Premature Ejaculation – Types, causes and cures

The sudden ejaculation

Rohan was making out with his girlfriend when he suddenly ejaculated. Not only did it end all and any prospect of taking things forward like they both wanted to but it also left Rohan feeling extremely embarrassed. He sheepishly made an excuse to cut short the date. 

Days later, it happened again. He was watching porn, and felt an orgasm come on without any stimulation. Before he could even make sense of the sensation, he had ejaculated. The two back-to-back incidents had him wondering whether he was suffering from premature ejaculation. Given his young age, Rohan has been extremely worried about what it means for his sex life. 

Understandably, this can be an unnerving experience for anyone. However, the thing with premature ejaculation is that the more you stress about it, the worse it can get. That’s why, to ease the worries of Rohan and others like him, we decided to look deeper into the possible causes and cures of premature ejaculation. 

What is Premature Ejaculation? 

As the term suggests, premature ejaculation refers to the phenomenon of ejaculation or before you want to. And because of that, you may experience difficulty in holding an erection for long or continuing with intercourse for a satisfactory duration. While this condition doesn’t pose any health risk, it can be extremely embarrassing and frustrating to live with. 

Premature ejaculation can interfere with you ability to lead a robust sex life, as you may struggle to both enjoy fulfilling sex as well as satisfy your partner in bed. As a result, for some men, premature ejaculation can give way to intimacy issues and have a damaging impact on their relationships. 

However, this condition is more common than most people think. Nearly 30 to 40% of men experience it at some point. The good news is that experiencing it once – or even more than a few times in a row- doesn’t mean that you’re doomed to live with. There are different ways to manage and treat premature ejaculation. 

What are the symptoms of Premature Ejaculation? 

Of course, one of the most telling signs of premature ejaculation is that you ejaculate prematurely. But that happens to a lot of men, and more than once. Does a one-off incident mean you’re dealing with premature ejaculation? Well, no. It can be classified as a condition warranting medical attention, if you experience the following: 

• Almost always ejaculating before or under a minute of penetration 
• Not being able to delay ejaculation 
• Inability to hold an erection for long 
• Occasional incidents of ejaculating without any physical stimulation to the penis 

Premature ejaculation can also lead to secondary symptoms such as:

• Intimacy issues 
• Decreased connection with the partner 
• Mental distress and frustration 
• Anxiety 
• Depression 

What causes Premature Ejaculation? 

The causes for premature ejaculation can be psychological as well as physiological. In the case of younger males, the former is most commonly the case. Some of the most common underlying triggers for premature ejaculation include: 

• Low levels of feel good hormone serotonin 
• Performance anxiety in case of new relationships or first sexual encounter with a new partner
• High levels of sexual arousal 
• Unrealistic expectations about one’s own sexual performance 
• Sexual repression 
• Relationship issues 
• Body image issues 
• Lack of confidence 
• Stress 
• Guilt 
• Mental health issues such as anxiety or depression 
• Age 
• Unhealthy or underperforming prostate 
• Weakened pelvic floor muscles 
• Genetics 

What are the types of Premature Ejaculation? 

Different people can experience premature ejaculation differently. For some, it is characterised by ejaculating sooner than a person or their partner wishes, typically within a minute or two of penile stimulation in the form of masturbation, hand job or intercourse. 

Whereas some people may ejaculate just by visual or mental stimulation such as watching porn, talking dirty with their partners, or any form of physical contact that may lead to sexual arousal such as kissing. 

Medically, premature ejaculation is classified into two types: 

• Primary premature ejaculation: In this type, the affected person has always experienced the problem. This happens largely due to psychological reasons such as a traumatic sexual experience or abuse during childhood 
• Secondary premature ejaculation: In this type, a person develops this condition at a later stage in life. The underlying factors can be psychological such as stress or relationship issues as well as physical such as excessive alcohol consumption, weakened pelvic floor muscles or prostatitis (inflammation of the prostate gland) 

What is the diagnosis for Premature Ejaculation? 

If the issue of premature ejaculation has been affecting your sex life, seeking a medical consult is always recommended. A doctor, generally a urologist or a sexologist, will diagnose it as a sexual disorder only if your experience meets the following criteria: 'Ejaculation with minimal sexual stimulation before or shortly after penetration and before the person wishes it. The condition is persistent or occurs frequently and causes significant distress.'

To make that assessment, they will ask you a series of detailed questions, look into your sexual history and do a physical exam. 

What is the cure for Premature Ejaculation? 

In most cases, premature ejaculation can be managed without any treatment. Your doctor may advise certain changes in your sexual routine such as masturbating shortly before intercourse to delay ejaculation or experiment with means other than penetration for sexual gratification. This is often done to break the pattern and the stress that comes with it. 

However, if premature ejaculation persists and is causing you mental distress, anyone of the following treatments can be recommended: 

Therapy 

If your doctor deduces that the reasons for this disorder are psychological, you may be advised to go into individual or couple’s counselling. Working with a sex therapist as a couple is also commonly recommended. 

Behavioural treatment 

This is another common – and the most successful – approach for treating premature ejaculation. This includes two methods: 

• Start-and-Stop method: In this method, either you or your partner will stimulate the penis until you start feeling the sensation of an orgasm building up. At this point, the stimulation will be stopped for nearly 30 seconds to allow that sensation to pass without resulting in ejaculation. After which, the stimulation will begin again. This process is repeated 3 to 4 times before letting an orgasm happen. 
• The Squeeze method: The squeeze method is also based on the same principle of delaying ejaculation. In this approach, you or your partner will squeeze the head of the penis gently for about 30 seconds just as you feel that you’re about to cum. The process is repeated a few times before allowing an orgasm to happen. 

Pelvic floor exercises 

If premature ejaculation is the result of advancing age or weakening of muscles, you may be advised pelvic floor exercises like Kegel to restore strength and the ability to hold off an orgasm. 

Medical treatments 

If none of these treatment options work, your doctor may prescribe medicines to treat the condition. Some anti-depressants have proven effective in managing premature ejaculation. However, these can lead to side-effects such as nausea and drowsiness, and must not be taken unless prescribed by a medical practitioner. 

Dapoxetine is also prescribed for better management of premature ejaculation, as are some drugs used for treating erectile dysfunction. However, do not use these drugs without medical consultation. In addition to that, topical application of anaesthetic cream is also a common course of treatment. 

In many cases, the cure for premature ejaculation can be as simple as wearing a condom. Condoms might decrease the sensitivity of the penis and help you last longer.

Living with premature ejaculation isn’t easy, even if it impacts you temporarily. Seeking the right help from the right experts can go a long way in preventing your mental and sexual health from taking a hit. 

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Arushi Chaudhary is a freelance journalist and writer with 5 years of experience in print publications such as the Pune Mirror and Hindustan Times, and has spent close to a decade writing for digital platforms and print publications – The Tribune, BR International magazine, Make My Trip, Killer Features, The Money Times, and Home Review, to name a few. Of the many things she's written about over the years, exploring the space of love and relationships through the prism of psychology excites her the most. Writing is her first and forever love. You can find her on Twitter here.