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Causes
By Mayo Clinic staffThe exact cause of premature ejaculation isn't known. While it was once thought to be only psychological, we now know premature ejaculation is more complicated and involves a complex interaction of both psychological and biological factors.
Psychological causes
Some doctors believe that early sexual experiences may establish a pattern that can be difficult to change later in life, such as:
- Situations in which you may have hurried to reach climax in order to avoid being discovered
- Guilty feelings that increase your tendency to rush through sexual encounters
Other factors that can play a role in causing premature ejaculation include:
- Erectile dysfunction. Men who are anxious about obtaining or maintaining their erection during sexual intercourse may form a pattern of rushing to ejaculate which can be difficult to change.
- Anxiety. Many men with premature ejaculation also have problems with anxiety — either specifically about sexual performance, or caused by other issues.
- Relationship problems. If you have previously had satisfying sexual relationships in which premature ejaculation happened infrequently or not at all, it's likely that interpersonal issues between you and your current partner are contributing to the problem.
Biological causes
A number of biological factors may contribute to premature ejaculation, including:
- Abnormal hormone levels
- Abnormal levels of brain chemicals called neurotransmitters
- Abnormal reflex activity of the ejaculatory system
- Certain thyroid problems
- Inflammation and infection of the prostate or urethra
- Inherited traits
Rarely, premature ejaculation is caused by:
- Nervous system damage resulting from surgery or trauma
- Withdrawal from narcotics or a drug called trifluoperazine (Stelazine) that is used to treat anxiety and other mental health problems
Although both biological and psychological factors likely play a role in most cases of premature ejaculation, experts think a primarily biological cause is more likely if it has been a lifelong problem (primary premature ejaculation).
- Lue TF, et al. Evaluation and nonsurgical management of erectile dysfunction and premature ejaculation. In: Wein AJ, et al, eds. Wein: Campbell-Walsh Urology. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2007:756.
- Premature ejaculation. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed Jan. 28, 2009.
- Waldinger, MD. Premature ejaculation: State of the art. Urologic Clinics of North America. 2007;34:591.
- McMahon CG. An evidence-based definition of lifelong premature ejaculation: Report of the International Society for Sexual Medicine (ISSM) ad hoc committee for the definition of premature ejaculation. The Journal of Sexual Medicine. 2008;5:1590.
- Althof SE. Psychological approaches to the treatment of rapid ejaculation. The Journal of Men's Health & Gender. 2006;3:180.
- Park J, et al. Complementary and alternative medicine in men's health. Journal of Men's Health. 2008;5:305.
- Dhikav V. Yoga in premature ejaculation: A comparative trial with fluoxetine. The Journal of Sexual Medicine. 2007;4:1726.
