causes of premature ejaculation


Premature ejaculation (PE) is a common sexual issue. It’s when you ejaculate before the desired moment, with little control over it. This can cause distress and strain in sexual relationships, making it hard to form new ones. It can also lower self-confidence and satisfaction during intimate encounters.

The cause isn’t known, but there are several factors. Psychological issues like stress, depression, and low self-esteem might be at the root. Medical issues such as hormone imbalances, thyroid problems, or prostate issues could also contribute. Lifestyle behaviours like drinking and smoking could be factors.

It’s important to talk to a doctor and get treatment if needed.

Physical Causes

Premature ejaculation can be brought about by numerous physical factors. Diabetes, neurological conditions, prostate conditions, and hormonal imbalances are some medical causes. Physical issues, such as anatomical anomalies and tissue harm, can also play a role.

We’ll go into more detail on these physical causes here:

Abnormal hormone levels

Abnormal hormone levels can cause premature ejaculation. Testosterone, linked to male sex drive, is made in the testes and helps control ejaculation time. Abnormal hormone levels have been linked to both delayed and early ejaculation. Plus, prolactin (a female hormone) can also affect sex. High prolactin levels can be caused by physical issues or particular meds. Evaluating hormone levels may help identify those more prone to premature ejaculation.

Abnormal levels of brain chemicals

Neurotransmitters like serotonin, dopamine, and norepinephrine can influence the physical processes involved in ejaculation. This may result in premature ejaculation.

Hormone imbalance or imbalances between testosterone and other hormones can cause tense and over-sensitive genitalia. Stress hormones such as cortisol can also cause heightened arousal and faster ejaculations.

Other physical factors include:

  • Inflammation or infection of the prostate gland
  • Scarring from surgery
  • Peyronie’s disease
  • Anatomical abnormalities of the penis. These can reduce sensation and increase stimulation needed for orgasm.

Abnormal reflex activity of the ejaculatory system

Inability to control ejaculation is the most common form of premature ejaculation. Abnormal reflex activity of the ejaculatory system and hormonal imbalances are connected to it. Psychological stress or worry can also cause it.

The misfiring of messages between nerve centers in the brain and another part of the body that signals orgasm results in inability to control ejaculatory reflex. People affected by this show higher-than-usual levels of excitability and sensitivity in certain regions of their brains when aroused.

Hormonal imbalances such as hypogonadism (insufficient production of testosterone) or hypothyroidism (too little thyroid hormone) can lead to impaired ability to delay ejaculation and/or decreased sexual desire.

Inflammation and infection of the prostate or urethra

Inflammation and infection of a man’s prostate or urethra can cause premature ejaculation. Both are part of the male reproductive system. This dysfunction can make it hard to control when a man ejaculates.

Bacterial or viral infections that can come from untreated STIs are a main cause of prostatitis, an infection of the prostate. Urethritis, inflammation and swelling in the urethra, is often caused by an STI such as chlamydia or gonorrhea.

Symptoms associated with inflammation and infection include:

  • Burning during urination
  • Bloody discharge from the penis
  • Urgency to urinate
  • Pain during ejaculation
  • Pelvic pain
  • Fever

If not treated, chronic prostatitis may lead to infertility and an increased risk of BPH. If premature ejaculation keeps happening due to inflammation and infection, medical help should be sought out. This could affect a man’s sexual performance and cause other health problems.

Certain prescription medications

Certain prescription meds may cause premature ejaculation. These drugs treat depression, mental health, high blood pressure, heart and prostate issues. They cause a hormonal imbalance which interferes with normal ejaculatory control.

Examples of drugs that can cause this side effect are SSRIs, tricyclic antidepressants, dopamine antagonists, and alpha-blockers. If you experience this while taking one of these drugs, tell your doctor.

Psychological Causes

Premature ejaculation is a condition where a man releases semen earlier than he would like during sex. It affects men of all ages. Possible causes of this include psychological issues. These could be stress, anxiety, depression, or guilt.

Let’s look deeper into the psychological reasons:


Premature ejaculation is often thought to be a physical problem, but research shows psychological issues can be the cause. Anxiety is a major factor. It can be conscious or unconscious, and may include feelings like worry, guilt, shame, or inadequacy, as well as performance anxiety.

This can create a cycle of premature ejaculation and increased anxiety before the next sexual encounter. Other anxieties may be related to relationships, or to negative messages from family, childhood experiences, or cultural learning. In some cases, even engaging in intimacy can trigger panic, leading to an expedited orgasm.

Psychological treatment for premature ejaculation may involve:

  • Individual counseling
  • Sex therapy
  • Couples counseling

This helps address issues with intimacy, communication, and performance anxiety which are the underlying causes of the issue.


Stress is a major psychological influence on premature ejaculation. Sources can include work, relationship issues, money worries, and performance anxiety related to intercourse. This condition can become a vicious cycle if not addressed. An individual’s embarrassment and rising performance anxiety increase the chance of premature ejaculation.

Stressful situations can also cause physical responses that lead to it. These include: a higher heart rate, shallow breathing, and tightness or spasms in the pelvic region, which can’t be controlled during sexual excitement.

Stress management and mental health attention should be part of a strategy for treating premature ejaculation. In addition, relaxation methods like deep breathing or mindfulness meditation can help reduce stress levels regularly and during sex.


Depression can be a major cause of premature ejaculation. It can make men anxious about their performance. As a result, they lose focus or control during intimate moments. It can even cause physical changes in the body that can lead to early climax.

If you think you have depression, you should seek professional help. This will help to restore balance and protect your sexual health.


Guilt can be a cause of premature ejaculation. It ties to anxiety, low self-esteem and a quicker ejaculation.

Religion can contribute to guilt about sex. This can lead to PE. Working through those feelings may help.

Getting help from a therapist trained in sex therapy and psychotherapy can reveal underlying issues related to pleasure during intercourse.

Performance anxiety

Performance anxiety is one of the most common psychological causes of early ejaculation. It involves both worries about if you can perform and self-doubt. These can make arousal higher and cause you to come quickly.

This type of anxiety can come from mental issues like depression or insecurity. It can even come from physical issues like erectile dysfunction (ED). If you have trouble keeping an erection, it can lead to anxiety around performance and premature ejaculation.

Your doctor may suggest speaking to a sex therapist. They can help you learn to control your feelings and thoughts during sex, so they don’t lead to early ejaculation. You may also need medication for depression or anxiety, which can be factors in the problem.

Lifestyle Factors

Premature ejaculation can be caused by stress. Cortisol rises in the body when stressed, and this can disrupt signals sent from the brain to the penis, causing sexual performance to suffer. Other lifestyle factors that can lead to premature ejaculation are drinking, smoking, poor nutrition, and no exercise.

Let’s look deeper into these lifestyle factors:

Alcohol use

Alcohol and premature ejaculation can be linked. Drinking too much can harm a man’s sexual performance. This can lead to premature ejaculation. People should limit or avoid alcohol before sex if they are having this problem.

To improve the situation, people should change their lifestyle. They should

  • eat better
  • exercise more

This can help reduce performance anxiety. Also, managing stress and getting enough restful sleep can improve overall health and reduce the frequency of premature ejaculation. It is wise to talk to a doctor for tailored advice.

Drug use

Drug use is a factor that may cause premature ejaculation. Drugs can stop a person from controlling when they ejaculate, and in some cases, it can even cause permanent sexual dysfunction due to nerve damage.

Illegal drugs such as cocaine, methamphetamine, and GHB can have bad effects on sex. Even legal drugs, like alcohol and tobacco, can mess with the nerves that control ejaculating, leading to premature ejaculation. Prescription drugs, like antidepressants, high blood pressure medication, and hormones, can also cause premature ejaculation.

If the drug use is making the condition worse, talk to a doctor about changing or reducing any prescriptions that may be causing issues. Also, men who are looking for natural solutions should avoid taking OTC or recreational drugs, as they may be causing harm or making the condition worse.


Smoking can result in premature ejaculation. The reason? It reduces the blood supply to a man’s sex organs. This means less sensation and arousal. If the penis doesn’t get much stimulation, a man may not stay erect for long and ejaculate too soon.

Studies show smoking can also lower sperm count and quality. It’s even been linked to male infertility in some cases. That can really put a strain on any relationship. So, if you want to be healthier, both physically and sexually, quitting smoking is key.


Premature ejaculation can be a vexing and embarrassing problem. Luckily, there are treatments out there to help. The treatments depend on the cause. They could be medicines, lifestyle adjustments, counsel, or even sex therapy.

This section looks at the various treatments for premature ejaculation:

Psychological counseling

Psychological counseling is a treatment option for men with premature ejaculation. It combines behavior, psychosexual, and medical therapy. This helps address underlying issues causing the condition. A positive attitude can change behavior and give insight into why the problem occurs.

Counseling sessions may help work through psychological components such as depression, anxiety, and conflicts. This could resolve problems in sexual relationships. Experienced counselors specializing in sex therapy provide advice and treatment. This includes tips on relaxation techniques like breathing exercises. This could help with better control over ejaculation during sexual activity.


There are many drugs to help with premature ejaculation. They work by changing serotonin levels in the brain, which affects arousal and slows ejaculation. Some may also increase blood flow to the penis, resulting in a firmer erection and a longer experience.

The most common medications are:

  • SSRIs,
  • tramadol,
  • dapoxetine,
  • and topical anesthetics.

Each of these drugs is different and you should ask your doctor to decide which one is right for you.

  • SSRIs are not only used for depression, but can also be helpful for PE if taken in small amounts at the right time.
  • Tramadol works quickly and should be taken 1-2 hours before sex.
  • Dapoxetine should be taken daily, as it works faster than SSRIs and has better results.
  • Topical anesthetics (like creams) help numb up certain areas so you can last longer. However, this may make it harder for your partner to get aroused.

Lifestyle changes

Cutting back on drinking and quitting smoking can help with sexual performance. Managing stress, communicating better, and getting enough sleep are all good too. Sometimes, therapy and/or meds may be needed.

Trying different sexual positions or techniques may aid in premature ejaculation. Exercising may help too, though more research is needed. Above all, have patience with yourself and your partner during treatment.


Finally, PE does not have one single cause. It might be a mixture of physical and psychological elements. To help hold off ejaculation, you can try different sexual behaviors, use numbing lubricants, be patient, do hypnosis, or get counseling.

Know that PE is ordinary; don’t feel embarrassed or lonely. Talk to your partner and doctor to better cope with the condition and enjoy your sex life.

Frequently Asked Questions

1. What are the common causes of premature ejaculation?

The common causes of premature ejaculation include psychological factors such as stress, anxiety, depression, and relationship issues. Physical factors like hormonal imbalances, prostate problems, and neurological disorders can also cause premature ejaculation.

2. Is premature ejaculation a sign of erectile dysfunction?

While premature ejaculation and erectile dysfunction can occur together, premature ejaculation is not a sign of erectile dysfunction. Premature ejaculation is a condition where a man ejaculates sooner than he or his partner desires, whereas erectile dysfunction is the inability to achieve or maintain an erection.

3. Can excessive masturbation cause premature ejaculation?

Excessive masturbation is not a direct cause of premature ejaculation. However, it can lead to habituation, which can decrease the ability to control ejaculation.

4. Can medication cause premature ejaculation?

Some medications like antidepressants, blood pressure medication, and opioids can cause premature ejaculation as a side effect.

5. Can premature ejaculation be cured?

Yes, premature ejaculation can be treated through a combination of medical and psychological interventions. Medications like antidepressants, topical anesthetics, and phosphodiesterase inhibitors can help delay ejaculation. Psychological techniques like pelvic floor exercises, behavioral therapy, and sex therapy can also be effective in managing premature ejaculation.

6. Is premature ejaculation common?

Yes, premature ejaculation is a common sexual problem among men. It affects about 30% of men at some point in their life.

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