:

Antidepressants such as Prozac and other selective serotonin reuptake inhibitors (SSRIs) may be helpful because one of their side effects is to prolong the time it takes to reach ejaculation.

You can apply a local anesthetic cream to the penis to reduce stimulation. Decreased feeling in the penis may delay ejaculation. Condom use may also have this effect for some men.

Evaluation by a sex therapist, psychologist, or psychiatrist may help some couples.

Outlook (Prognosis)    Return to top

In most cases, the man is able to learn how to control ejaculation through education and by practicing the simple techniques outlined. Chronic premature ejaculation may be a sign of anxiety or depression. A psychiatrist or psychologist can help treat these conditions.

Possible Complications    Return to top

When to Contact a Medical Professional    Return to top

Call for an appointment with your health care provider if you are having a problem with premature ejaculation and it does not respond to techniques such as those described above.

Prevention    Return to top

There is no way to prevent this disorder. However, relaxation can make it less likely to occur.

References    Return to top

Lue TF, Broderick GA. Evaluation and Nonsurgical Management of Erectile Dysfunction and Premature Ejaculation. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 22.

Moore DP, Jefferson JW. Premature Ejaculation. In: Moore DP, Jefferson JW, eds. Handbook of Medical Psychiatry. 2nd ed. Philadelphia, Pa: Mosby Elsevier; 2004: chap 103.

Update Date: 9/7/2008

Updated by: Linda Vorvick, MD, Seattle Site Coordinator, Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Louis S. Liou, MD, PhD, Assistant Professor of Urology, Department of Surgery, Boston University School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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