When a man ejaculates during intercourse at a point earlier than is preferable to either his partner or himself, this is referred to as premature ejaculation. This is one of the most common sexual complaints, with up to one in three men experiencing this problem at some point in their lives. However, it is not a matter for concern unless it begins to happen on a regular basis. You are likely to be suffering from premature ejaculation if you:

• Regularly ejaculate in less than a minute following penetration

• Cannot delay ejaculation during intercourse most of the time

• Consequently avoid sexual intimacy as a result of the distress and frustration caused

Premature ejaculation can be the result of both biological and psychological factors. Many men are embarrassed to discuss it, but the good news is that premature ejaculation is a condition that is both common and very treatable. Sex for you and your partner can be improved by delaying ejaculation with the use of counselling, sexual techniques and medication.

Symptoms

Being unable to delay ejaculation following penetration is the main symptom of premature ejaculation, but the problem can also occur in a number of other sexual scenarios, even including masturbation. Premature ejaculation comes in two forms – primary (lifelong) or secondary (acquired).

Primary premature ejaculation applies to those who have always, or almost always suffered from the problem from their first sexual encounters onwards. Secondary premature ejaculation comes with the same symptoms, but is a condition that has developed, despite having no problems in prior sexual encounters. If you believe you are suffering from premature ejaculation on a regular basis then you should talk to your doctor. Men are often embarrassed by the condition, but can gain great reassurance to know that occasionally prematurely ejaculating is entirely normal, and that five minutes is actually the average time for ejaculation from the beginning of intercourse.

Causes

The precise cause of premature ejaculation remains something of a medical mystery. Doctors once believed that it was a purely psychological condition, but now recognise that it is actually considerably more complicated, and that complex linked biological and psychological factors are involved.

Psychological factors that can play a role in premature ejaculation include:

• Erectile dysfunction, where men may have formed a pattern, which can be difficult to alter, of ejaculating quickly out of anxiety over maintaining an erection

• Relationship problems

• Anxiety, as men who suffer from premature ejaculation also have anxiety issues, which can be related to sexual performance

Biological factors that can play a role in premature ejaculation include:

• Abnormal hormone levels

• Abnormal reflex activity in the ejaculatory system

• Infection and inflammation of the urethra or prostate

• Nerve damage from trauma or surgery, although this is rare

• Abnormal amounts of brain chemicals known as neurotransmitters

• Thyroid problems

• Genetic traits

Consultation

It is normal to be embarrassed discussing sexual problems, but you can talk to your doctor knowing that they will have many such conversations with a lot of other men. Being able to talk about the problem will help you to receive treatment and resolve the issue. Be sure to tell your doctor about your symptoms, as well as your medical and sexual history. Write down a list of questions that you may wish to ask about, such as the possible causes of the condition, as well as the treatments and the length of time after which you can expect any treatment to begin working. Premature ejaculation can cause considerable anxiety and strain on a relationship, but it is important to remember that it is treatable.

Treatments

There are a number of common treatments for premature ejaculation including:

• Topical anaesthetics that are used on the penis before sex to reduce sensation and therefore delay ejaculation

• Counselling, which involves discussing your experiences and relationships with a mental health provider, who can assist you to reduce stress and performance anxiety

• Behavioural techniques, which can include avoiding intercourse and pursuing other forms of sexual play, or masturbating prior to intercourse

• Oral medications such as anti-depressants, phosphodiesterase-5 inhibitors, and analgesics.