30% of the world’s global population of adult men experience premature ejaculation (PE) – the most common sexual performance issue men face.
PE is defined by the DSM-5 as an ejaculation that happens in the middle of sexual activity within sixty seconds of penetration before the person wants it and without a known medical reason for it happening. Premature ejaculation would also have to cause distress to fall under this category.
Like many sexual dysfunctions, PE can have different levels of severity. Mild PE is usually categorized as ejaculating 30 seconds to a minute after vaginal penetration. Severe PE, however, can result in ejaculation at the very beginning of sexual stimulation or penetration.
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What are the leading causes of PE?
The jury is out on what exactly causes PE, but the current research points toward psychological and emotional factors that may lead to its development, such as the following:
- Depression and anxiety. Depression and anxiety share close links to premature ejaculation. This is supported by a 2016 study linking men with depression having a higher likelihood of developing PE, as did a 2014 study suggesting that sexual performance anxiety had a close relationship to premature ejaculation symptoms.
- Stress. As with depression and anxiety, stress is a known risk factor for sexual dysfunctions such as erectile dysfunction (ED) and premature ejaculation.
- Emotions such as guilt. Feeling a sense of guilt about engaging in sexual activity can diminish a person’s sexual performance, which plays a role in PE and ED.
- Low self-esteem or confidence issues. Self-esteem-related issues such as body dysmorphia or having a low opinion of one’s body image can lead to discomfort and anxiety about having sex, leading to PE.
- Relationship difficulties. Certain relationship issues can interfere with overall sexual function and health and may manifest in premature ejaculation or erectile dysfunction. They could also exacerbate existing relationship problems with a person’s partners.
- Traumatic events such as past sexual abuse. Trauma from past sexual relationships may increase your chances of developing PE, as they are linked to mental and emotional distress in adulthood.
Physiological factors may also play a role in PE, such as fluctuations in hormonal levels such as testosterone, or a urethral or prostate infection may interfere with ejaculation.
How is psychologically-induced PE treated?
PE can be difficult to deal with, especially when it meddles with your ability to hold down your sexual relationships and enjoy sexual satisfaction and intimacy.
Fortunately, premature ejaculation can be treated regardless of its cause.
PE treatment ranges from employing psychotherapy to address any potential mental health issues, performing techniques that may help delay ejaculation, using topical products, or taking prescription medications. Here’s a rundown of each PE treatment option.
Psychotherapy
Psychotherapy can be a boon to PE caused by negative emotions, feelings, thoughts, anxiety, and depression. This treatment method involves talking about the aforementioned things with a mental health practitioner or in a support group.
This treatment method can help reduce anxiety about sexual performance and psychological issues exacerbated by symptoms of premature ejaculation. However, you need to be able to commit the discipline, time, and effort to attend therapy sessions.
To reinforce your therapy, your mental health provider might prescribe supplemental prescription medication to take simultaneously, since the law of diminishing returns has been observed in this treatment method – meaning its effectiveness decreases over time. Medications such as antidepressants and anti-anxiety medicines may be prescribed by your mental health provider for this reason.
Behavioral Techniques That Prolong Time to Ejaculation
Behavioral techniques thought to help prolong sexual activity before ejaculation has had some proponents. These include the “stop-start” technique, the “squeeze” technique, and masturbating before sex.
The “stop-start” technique basically means pausing sexual activity or stimulation just as you feel that you’re about to climax and ejaculate.
On the other hand, the squeeze technique pertains to the act of squeezing the shaft and head of your penis as you feel like orgasming and cumming, inhibiting the urge to ejaculate and helping you last longer in bed.
These two techniques are simple, quick fixes to PE that are worth trying on their own or combined with other approaches.
Lastly, masturbation before sex is exactly what its name suggests. Precoital masturbation employs the penis’ refractory period, making it harder for you to prematurely ejaculate. A word of caution: there’s not much science behind the effectiveness of these techniques, so your mileage may vary.
Topical Products to Delay Ejaculation
Topical medications that reduce sensations that could cause you to ejaculate prematurely can be used to help delay ejaculation. These confidence-boosting products can be found as wipes, creams, and sprays, which contain topical anesthetics such as lidocaine that may help you last longer in bed without totally making your penis numb.
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Off-Label Prescription Medications
Several medications, such as selective serotonin reuptake inhibitors or SSRIs, have been used off-label to treat PE. However, no FDA-approved medication exists for the condition. These include drugs such as Prozac, Zoloft, Paxi, or Lexapro. They work by boosting serotonin levels in your brain and body. Low serotonin levels are thought to cause premature ejaculation, shortening the time it takes to do so.
The research thus far supports the notion that SSRIs work well as off-label treatments for PE, with a review on sertraline (Zoloft) resulting in improved ejaculation times and sexual satisfaction outcomes in men with PE.
The final word on premature ejaculation treatment
The exact cause of PE is still up in the air; however, the existing research points to psychological reasons playing a partial role in its development.
Mental health issues such as stress, anxiety, depression, and low confidence have been linked as risk factors for premature ejaculation, just as negative thoughts and behaviors related to sex do.
If you are experiencing symptoms of premature ejaculation and suspect a psychological cause behind them, seeing a mental healthcare provider might benefit you.
Premature ejaculation is a common sexual dysfunction that is absolutely treatable with the right approach using the right medicine, behavioral techniques, mental health care, helpful products, or a combination of any of them.
And yes, you can control your PE and have a more enjoyable, satisfying, and thrilling sex life. It’s possible.
