Premature ejaculationCauses, symptoms, treatments

Premature ejaculation is the persistent or recurrent inability to delay ejaculation during sexual intercourse, occurring before the person wishes it, typically within 1 to 3 minutes after penetration. It can be primary (present since first sexual experiences, affecting about 2-5% of men) or secondary (developed after a period of normal sexual function, more common and affecting 10-12% of men). Premature ejaculation is often accompanied by personal distress, anxiety, and can affect quality of life and intimate relationships. It is important to note that this sexual disorder is very common and can be effectively treated in the majority of cases. Consultation with a doctor or sex therapist allows identification of the cause and implementation of appropriate treatment.

Premature ejaculation is the most common male sexual disorder and can occur at any age, from adolescence to old age. Between 20 and 30% of men regularly experience it, regardless of age, although prevalence is slightly higher in young men (30-35% before age 30). Occasional episodes of rapid ejaculation are normal, especially early in sexual life, after a long period of abstinence, or during intense stress situations. Premature ejaculation disorder is diagnosed when the problem persists for at least 6 months and occurs in more than 75% of sexual encounters. Medical consultation helps identify specific causes (performance anxiety, glans hypersensitivity, neurological factors, hormonal problems) and propose strategies adapted to your personal situation. This problem is not inevitable and does not define your masculinity.

Treatments for premature ejaculation are varied and can be combined for optimal effectiveness. Behavioral exercises include the squeeze technique (60-70% effectiveness) and start-stop method, which help better recognize pre-ejaculatory sensations. Topical anesthetic creams and sprays containing lidocaine or prilocaine can delay ejaculation by 5 to 10 minutes by reducing glans sensitivity. Medications include Dapoxetine (SSRI specifically developed for PE, 70-80% effectiveness), or certain low-dose SSRI antidepressants (paroxetine, sertraline) that increase ejaculatory latency time by 2 to 4 times. Sex therapy and cognitive-behavioral therapy treat psychological aspects (performance anxiety, trauma). A combined approach associating behavioral techniques, therapy, and sometimes medications is often most effective, with success rates reaching 85-90%. Medical consultation determines the most appropriate treatment for your situation.

Some natural approaches can help improve ejaculatory control, although their effectiveness is generally moderate compared to medical treatments. Deep breathing and relaxation exercises (cardiac coherence, mindfulness meditation) reduce performance anxiety and increase body awareness. Kegel exercises strengthen pelvic floor muscles, allowing better control of ejaculatory reflexes with improvement observed in 40-50% of men practicing regularly (3 sets of 10 contractions, 3 times daily for at least 3 months). Regular yoga practice and mindfulness techniques help manage stress and improve mind-body connection. Some supplements like zinc (important for hormone production) and magnesium may have modest beneficial effects. Regular physical activity improves self-confidence and reduces anxiety. However, the effectiveness of these natural approaches varies considerably depending on individuals and underlying causes. For severe premature ejaculation cases, combination with medical treatments often remains necessary.

Yes, it's potentially risky. Many unregulated delay products sold online or in certain stores may contain irritating substances, excessive concentrations of local anesthetics, or undeclared ingredients that can cause significant side effects. Risks include allergic reactions (redness, itching, swelling), complete loss of sensitivity making erection difficult to maintain, transfer of anesthetic to partner reducing their pleasure (about 20-30% of cases), and in rare cases, more serious complications like chemical burns or systemic reactions. Products certified as medical devices containing lidocaine or prilocaine in controlled concentrations (typically 5-10%) are safer but still require proper use. It is essential to respect application time (generally 15-30 minutes before intercourse) and clean if necessary before penetration. Always consult a healthcare professional (doctor, sex therapist, pharmacist) before using any treatment for premature ejaculation to obtain appropriate and safe recommendations.

You should consult a doctor or sex therapist if this problem persists for more than 6 consecutive months, if you systematically ejaculate within 1 to 2 minutes after penetration in more than 75% of your intercourse, if this situation causes significant personal distress or affects your self-esteem and confidence, if it creates tension or conflicts in your relationship, or if you avoid sexual intercourse because of this anxiety. Consultation is also recommended if premature ejaculation appeared suddenly after a period of normal sexual function (secondary premature ejaculation), as this may indicate an underlying medical cause such as prostatitis, hormonal or thyroid problem. A complete professional evaluation will identify specific causes (psychological, biological, relational) and propose personalized and effective solutions. Remember that this problem affects 1 in 3 men at some point in their lives and talking to a healthcare professional is a courageous and constructive step. The earlier you consult, the faster and more effective treatments will be.

In the majority of cases (70-80%), premature ejaculation is related to psychological factors (performance anxiety, stress, past negative sexual experiences) or sexual habits (frequency of intercourse, habitual rapid masturbation). However, in 20-30% of cases, it may be associated with underlying medical conditions that are important to identify. Possible organic causes include chronic prostatitis (prostate inflammation present in 8-12% of men with PE), hormonal imbalances such as hyperthyroidism (overactive thyroid) or low testosterone, neurological problems affecting sensitivity, or underlying erectile dysfunction (35-40% of men with erectile dysfunction develop compensatory premature ejaculation). Some medications (stimulants, decongestants) may also contribute to the problem. Medical consultation allows for a complete assessment (physical examination, blood tests if necessary, urological evaluation) to rule out any underlying health problems and propose targeted treatment. In the vast majority of cases, once the cause is identified, treatment is very effective.

Yes, absolutely. Psychological factors are the primary cause in 50-70% of primary premature ejaculation cases and contribute significantly in almost all cases of premature ejaculation. Performance anxiety is the most common factor: fear of not satisfying your partner or not controlling ejaculation creates tension that paradoxically accelerates the ejaculatory reflex. Chronic stress (professional, financial, family) increases cortisol and adrenaline levels, hormones that can disrupt normal sexual response. Relationship concerns, unresolved conflicts with partner, or insufficient communication about sexual needs often worsen the problem. Past negative sexual experiences, trauma, or repressive sexual education can also play a role. Societal and media pressure to "perform well" sexually creates unrealistic expectations. The vicious cycle is common: premature ejaculation generates anxiety, which itself worsens the problem. Stress management techniques (meditation, breathing, physical exercise), cognitive-behavioral therapy (60-70% effectiveness), and open communication with partner prove very beneficial. In some cases, temporary medication treatment can help break this cycle by restoring confidence.

Premature ejaculation can generally be treated very effectively and is absolutely not permanent. Treatment success rates are excellent: with an appropriate combination of behavioral therapies (60-70% improvement), relaxation techniques, and medications (70-80% effectiveness for Dapoxetine), approximately 85-90% of men manage to significantly improve their ejaculatory control. Ejaculatory latency time can be multiplied by 3 to 5 times with appropriate treatments. For primary premature ejaculation (present since always), regular behavioral exercises over 3 to 6 months often allow lasting improvement. For secondary premature ejaculation (acquired), identifying and treating the underlying cause (prostatitis, anxiety, relationship problems) generally resolves the problem. Individual or couple sex therapy improves the situation in 65-75% of cases. Perseverance and patience are important in this process: results typically appear after 4 to 8 weeks of regular treatment. Partner involvement in the therapeutic process significantly increases chances of success. Even after improvement, regular practice of learned techniques helps maintain long-term benefits.

The diagnosis of premature ejaculation is primarily based on a detailed and confidential medical interview. The doctor or sex therapist will evaluate several aspects: complete sexual history (age of sexual activity onset, when problem started, evolution over time), frequency and duration of problem (systematic ejaculation in less than 1 minute = severe PE, 1-2 minutes = moderate PE), context (with all partners or only certain ones, also during masturbation), psychological and relational impact (distress, avoidance, couple conflicts), and medical history and current treatments. The doctor often uses validated questionnaires like IELT (Intravaginal Ejaculatory Latency Time) or PEDT (Premature Ejaculation Diagnostic Tool) to objectify the problem. A physical examination may be performed to check prostate condition, genitals, and neurological reflexes. Blood tests may be prescribed if a hormonal cause is suspected (testosterone, prolactin, thyroid hormones). In some cases, a more thorough urological evaluation is necessary. This complete assessment allows for precise diagnosis, differentiation of primary from secondary premature ejaculation, identification of contributing causes, and proposal of a personalized and effective treatment plan.