Premature ejaculation:
causes, symptoms,
treatments and
medical care.
The most common male sexual disorder, premature ejaculation affects around 1 in 4 men, at any age. A specialised medical team assesses your situation in complete confidence and recommends the best course of action, from medication to behavioural techniques.
Online consultation
Confidential medical questionnaire in 5 minutes, reviewed by a doctor registered in the European Union.
Written medical report
Diagnosis, personalised care pathway and prescription if indicated, within 24 hours.
Discreet delivery
Treatment delivered to your home within 48 to 72 hours, in plain packaging, if prescribed.
Ongoing support
The Control programme in the app, medical follow-up and messaging with your doctor.
Doctors online
What is
premature ejaculation?
Premature ejaculation, also called rapid or early ejaculation, is ejaculation that always or nearly always occurs too soon (typically within 1 to 3 minutes of penetration), with an inability to delay it and a negative impact on your well-being or your relationship. Here is the medical summary to understand it in under a minute, before going further.
- 01The most common male sexual disorder: around 1 in 4 men is affected, at any age.
- 02Ejaculation within 1 to 3 minutes, an inability to delay it, and personal or relationship distress: the three diagnostic criteria.
- 03Two forms: lifelong (present since the first sexual experiences, mostly neurobiological in origin) and acquired (often psychological or medical).
- 04It is neither inevitable nor a lack of willpower: serotonin regulates the ejaculatory reflex, and that brake can be strengthened.
- 05Validated treatments exist: dapoxetine, local anaesthetics, behavioural techniques, sex therapy — often combined.
- 06An online consultation allows a full assessment and a prescription if indicated, in complete confidence.
Rapid ejaculation or a genuine disorder?
Occasional episodes of rapid ejaculation are normal: the start of your sex life, a long period of abstinence, stress. We speak of a disorder when three criteria are met (ISSM definition): a consistently short time to ejaculation (under 1 to 3 minutes), an inability to delay ejaculation in nearly all sexual encounters, and negative consequences: distress, frustration, avoidance of intimacy.
It is the impact on your well-being and your relationship that guides the decision to treat, not the stopwatch alone.
Lifelong or acquired: two distinct forms
Lifelong (primary) premature ejaculation has been present since the first sexual experiences: its origin is mostly neurobiological (serotonin regulation, penile hypersensitivity, family predisposition) and it responds well to on-demand treatments.
The acquired (secondary) form appears after a period without difficulty: it is often linked to a psychological, relationship or medical factor (erectile dysfunction, prostatitis, thyroid disorder). The doctor then looks for the cause and treats it as a priority.
How
common
is premature ejaculation?
Premature ejaculation is the most common male sexual disorder, well ahead of erectile dysfunction. Unlike the latter, its frequency does not depend on age: young men are affected just as much as older men. Yet fewer than 1 in 10 men dares to raise it with a doctor.
What are the
causes
of premature ejaculation?
Long considered purely psychological, premature ejaculation also has well-documented neurobiological foundations. In practice, the two dimensions intertwine: a biological predisposition, maintained or worsened by anxiety. This is why the best care combines medication with behavioural work.
Biological causes
- Serotonin dysregulation
Serotonin is the main brake on the ejaculatory reflex: low serotonergic tone shortens the time to ejaculation. It is the direct target of dapoxetine and SSRIs.
- Penile hypersensitivity
A lowered trigger threshold precipitates the reflex. It is the target of local anaesthetics (lidocaine/prilocaine), which reduce sensitivity without removing pleasure.
- Genetic predisposition
Familial forms of the lifelong variant have been described, associated with polymorphisms of the serotonin transporter.
- Chronic prostatitis
Inflammation of the prostate is found in a proportion of acquired forms. It can be detected and treated, and premature ejaculation often resolves with it.
- Hormonal disorders
Hyperthyroidism in particular can shorten the time to ejaculation. The disorder generally improves once the thyroid is brought back into balance.
Psychological and relationship causes
- Performance anxiety
The classic vicious circle: the fear of ejaculating too quickly increases tension and… precipitates ejaculation. Every encounter becomes a test.
- Stress and depression
Mental load, conflict, a depressive episode: your psychological state weighs directly on ejaculatory control.
- Early conditioning
Hurried or furtive first sexual experiences can establish a “rapid” reflex that persists into adulthood.
- Relationship difficulties
Tension, blame or a lack of communication keep the disorder going. Your partner is part of the solution, not part of the problem.
- Associated erectile dysfunction
The fear of losing the erection pushes men to “hurry up”. When both disorders coexist, the erection is treated first.
Premature ejaculation and
erectile dysfunction:
a frequent pair.
Nearly 1 in 3 men with erectile dysfunction also reports premature ejaculation. The two disorders feed each other, and the order in which they are treated changes everything.
The mechanism is well described: when a man fears losing his erection, he unconsciously speeds up intercourse to “finish in time” and establishes a rapid ejaculatory reflex. Conversely, the anxiety generated by premature ejaculation can end up undermining the erection. International guidelines (ISSM, EAU) are clear: when both disorders coexist, the erectile dysfunction is treated first. Once the erection is secured, premature ejaculation often improves on its own.
This is why the Kano questionnaire also asks about your erectile function: the doctor identifies the dominant disorder and builds the care pathway in the right order, rather than prescribing blindly.
Symptoms and
warning signs:
when to see a doctor?
Embarrassment, shame or the idea that “nothing can be done” hold most men back from seeking help: fewer than 1 in 10 raises it with a doctor. An online consultation lets you take stock in a few minutes and obtain an online prescription if a treatment is indicated, with no waiting room and no awkward looks.
- Ejaculation within 1 to 3 minutes in more than 75% of sexual encounters
- A problem that has persisted for more than 6 months
- Distress, frustration or loss of confidence linked to the problem
- Avoidance of sex or tension in the relationship
- Associated erectile dysfunction: worth mentioning, it changes the strategy
What are the
treatments
for premature ejaculation?
There is no single treatment for premature ejaculation. Your Kano.care doctor recommends the care plan best suited to you: medication, behavioural techniques, or both, often combined for results that are both rapid and lasting.
The only medicine with a specific marketing authorisation for premature ejaculation in France. This short-acting SSRI strengthens the serotonergic brake on the ejaculatory reflex: in clinical trials, time to ejaculation was multiplied by 2.5 to 3 on average. Taken on demand, only on days when you have sex. Possible side effects: nausea, dizziness, headache. Avoid alcohol on the day you take it.
A spray applied to the glans 5 minutes before sex: it reduces hypersensitivity without removing pleasure or affecting the erection. In clinical trials (TEMPE study), time to ejaculation was multiplied by 3 to 6. Very well tolerated; reduced sensitivity in the partner is possible, and can be avoided with a condom or by wiping off the excess.
Serotonergic antidepressants prescribed off-label at low dose, taken continuously. The effect on time to ejaculation is greater than with on-demand treatment, at the cost of taking a tablet every day. An option discussed when intercourse is frequent or when dapoxetine is not enough. Medical follow-up is essential: never self-medicate, never stop abruptly.
The stop-start method (Semans) and the squeeze technique (Masters and Johnson) teach you to recognise the sensations that precede the point of no return. Cognitive behavioural therapy and sex therapy address performance anxiety and the relationship dimension. Combined with medication, they give the most lasting results (ISSM recommendation).
Complementary approaches and special cases
Beyond the four main options, several levers improve ejaculatory control or treat an associated cause. The doctor builds them into the care pathway according to your situation.
- Pelvic floor exercises
Pelvic floor training (Kegel exercises) strengthens the muscles involved in ejaculatory control. Studies show a significant improvement in time to ejaculation in lifelong PE, after a few weeks of daily practice.
- Treat the erectile dysfunction first
When erectile dysfunction coexists, a PDE5 inhibitor is prescribed as first-line treatment. Once the erection is secured, premature ejaculation often improves without any other treatment.
Understanding erectile dysfunction → - Delay condoms
Condoms containing a mild anaesthetic (benzocaine), available without prescription. A stopgap option, less effective and less precise than a metered spray.
- Couples therapy
When relationship tension dominates, involving your partner in the care reduces the pressure and improves the results of behavioural techniques.
- Treat an underlying cause
Chronic prostatitis, hyperthyroidism, withdrawal from certain substances: in acquired forms, treating the cause often makes the disorder regress.
- Combined approach
Medication for immediate results, behavioural techniques for lasting results after stopping: this is the reference strategy recommended by the ISSM.
Prescription-only medicines. The molecule and the dosage are determined by your doctor after a full assessment (lifelong or acquired form, medical history, contraindications).
A care
pathway
built around you.
Four steps that work together: assessment, medical report, treatments and support. A full medical assessment of your situation, in complete confidence, with a care pathway that can combine medication and a guided programme, according to your needs.
Assessment by a specialised doctor
Confidential medical questionnaire: how long the problem has lasted, frequency, time to ejaculation, personal and relationship impact, treatment preferences. Your file goes to a doctor registered in France or in the European Union, for a quick, discreet remote assessment.
- Confidential questionnaire in 5 minutes
- Timing, control and impact assessed
- Medical history and treatments checked
Diagnosis and care pathway
You receive a personalised medical report: an interpretation of your situation and the recommended care pathway (medication, guided programme and more), with referral to a specialist where appropriate.
- Written medical report
- Care pathway tailored to your situation
- Referral to a sex therapist if useful
Your treatments, at home and in the app
If a medicine is indicated, request delivery from our partner pharmacy — always discreet, in plain packaging. At the same time, set up your Control programme, the guided programme to last longer and regain control.
- Secure digital prescription
- Discreet delivery within 48 to 72 h
- The Control programme in the KANO app
Beyond medication
Structured medical follow-up with your doctor, with treatment adjustments if needed, a dedicated care assistant available 24/7, and daily exercises in the KANO app: pelvic floor, control techniques, anxiety management.
- Medical follow-up with your doctor
- Dedicated care assistant, 24/7
- Daily exercises in the KANO app
What changes: serious medical care, in complete confidence.
No waiting room, no awkward looks. A complete medical file, reviewed by a doctor, and support that does not stop at the prescription.
€35 per consultation, no commitment.
The consultation fee covers the remote medical assessment by a doctor, the medical report and the prescription if a treatment is indicated. You then decide how to proceed, based on your doctor’s recommendation: request delivery, start the Control programme, and more. Any treatments are ordered after the consultation and billed separately.
- Consultation with a doctor specialised in men’s health
- Medical report and personalised care pathway
- Secure digital prescription if indicated
- Secure messaging: your doctor and a dedicated care assistant
- KANO app: follow-up, information, messaging
Going further than
medication.
Behavioural techniques are recommended at every stage and make the results last. But they need to be practised methodically: the Control programme guides you day after day, in the KANO app.
Locate the muscles that stop the flow of urine, then contract them: 3 sets of 10 a day strengthen ejaculatory control.
Stop before the point of no return, let the arousal subside, then resume. First alone, then with your partner.
Deep abdominal breathing brings arousal down and defuses performance anxiety during sex.
Talking about it with your partner removes the pressure of secrecy. Complicity is half of the behavioural treatment.
Long periods of abstinence shorten the time to ejaculation. A regular sex life makes control easier.
Alcohol sometimes “helps” by reducing sensitivity, but it worsens anxiety and impairs the erection. A false good idea.
A medical team
expert in men’s health,
always by your side.
Medical DirectorDr Sam Ward
“Premature ejaculation is the most common male sexual disorder, and one of the least talked about with a doctor. It is neither inevitable nor a lack of willpower: validated treatments exist, and they work.”
Your questions about
premature ejaculation.
Several techniques can help improve your ejaculatory control. Behavioural exercises such as the squeeze technique and the stop-start method help you recognise pre-ejaculatory sensations more clearly. Kegel exercises strengthen the pelvic floor muscles. Relaxation and deep-breathing techniques reduce performance anxiety. For more severe cases, medication can be prescribed by a doctor. It is recommended that you consult a healthcare professional to identify the cause and receive appropriate treatment.
We speak of premature ejaculation when ejaculation consistently occurs within 1 to 3 minutes of penetration, before the person wishes it. Severe premature ejaculation corresponds to ejaculation within one minute, while the moderate form falls between 1 and 2 minutes. However, duration alone does not always define the disorder: what matters is that it causes personal distress or affects sexual satisfaction. Occasional episodes of rapid ejaculation can be normal, especially at the start of your sex life or in stressful situations. It is considered a disorder when the problem persists for at least 6 months and occurs in more than 75% of sexual encounters.
You may suspect premature ejaculation if you consistently ejaculate within 1 to 3 minutes of penetration in more than 75% of your sexual encounters, if this happens before you wish it, and if it causes you personal distress or affects your sexual satisfaction or that of your partner. The disorder is generally diagnosed when the problem has persisted for at least 6 consecutive months. Other signs include avoiding sex because of this anxiety, or tension in your relationship. If you recognise yourself in these situations, it is recommended that you consult a doctor or a sex therapist for an accurate diagnosis.
To improve your ejaculatory control, several approaches can be combined. Start by working on stress and anxiety management with relaxation techniques (meditation, deep breathing). Practise Kegel exercises regularly to strengthen the pelvic floor muscles. Behavioural techniques such as the squeeze technique and the stop-start method help you recognise and control pre-ejaculatory sensations more effectively. Communicate openly with your partner to reduce pressure and performance anxiety. Cognitive behavioural therapy can be very beneficial for addressing the psychological aspects. In some cases, medication can be prescribed by a doctor. It is important to consult a healthcare professional to identify the specific causes and receive appropriate treatment.
It depends on the context. Occasional episodes of ejaculating within 2 minutes can be normal, especially at the start of your sex life, after a long period of abstinence, or in situations of intense stress. However, if this happens consistently in more than 75% of your sexual encounters and causes personal distress or affects your sexual satisfaction, it may indicate moderate premature ejaculation. What matters is not only the duration, but also the impact on your well-being and your relationships. If the problem persists for more than 6 months, it is recommended that you consult a doctor or a sex therapist to assess the situation.
If you consistently ejaculate within 30 seconds, this corresponds to severe premature ejaculation. Several techniques can help improve your control. Kegel exercises strengthen the pelvic floor muscles. Behavioural techniques such as the squeeze technique and the stop-start method help you recognise pre-ejaculatory sensations more clearly. Relaxation and deep-breathing techniques reduce performance anxiety. For severe cases, medication can be prescribed by a doctor. It is strongly recommended that you consult a healthcare professional to identify the cause and receive appropriate treatment.
Several medications are available for premature ejaculation. Dapoxetine (Priligy) is the only medicine specifically approved for this indication in France: it is a short-acting selective serotonin reuptake inhibitor (SSRI), taken 1 to 3 hours before sex. Other SSRIs such as paroxetine or sertraline can be prescribed off-label as a daily treatment. Local anaesthetics (lidocaine/prilocaine as a cream or spray) reduce the sensitivity of the glans and delay ejaculation. Low-dose tramadol is sometimes used off-label. The choice of treatment depends on severity, frequency of intercourse and the patient’s preferences. A medical consultation is essential to determine the most appropriate treatment.
Premature ejaculation can have psychological causes, physical causes, or a combination of both. On the psychological side, performance anxiety, stress, depression, relationship problems or negative early sexual experiences can play a major role. On the physical side, an imbalance of neurotransmitters (particularly serotonin), hypersensitivity of the glans, inflammation of the prostate (prostatitis), thyroid disorders or genetic factors may be involved. A distinction is made between lifelong premature ejaculation (present since the start of sexual life, often linked to biological factors) and acquired premature ejaculation (appearing after a period of normal control, often linked to psychological or medical factors). A medical diagnosis makes it possible to identify the specific causes and propose appropriate treatment.
Disclaimer: the information on this page is provided for information purposes only and does not replace professional medical advice. The treatments mentioned (dapoxetine, topical anaesthetics, SSRIs) are prescription-only medicines. Never take a treatment without first consulting a qualified doctor. In an emergency, call 112 (or 15 in France).
