Premature ejaculation: causes and solutions

What is premature ejaculation? 

Nearly 30% of men suffer from premature ejaculation, making it one of the most common sexual dysfunctions (along with erectile dysfunction).

Ejaculation is considered to be premature when a man has no control over it, and it occurs between less than one minute and three minutes after penetration.

The definition of premature ejaculation varies from country to country, but there are three common points:

• ejaculation that occurs too quickly, before the man and his partner want it to occur; this happens systematically or almost systematically,
  
• inability to hold back or control ejaculation,
  
• negative psychological repercussions.
  

However, it should be noted that premature ejaculation, whether during first sexual relations or with a new partner, is normal. It only becomes a problem if the premature ejaculation persists over time and causes real discomfort.

There are two types of premature ejaculation:

Primary premature ejaculation 

It is present at every sexual encounter, with different partners, throughout life.

Secondary, or acquired premature ejaculation 

Secondary premature ejaculation can be suspected when it was not present during previous sexual intercourse. It is generally associated with an underlying illness such as prostatitis, an erectile or neurological disorder, or a psychological problem.

Premature ejaculation is not an illness as such. It is a disorder that only becomes problematic if it causes embarrassment, discomfort or distress for the person affected and their partner.

The psychological consequences of premature ejaculation can be very negative, both for the person concerned and for their partner. The person affected may develop symptoms of depression or anxiety, or tend to withdraw into himself and avoid romantic and/or sexual relationships.

What are the possible causes of premature ejaculation? 

For a long time, premature ejaculation was considered to be a purely psychological disorder, but it is now recognised that it is linked to neurobiological disorders and/or genetic susceptibility.

However, the exact causes are still unknown.

Several biological factors may contribute to premature ejaculation, such as:

• Penis hypersensitivity,
  
• Hyperexcitability of the ejaculation reflex,
  
• Impaired transmission of nerve messages in the brain or hypersensitivity of certain nerve receptors (particularly serotonin),
  
• Inflammation of the prostate (known as chronic prostatitis),
  
• Thyroid gland abnormalities (hyperthyroidism),
  
• A neurological disease, such as multiple sclerosis.

Psychological and environmental factors may also play a role.

Psychological factor 

The psychological factor is often the most talked of by patients affected by premature ejaculation. It may be stress, difficulty in relationships or fear of sexual intercourse itself.

Emotional factor

It is very common for premature ejaculation to occur during the first intercourse: one (especially if one has little or no experience) can be rather tense and stressed.

Relationship problems

Problems within the couple can also cause premature ejaculation. Feelings of betrayal or guilt can play an important role as well.  

Metabolic causes

Although they may not suffer from a disease, people affected by premature ejaculation may have ‘physical’ causes. Premature ejaculation can be caused by a foreskin that is too short, a hypersensitive glans or irritation of the urethra.

In addition, poor masturbation habits, such as the need to release sexual tension quickly and at all costs, can alter the way in which sexual intercourse is approached and viewed.

What are the possible solutions for premature ejaculation? 

To avoid premature ejaculation, it is essential to reduce arousal and tension. This means avoiding too many over-exciting images, whether real (erotic films, for example) or mental, because the more a man gets used to having an ejaculation as soon as he feels aroused, the less he will be able to make the pleasure last.

You should also try to reduce stress in your daily life as well as before sexual intercourse.

During intercourse, it is important to introduce some foreplay that will make the situation less stressful, relax both partners, make your partner more receptive and prevent you from penetrating too quickly.

Other techniques can also be used:

Using a condom 

Using a condom, especially a slightly thick one, can help by creating a ‘barrier’ to the sensitivity of the frenulum (just below the glans).

There are even special condoms which reduce the sensation in the glans, allowing sex to last longer.

There are two types of delay condoms:

• Anatomical delay condoms, which have a particular shape,
  
• Anaesthetic delay condoms, which use a substance to numb the penis (benzocaine).  

Delaying ejaculation 

With a little practice, most men can learn to delay their ejaculation. These practices allow you to feel aroused without ejaculating:

• The ‘stop-and-start’ technique: stop intercourse when you feel the orgasm coming, for about 30 seconds, and then resume,
  
• The compression technique: stop intercourse when you feel yourself climaxing, and squeeze the tip of your penis for 10 to 20 seconds, then resume intercourse after about 30 seconds.
  

You can practise these techniques first on your own, by masturbating, and then with your partner.  

Breathing correctly 

Breathing from the abdomen gives a feeling of relaxation, while short breaths from the chest increase muscle tension and tone, and often lead to greater sexual arousal.

Breathing correctly helps to manage stress and arousal through progressive exercises: breathing through the abdomen, synchronising breath and pelvic movements, and then incorporating these techniques into masturbation. Once mastered, these steps can be shared with your partner, progressing from caresses to penetration, to rediscover sexual harmony.

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