Premature ejaculation can be distressing and alarming to men and their partners. It creates relationship challenges. With premature (or rapid) ejaculation comes feelings of:
- shame,
- embarrassment,
- and inadequacy.
In Western culture, the man who lasts longest is praised as having a skill set that is ideal for pleasing a partner. This leaves men who ejaculate more rapidly to grapple with a feeling of “not being good enough.”
It is vital that this fact be better understood. Education is the first step in allowing men and their partners to have happier, more connected relationships.
What is Ejaculation?
Ejaculation is a two-part process most associated with male sexual climax. The process of climax involves both the mind and the body, with orgasm being an experience of the mind.
Emission – Emission is when secretions from the prostate, vas deference, and seminal vesicles enter the urethra and are ready to be secreted or ejected.
Expulsion – Expulsion occurs when involuntary, rhythmic spasms take place in the pelvic floor. This pulsates in the urethra causing the ejection or expulsion of semen.
Orgasm – Orgasm is the mental or psychological experience of intense pleasure that occurs during or in conjunction with ejaculation.
Emission is associated with ejaculatory inevitability, which men know as “the point of no return.” This leads to an involuntary, irreversible expulsion and orgasm. Therefore, ejaculation control is generally at a pre-emission stage.
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Defining Premature Ejaculation
Premature ejaculation is when a man consistently ejaculates more rapidly than desired. Time ranges have been added to give a more objective definition with ranges of ejaculation in under 1-3 minutes. Premature ejaculation must cause distress for it to be considered a disorder.
Many men will experience encounters that result in premature ejaculation from time to time. This is normal and generally not considered to be premature ejaculation.
Premature ejaculation has traditionally been measured and diagnosed based on penetrative sex but can be applied to a range of sexual activities. You can learn about Premature Ejaculation’s connection to Erectile Dysfunction on our podcast.
How Common is PE?
It is estimated that up to 30% of men will experience PE over the lifespan. It is more common in younger men who generally have less sexual skills. Younger men are more sensitive to excitation factors. (Watch our podcast: Can Overexcitation Lead to Erectile Dysfunction, Premature Ejaculation? to learn more). However, some men will develop PE later in life for other reasons.
It is broadly accepted that PE is categorized with four subtypes:
- Lifelong
- Acquired
- Situational
- Subjective
These subtypes can overlap and are not mutually exclusive. For example, a man can have lifelong PE in a specific situation, like being with a partner. Each of these subtypes can indicate potential causes and solutions for PE.
Lifelong – Lifelong premature ejaculation occurs when rapid ejaculation is present from the start of sexual activity and, with little to no exception, persists.
Acquired – Acquired PE occurs when a man develops rapid ejaculation with sexual activities that previously lasted significantly longer.
Situational – Situational PE occurs when a man can last longer in one setting while rapidly ejaculating in another. This is common with differences in ejaculation time between masturbation and partnered sexual activity.
Subjective – Subjective PE occurs when men are distressed by not lasting “long enough” during sex despite lasting longer than three minutes during sexual activity.
Exact PE Causes
The exact causes of PE are not clear because the understanding of what causes ejaculation is not well understood. There are several factors, both physical and psychological that seem to play a role in the process and can lead to ejaculatory issues including PE.
There are some physical components involved in premature ejaculation. It is believed that serotonin, a neurotransmitter, plays a key role in the ejaculatory process. Higher levels of serotonin are associated with a longer ejaculatory latency period or lower ejaculation. Therefore, many consider PE to be a disorder of lower levels of serotonin or a higher sensitivity of receptors that trigger emission.
There are several behavioral and psychological approaches to understanding PE.
Over excitation
Ejaculation is associated with excitation and receptivity to stimulation. When excitation reaches a certain level the brain signals to the body to start the emission process.
Some men experience excitation more intensely and rapidly than others. This leads to an expedited climax process which encompasses rapid ejaculation.
Lack of control
Another approach to the ejaculatory process involves a lack of sense of control while in a higher state of arousal. This approach assumes that the primary challenge that men face is not having a sense of how to stay in higher levels of pleasure and excitation without immediately progressing toward ejaculation.
This implies that a lack of sexual skills is a cause of PE.
Anxiety
Many men experience some anxiety with sexual activity, in particular when with a partner. For some men, performance anxiety and not excitation, can cause a loss of ejaculatory control. This may be due to an inability to concentrate or an impulse to finish up the experience as soon as possible.
Comorbid Sexual Dysfunction
For men who experience ED, PE is believed to develop as a way to avoid loss of erection during sexual activity. This is similar to an anxiety driven PE.
Withholding From a Partner
Early psychodynamic theories suggested that PE may be a man’s way of withholding sexual pleasure from a partner.
By ejaculating more rapidly, his partner would not be able to climax or experience much pleasure. As more has been learned about female sexual experience this theory appears to be less applicable.
Premature Ejaculation Solutions
If you are experiencing PE, here is what we recommend doing:
- Talk to your doctor about medications and numbing sprays
- Learn ejaculatory control skills with a therapist or guided program
- Address anxiety and other contributing factors with a sex therapist
Communicate with your partner to decrease worry and preoccupation. Communication may help you and your partner find a desired outcome collaboratively.
Ready to Learn More?
To start your in-depth approach to resolving the psychological issues that come with premature ejaculation or ED, try our online learning course called BEYOND THE LITTLE BLUE PILL, The Thinking Man’s Guide to Understanding and Addressing ED.
Ready to talk to an expert? Erection IQ founder Mark Goldberg helps men resolve erectile dysfunction and premature ejaculation. He is a certified sex therapists and offers individual, one-on-one services to men throughout the world through a secure, telehealth platform. It’s 100% confidential. You can visit the Center for Intimacy, Connection and Change website to schedule a free consult with Mark.
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Article Updated – August 2022