Sex 27

What is premature ejaculation?

5 min read

Simon Körösi

Reviewed by: Joanna Elmes

Premature ejaculation (PE) is a condition characterised by ejaculation occurring within a minute of penetration, with the individual having minimal or no control over the event.

In recent years, the concept of IELT (Intravaginal Ejaculatory Latency Time) has gained acceptance. By this measure, an IELT of 1 minute or less is taken to indicate explicit PE, 1-2 minutes is seen as borderline PE, and IELT exceeding 2 minutes falls within the broader range of normal variation.

PE is further categorised as either lifelong (primary) or acquired (secondary). Lifelong PE is present if the issue has always, or almost always, occurred since one's first sexual encounter. Acquired PE, on the other hand, develops after prior sexual experiences without ejaculation issues.


How can I identify if I'm suffering from premature ejaculation?


If you frequently find yourself ejaculating within a minute or two following penetration, and this occurs uncontrollably, causing frustration, distress and/or discomfort, you may be experiencing premature ejaculation. This is a concern that needs to be addressed. To gain a better understanding of your situation and to receive advice and assistance, it is advised to consult your healthcare provider.


How common is premature ejaculation?


In Sweden, it is estimated that overt premature ejaculation (occurring most of the time, nearly always or always) affects roughly 5-8% of the adult male population. Occasional premature ejaculation (happening infrequently or every so often) is substantially more common, with an estimated prevalence close to 40% among adult males between the ages of 18-74 years. The condition becomes more prevalent with age. Premature ejaculation is closely associated with low libido or a lack of sexual interest, as well as erectile dysfunction.


What is the average duration before ejaculation during sexual intercourse?


Recent epidemiological studies suggest an average intravaginal ejaculatory latency time (IELT) between 5 and 14 minutes. There have been debates as to whether circumcised men have a longer IELT, but these findings have not been substantiated.


What leads to premature ejaculation?


The root cause of premature ejaculation is multifactorial, and the exact origin isn't entirely understood. In men with lifelong overt premature ejaculation, there may be a genetic component, while a dysregulation in the central nervous system is recently believed to play a significant role in premature ejaculation.

The prevailing theory is that it is a combination of biological, psychological, and interpersonal factors

Biological factors contributing to premature ejaculation include disturbances in neurotransmitters, principally serotonin, but also encompassing oxytocin, nitric oxide, GABA, and oestrogen, in addition to genetic factors. Psychological contributors encompass performance anxiety, heightened stress levels, and low self-esteem. Medical conditions such as erectile dysfunction, prostate issues, and chronic substance misuse are also recognised potential risk factors that can contribute to the onset of PE. Interpersonal factors known to influence the prevalence of PE incorporate relationship difficulties, traumatic sexual experiences, and a perceived deficiency of intimacy.


How can premature ejaculation be prevented?


There are numerous self-help strategies that can be explored prior to intercourse and before considering seeking medical intervention:

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Utilising a thick condom


Taking intervals during intercourse


Distracting oneself by attempting to concentrate on something different

What does an investigation into premature ejaculation entail?


An investigation typically involves a doctor conducting a physical examination, which includes a check of the prostate gland, with the aim of understanding the patient's social history, inclusive of both alcohol and other drug use, as well as the complexities of the ejaculatory problem.

What are the treatment options for premature ejaculation? Currently, the treatment for premature ejaculation (PE) typically involves one or a combination of the following:








The pharmacological approach to treating PE usually involves one of the following:



Topically applied anaesthetic

The more commonly employed treatment is SSRI, which is taken either on a daily basis or a few hours before planned sexual activity.




Psychotherapy aims to reduce stress and anxiety related to performance. Various techniques can also be recommended, which can be practised alone or with a partner.




The Start-and-Stop Technique
A proven method to extend the duration before ejaculation is the "start-and-stop technique". This approach focuses on enhancing bodily awareness. The idea involves ceasing stimulation just before reaching the point of ejaculation and repeating this process. It's advised to incorporate this technique with couples counselling.

Pelvic Floor Exercises
Some suggest that a weak pelvic floor may contribute to premature ejaculation. One potential strategy could be to strengthen the pelvic floor.


When should medical assistance be sought for premature ejaculation?


Occasional premature ejaculation doesn't inherently necessitate concern. However, you should consider seeking medical assistance if you:

Always or nearly always feel like you ejaculate within 2 minutes of penetration


Always or nearly always feel that you cannot delay ejaculation during sex


Tend to avoid sexual intimacy due to premature ejaculation


Experience distress and frustration as a result of premature ejaculation