Premature Ejaculation

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Premature Ejaculation

Topic Overview

What is premature ejaculation?

Premature ejaculation is uncontrolled ejaculation either before or shortly after sexual penetration, with minimal sexual stimulation and before the person wishes. It may result in an unsatisfactory sexual experience for both partners. This can increase the anxiety that may contribute to the problem. Premature ejaculation is one of the most common forms of male sexual dysfunction and has probably affected every man at some point in his life.

What causes premature ejaculation?

Most cases of premature ejaculation do not have a clear cause. With sexual experience and age, men often learn to delay orgasm. Premature ejaculation may occur with a new partner, only in certain sexual situations, or if it has been a long time since the last ejaculation. Psychological factors such as anxiety, guilt, or depression can cause premature ejaculation. In some cases, premature ejaculation may be related to an underlying medical cause such as hormonal problems, injury, or a side effect of certain medicines.

What are the symptoms?

The main symptom of premature ejaculation is an uncontrolled ejaculation either before or shortly after intercourse begins. Ejaculation occurs before the person wishes it, with minimal sexual stimulation.

How is premature ejaculation diagnosed?

Your doctor will discuss your medical and sexual history with you and conduct a thorough physical examination. Your doctor may want to talk to your partner also. Because premature ejaculation can have many causes, your doctor may order laboratory tests to rule out any other medical problem.

How is it treated?

In many cases premature ejaculation resolves on its own over time without the need for medical treatment. Practicing relaxation techniques or using distraction methods may help you delay ejaculation. For some men, stopping or cutting down on the use of alcohol, tobacco, or illegal drugs may improve their ability to control ejaculation.

Your doctor may recommend that you and your partner practice specific techniques to help delay ejaculation. These techniques may involve identifying and controlling the sensations that lead up to ejaculation and communicating to slow or stop stimulation. Other options include using a condom to reduce sensation to the penis or trying a different position (such as lying on your back) during intercourse. Counseling or behavioral therapy may help reduce anxiety related to premature ejaculation.

Certain antidepressant medicines called selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft), are sometimes used to treat premature ejaculation. These medicines are used because a side effect of SSRIs is inhibited orgasm, which helps delay ejaculation. The use of SSRIs for the treatment of premature ejaculation is not related to depression and is considered an "off-label" use.

Other Places To Get Help

Organizations

National Kidney and Urologic Diseases Information Clearinghouse
3 Information Way
Bethesda, MD  20892-3580
Phone: 1-800-891-5390
Fax: (703) 738-4929
TDD: 1–866–569–1162 toll-free
Email: nkudic@info.niddk.nih.gov
Web Address: http://kidney.niddk.nih.gov
 

The National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC), a federal agency, is a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). NIDDK is part of the National Institutes of Health under the U.S. Department of Health and Human Services. The clearinghouse provides information about diseases of the kidneys and urologic system to people with kidney and urologic disorders and to their families, to health professionals, and to the public. NKUDIC answers inquiries; develops, reviews, and distributes publications; and works closely with professional and patient organizations and government agencies to coordinate resources about kidney and urologic diseases.


UrologyHealth.org, American Urological Association
1000 Corporate Boulevard
Linthicum, MD  21090
Phone: 1-866-RING AUA (1-866-746-4282) toll-free (U.S. only)
(410) 689-3700
Fax: (410) 689-3800
Email: auafoundation@auafoundation.org
Web Address: www.urologyhealth.org
 

UrologyHealth.org is a Web site written by urologists for patients. Visitors can find specific topics by using the "search" option.

The Web site provides information about adult and pediatric urologic topics, including kidney, bladder, and prostate conditions. You can find a urologist, sign up for a free quarterly newsletter, or click on the Urology Resource Center to find materials about urologic problems.


References

Other Works Consulted

  • Becker JV, Stinson JD (2008). Premature ejaculation section of Human sexuality and sexual dysfunctions. In RE Hales et al., eds., The American Psychiatric Publishing Textbook of Psychiatry, 5th ed., pp. 722–723. Washington, DC: American Psychiatric Publishing.
  • Stone KJ, et al. (2003). Off-label applications for SSRIs. American Family Physician, 68(3): 498–504.

Credits

By Healthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer Christopher G. Wood, MD, FACS - Urology, Oncology
Last Revised September 3, 2010

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