Premature ejaculation: causes and what helps
It’s coming sooner than you or your partner want. Now and then is common. If it keeps happening, practice and medicines can help. But sometimes the real cause is an erection problem.
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What is premature ejaculation?
It means you ejaculate, or come, sooner than you or your partner wish during sex. The NHS says it happening now and then is common and not a cause for concern.
It’s worth getting help if it happens more than you’d like and it’s a problem for you.
So how soon is too soon? There’s no stopwatch answer. European urology guidelines say time alone can’t define it, because men with and without it overlap.
| Men in the study | Middle time from entering to coming (half were quicker) |
|---|---|
| All 500 men | 5.4 minutes |
| Aged 18 to 30 | 6.5 minutes |
| Over 51 | 4.3 minutes |
Source: Waldinger 2005
These times come from 500 couples in 5 countries, including the UK, timed with a stopwatch from entering to coming, over 4 weeks. The men were in steady relationships with a woman. Some took under a minute and some took over 40 minutes.
What counts is whether it bothers you or your partner. If it does, start with the things to try yourself below.
What causes premature ejaculation?
| Type | Examples |
|---|---|
| Body | Prostate problems (a gland below the bladder), an overactive or underactive thyroid (a gland in your neck that sets your body’s speed), recreational drugs |
| Mind and mood | Depression, stress, relationship problems, worry about how you perform in bed |
| Since you first had sex | Training yourself to come fast as a teenager, an upsetting past sexual experience, a strict upbringing about sex |
Source: NHS
Worry about how you perform is most likely at the start of a new relationship, or after earlier problems in bed.
Habit matters too. The NHS says a teenager who learns to come fast so he isn’t caught masturbating may find the habit hard to break later.
Spot a likely cause? Read about thyroid blood tests or overthinking and anxiety, and mention it to your GP.
Is it really an erection problem?
That hidden cause is erection trouble.
European urology guidelines say many men with erection problems start coming early because they worry about losing their erection. The guidelines say to treat the erection problem first.
It can work the other way. Going soft after you come is normal. Some men mistake that for an erection problem when the real issue is coming early.
Hard to get or stay hard? Read about erection problems in younger men and blood pressure and erections, then tell your GP about both problems.
How can I last longer in bed?
Things that can sometimes help
- Masturbate an hour or 2 before sex.
- Use a thick condom to dull the feeling.
- Have sex with your partner on top, so they can pull away when you’re close.
- Practise the squeeze or stop-go method on your own first.
- Talk to your partner. The NHS says it usually helps to involve them as much as you can.
Source: NHS
The squeeze method, step by step
- 1
Get close
Masturbate, but stop before you ejaculate.
- 2
Squeeze
Squeeze the head of your penis for 10 to 20 seconds.
- 3
Wait
Let go and wait 30 seconds, then start again.
- 4
Repeat
Do this several times before you let yourself come.
Source: NHS
Stop-go is the same without the squeeze. Once you feel more in control, you can try it during sex, stopping and starting as needed.
The NHS says these methods may sound simple but need lots of practice. A psychosexual counsellor, a therapist for sex problems, can teach them to you and a partner.
Pelvic floor exercises, which train the muscles you use to stop peeing midstream, may help too. In one small study, 40 men had always come within a minute. After 12 weeks of pelvic floor training, 33 of them gained control.
In those 33, the average time rose from under 40 seconds to almost 2 and a half minutes. The study had no comparison group, so it’s a hopeful sign, not proof. See pelvic floor exercises for men for how to do them.
What treatment can a GP offer?
| Treatment | How it’s used | Good to know |
|---|---|---|
| Dapoxetine (Priligy) | 1 to 3 hours before sex, no more than once a day | Made for premature ejaculation. Not for some men with heart, kidney or liver problems. |
| Daily antidepressants: paroxetine, sertraline or fluoxetine | Every day | The full effect usually takes 1 to 2 weeks. |
| Sildenafil | On prescription, or from a pharmacy after a chat with the pharmacist | An erection medicine that may also help. |
| Numbing cream or spray (lidocaine or prilocaine) | On the head of the penis before sex | Can numb your partner too. The NHS says condoms also work, especially used with the cream. |
| Psychosexual counselling | Sessions with a therapist, with a partner if you have one | Teaches squeeze and stop-go, and helps with relationship worries. |
Dapoxetine is licensed in the UK, but local NHS areas choose whether to prescribe it. Your doctor reviews it after 4 weeks or 6 doses, then every 6 months.
The daily antidepressants are called SSRIs, and they also delay ejaculation. Side effects such as feeling sick, diarrhoea and sweating are usually mild and should ease after 2 to 3 weeks.
Dapoxetine can interact with other medicines, such as other antidepressants. Tell your GP everything you take. Never stop or change a prescribed medicine without your prescriber.
When to speak to a GP
Your GP will talk it through, may examine you and may refer you to a specialist. Book an appointment if:
- It keeps happening, more than you’d like, and it’s a problem for you.
- You also find it hard to get or keep an erection. Guidelines say to treat that first.
- You think a body cause could be involved, such as prostate or thyroid problems, or you use recreational drugs.
- You feel low, stressed or anxious, or it’s straining your relationship.
- You see blood in your semen.
Involve a partner if you have one. The NHS says it’s usually best to involve them as much as possible.