Premature ejaculation (PE) is a condition where a man ejaculates sooner than desired during sexual intercourse. It is a common sexual concern, with approximately 1 in 3 men experiencing it at least once in their lifetime. While occasional premature ejaculation is usually not a cause for concern, it may be considered a medical condition if it happens consistently.
A diagnosis of premature ejaculation is typically made when a man:
- Almost always ejaculates within 1 to 3 minutes of penetration,
- Is unable to delay ejaculation during sexual activity,
- Feels distress, frustration, or avoids sexual intimacy due to the condition.
The good news is that premature ejaculation is treatable. Treatment options such as therapy, medication, and ejaculation delay techniques can improve sexual satisfaction and relationship quality.
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Symptoms of Premature Ejaculation
The main symptom of premature ejaculation is the inability to delay ejaculation for more than three minutes after penetration. This condition can occur in any sexual context, including masturbation.
PE is categorized into two types:
- Lifelong PE: Occurs from a man’s first sexual experience and happens almost every time.
- Acquired PE: Develops after previous sexual experiences without ejaculation issues.
Many individuals feel they may have PE, but not all meet the medical criteria for diagnosis. Occasionally ejaculating early is normal and doesn’t necessarily indicate a disorder.
What Causes Premature Ejaculation?
Premature ejaculation is often caused by psychological factors such as anxiety. Additionally, a highly sensitive penile skin can contribute to the condition.
Common emotional or psychological causes include:
- Performance anxiety: Nervousness with a new partner, returning to sex after a break, overexcitement, or other concerns.
- Stress: From work, relationships, lifestyle changes, or other pressures.
- Relationship issues: Including past sexual trauma or negative feelings toward a partner.
- Emotional repression: Such as guilt or feeling overwhelmed.
- Low self-esteem: Including body image issues or lack of confidence.
Physical and chemical causes may include:
- Erectile dysfunction
- Hormonal imbalances (e.g., oxytocin, LH, prolactin, TSH)
- Low levels of serotonin or dopamine (brain chemicals linked to arousal)
- Hypersensitivity of the penis
- Prostate inflammation
It’s important to note that premature ejaculation is usually not caused by physical abnormalities, infections, or structural problems in the reproductive organs. In most cases, these organs function normally, and the main triggers are psychological stress, anxiety, or nervousness.
Complications of Premature Ejaculation
PE can lead to various personal and relationship-related issues, including:
- Stress and relationship problems: Tension or emotional distance between partners.
- Fertility challenges: In some cases, PE may interfere with conception, particularly if ejaculation occurs before penetration or outside the vagina.
When to See a Doctor
You should consult a doctor if you regularly ejaculate sooner than desired during most sexual encounters. Feeling embarrassed about sexual health is common, but don’t let it stop you from seeking help. PE is a treatable and common condition.
Talking to a doctor can ease your concerns. For example, learning that occasional PE is normal or knowing that the average time from penetration to ejaculation is about five minutes can provide a more realistic perspective.
Treatment for Premature Ejaculation
Treatment depends on the underlying cause and may involve behavioral therapy, counseling, and/or medication.
Most cases are initially treated with behavioral therapy and/or counseling to address emotional issues, performance anxiety, or stress. Combining multiple treatments is often more effective than using a single method.
1. Behavioral Therapy
Behavioral techniques train the body and mind to control arousal and delay ejaculation through practical exercises, such as:
- Start-stop technique: Stimulate the penis until nearing orgasm, then stop for about 30 seconds before resuming. Repeat this three to four times before ejaculation.
- Squeeze technique: Gently squeeze the penis head for 30 seconds when approaching orgasm to reduce arousal. Repeat as needed to gain better control.
- Mental distraction: Think about non-sexual topics (e.g., store names or sports team players) during intercourse to reduce arousal.
2. Counseling
If the cause is psychological or emotional—such as anxiety, depression, guilt, or relationship issues—consult a psychologist, psychiatrist, or sex therapist. A urologist may refer you to the appropriate specialist.
3. Medications
Doctors may recommend certain medications to help manage PE:
- Antidepressants: Often used off-label to delay ejaculation. Discuss potential side effects with your doctor. Common options include tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRIs).
- Topical anesthetic creams or sprays: Applied to the penis to reduce sensitivity, typically effective within 10–30 minutes. Clean the area before intercourse to avoid numbing your partner.
- Erectile dysfunction medications: Can help with PE, especially if erectile problems are also present.
- Certain opioids: Prescribed in specific cases as an alternative treatment.
While some alternative therapies claim to treat PE, current evidence is insufficient to support their effectiveness.
Andrology Specialists at RS Mandaya Puri for Premature Ejaculation
An andrology specialist is the right expert to consult for premature ejaculation. Andrology is a subfield of urology focused on male reproductive health, including:
- Premature ejaculation
- Erectile dysfunction
- Male hormonal disorders (e.g., low testosterone)
- Male infertility
- Issues with the testicles, penis, and prostate
If you’re experiencing premature ejaculation or other sexual function issues, consulting an andrologist is a smart step for proper diagnosis and personalized treatment.
At RS Mandaya Royal Puri, you can consult with dr. Heru Harsojo Oentoeng, M.Repro, Sp.And (K), FECSM, a highly experienced andrology specialist. He completed his medical training at Udayana University and holds credentials from the European Committee of Sexual Medicine as a Fellow. He is also a Consultant Andrologist in Sexology and Anti-Aging Medicine.
Besides treating PE, dr. Heru provides:
- PSA (Prostate-Specific Antigen) testing
- Semen analysis
- Hormone therapy
- Micro-TESE (Microdissection Testicular Sperm Extraction)
- Fertility consultations and rehabilitation programs
- Pharmacological therapy
Schedule at RS Mandaya Royal Puri:
- Monday: 18:00 – 20:00 WIB
- Friday: 18:00 – 20:00 WIB
To make your visit easier, use the WhatsApp Chat, Book Appointment feature, or download the Care Dokter app on Google Play or App Store to check queue numbers, book visits, and access complete information.
