What is premature ejaculation?
Premature ejaculation means repeatedly ejaculating earlier than desired, with limited ability to delay it and associated distress.
Timing alone does not establish the diagnosis. Occasional early ejaculation is common and does not necessarily require treatment.
It may be lifelong, beginning with the first sexual experiences, or acquired, developing after a period of satisfactory control.
What causes it?
The cause is not always clear. Biological factors, anxiety, stress and relationship difficulties may contribute. Acquired premature ejaculation can accompany erectile dysfunction, prostate inflammation or an overactive thyroid.
How is it assessed?
It is not necessarily a sign of low testosterone or “weakness.”
The doctor asks about onset, frequency, perceived control, erection quality, medications and the effect on your wellbeing. A focused examination may help identify contributing conditions.
Blood tests and scans are not routinely needed; they are selected according to symptoms and examination findings.
What treatments are available?
Treatment is selected according to the type of premature ejaculation, contributing conditions and your preferences.
| Option | What patients should know |
|---|---|
| Treating contributing conditions | Managing associated erection difficulties or another identified condition may help. |
| Counselling and behavioural techniques | Can address anxiety and communication. The stop–start technique involves pausing stimulation before ejaculation and resuming when the urge settles. |
| Topical anaesthetics | Prescribed creams or sprays reduce sensitivity. Follow instructions to avoid excessive numbness or transfer to your partner. |
| Prescription tablets | Options include on-demand dapoxetine, where available, or selected daily medicines such as certain SSRIs. Suitability, interactions and side effects require medical review. |
Combining approaches may be appropriate. Do not start or combine medicines yourself.
Common questions
Why prescribe an antidepressant?
Some medicines in this group also delay ejaculation. Their use does not mean you have depression.
Will treatment cure it permanently?
Results vary. Some men need ongoing treatment; improvement may depend on addressing contributing factors.
Do I need surgery?
Surgery is not standard treatment. Procedures that cut penile nerves are not recommended because of safety concerns.
When should I seek help?
Seek assessment if the problem recurs or causes distress—particularly if it starts suddenly or accompanies erection difficulties, painful ejaculation or urinary symptoms.
Medical references
- European Association of Urology — Disorders of ejaculation ↗
- International Society for Sexual Medicine — What is premature ejaculation? ↗
- NHS — Ejaculation problems ↗
General patient education; assessment and treatment should be individualised.