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What is Premature Ejaculation?

Premature ejaculation (PE) is often misunderstood as a permanent issue or an unfixable problem. However, this is not true. PE refers to a man reaching climax and ejaculating earlier than desired during sexual activity. It is a common concern, affecting approximately 1 in 3 men aged 18 to 59 in the United States. PE can be primary or acquired and tends to develop over time.How Does Ejaculation Work?

Experiencing PE can cause stress and dissatisfaction for both men and their partners. It is important to know that effective treatments are available, and these negative feelings can be overcome. If you or a loved one is affected by PE and it causes worry or stress, it is recommended to seek help from a healthcare provider. Remember, you are not alone, and your provider has the expertise to assist you. Together, you can identify the underlying causes and explore suitable treatment options.

Ejaculation is the pleasurable release of semen through the penis. It is controlled by the brain and central nervous system. During sexual stimulation, signals are sent to the brain through the spinal cord. When excitement reaches a certain level, the brain signals the reproductive organs to initiate ejaculation. This results in the ejection of semen through the penis. Ejaculation consists of two phases: emission and expulsion.

Ejaculation has two phases: emission and expulsion.

  • Phase 1: Emission – Emission occurs when sperm moves from the testicles to the prostate, where it combines with seminal fluid to form semen. The vasa deferentia, also known as vas deferens, are responsible for transporting the sperm from the testicles to the base of the penis through the prostate.
  • Phase 2: Expulsion – Expulsion happens when the muscles at the base of the penis contract, leading to the expulsion of semen from the penis. This process often coincides with ejaculation and orgasm (climax). While some men experience climax without ejaculation, it is common for erections to subside after this phase.

What is Premature Ejaculation?

Premature ejaculation (PE) occurs when a man or his partner desires a longer duration of sexual intercourse but ejaculates sooner, typically within 2 to 3 minutes. Occasional PE is also referred to as rapid ejaculation, premature climax, or early ejaculation. While occasional PE may not be a cause for concern, it can be frustrating if it affects sexual pleasure and relationships. If PE occurs frequently and causes problems, seeking assistance from a healthcare provider is recommended. Enhance your understanding of PE, its impact, and available solutions by consulting with a healthcare professional.

Premature Ejaculation and Erectile Dysfunction (ED)

Erectile dysfunction (ED) can be a challenge for men experiencing erection problems. It refers to the inability to achieve or maintain a firm enough erection for sexual activity. Distinguishing between premature ejaculation (PE) and ED can be difficult since an erection typically subsides after ejaculation. However, it is advisable to address ED first, as treating it may resolve any accompanying issues of PE.


The precise cause of premature ejaculation (PE) remains unknown, but there are various factors that can contribute to this condition. These factors may include biological, chemical, or emotional influences. Here are some more specific factors that can contribute to PE.


Serotonin plays a vital role in regulating mood, emotions, sleep, and sexual desire. As a natural substance produced by nerves in the body, it has a significant impact on ejaculation. Higher levels of serotonin in the brain can prolong the time to ejaculation, while lower levels may contribute to premature ejaculation (PE). Understanding the effects of serotonin on sexual health is crucial for optimizing wellbeing.

Psychological Issues

Psychological or mental health concerns can be associated with premature ejaculation (PE) and may encompass various aspects such as depression, anxiety, stress, guilt, unrealistic expectations about sex, lack of confidence, history of sexual repression, and relationship problems. Addressing emotional issues can often provide significant help and support.

Other Issues

PE and Age

Premature ejaculation (PE) can occur at any age and is not directly caused by aging. However, it’s worth noting that erectile dysfunction (ED) tends to be more prevalent as men get older, possibly due to lower levels of serum testosterone. In some cases, older men may experience less firm or smaller erections, as well as shorter duration before ejaculation. These changes can contribute to earlier ejaculation in older individuals.

PE and Your Partner

Premature ejaculation (PE) can impact your sexual connection and lead to feelings of anger, shame, and detachment from your partner. It not only affects you but also your partner, causing a sense of disconnection and hurt. Addressing this issue is crucial, and seeking couples counseling or sex therapy can be beneficial. Additionally, incorporating exercises like the squeeze technique can help prolong erections. Most importantly, learning relaxation techniques is essential as anxiety and worry can exacerbate PE.


Premature ejaculation (PE) can affect the sexual pleasure of men during partnered sex and masturbation. If you feel a lack of control over ejaculation timing and it causes concern for you or your partner(s), it may be a sign of PE. Seeking the guidance of a healthcare provider is recommended to address this issue.

To diagnose PE, your healthcare provider will conduct a physical examination and have a conversation with you. They may ask questions to understand the frequency and duration of PE, whether it is a lifelong condition or recent development, and if it occurs with all partners or specific ones. They may also inquire about your sexual activities, the impact of PE on your sexual experience, the state of your personal relationships, and any factors that may worsen or improve PE (e.g., drugs, alcohol).

Lab testing is typically unnecessary unless your healthcare provider identifies any abnormalities during the physical examination.


Premature ejaculation (PE) can be effectively treated through various methods including psychological therapy, behavioral therapy (such as sexual exercises), and medication. It is important to work closely with your doctor to determine the most suitable treatment option for you. Many individuals explore multiple treatment approaches simultaneously for optimal results.

Psychological Therapy

Psychological therapy is a way to work through the feelings and emotions that may lead to problems with sexual relationships. The goal of this type of therapy is to learn the source of problems and find solutions that may help PE. It can also help couples learn to grow closer. Psychological therapy can help you become less nervous about sexual performance. It can also give you greater sexual confidence and understanding to help your partner’s satisfaction. This type of therapy can be used as the only treatment, or it may be used along with medical or behavioral therapy.

Behavioral Therapy

Behavioral therapy is a proven technique that utilizes exercises to enhance tolerance to delay ejaculation. The primary objective is to train your body to overcome premature ejaculation (PE). Popular methods include the squeeze method and the stop-start method. While exercises can yield positive results, it’s important to note that they may not provide a permanent solution and their effectiveness may vary among individuals.

The Squeeze Method

This technique involves stimulating the penis until near ejaculation, then applying a firm squeeze to partially reduce the erection. The aim is to increase awareness of the sensations leading to climax. The squeeze method can assist in enhancing control and delaying climax.

The Stop-Start Method

In this technique, you or your partner engage in penis stimulation until just before reaching ejaculation. As you approach climax, you or your partner pause the stimulation until the urge subsides. Gradually regaining control, you resume the penis stimulation. This cycle is repeated three times, with ejaculation occurring on the fourth cycle. Practice this method three times per week to enhance control and stamina.

Medical Therapy

Currently, no drugs have been officially approved in the United States for the treatment of PE (premature ejaculation). However, there are various off-label options available such as numbing creams and sprays that effectively delay ejaculation in men with PE.

  • Drugs
    Doctors have observed that individuals taking antidepressants may experience delayed orgasms. Medications like clomipramine, fluoxetine, paroxetine, sertraline, and tramadol can impact serotonin levels. Some doctors prescribe these drugs “off-label” to address premature ejaculation (PE). If one medication proves ineffective, your doctor may recommend trying a different one. α1-Adrenoceptor antagonists are also used as a drug therapy option, although they may cause ejaculatory dysfunction such as retrograde ejaculation or failure of emission. Medications for PE can be taken daily or only before sexual activity, based on your healthcare provider’s recommendation. The optimal timing for taking the medication is not yet clear, but most doctors suggest taking it two to six hours before sex. It’s important to note that stopping these drugs may lead to a recurrence of PE, so most men with PE need to continue taking them on an ongoing basis.
  • Numbing Creams or Sprays
    Numbing creams and sprays can be applied to the head of the penis approximately 20 to 30 minutes before sexual activity. It is important to follow the recommended time frame as leaving the cream/spray on for longer may result in the loss of erection. During vaginal sex, it is advised not to keep the numbing cream/spray on the exposed penis to prevent vaginal numbness. Prior to engaging in sexual activity, it is recommended to wash off the cream from the penis five to ten minutes beforehand. Additionally, using a condom can help reduce sensation and provide protection against disease and pregnancy.

After Treatment

With the techniques provided in this guide, approximately 95 out of 100 men can achieve recovery from premature ejaculation (PE). While there are no guarantees, incorporating relaxation techniques may prove beneficial. If the issue persists, continue collaborating with your healthcare provider to explore suitable solutions for your specific needs.

If you’re in Schertz, TX or nearby areas, ReUP Men’s Clinic is the premier men’s clinic committed to advancing men’s health through innovative and ethical practices. Our expert team prioritizes your well-being, offering personalized in-person consultations and cutting-edge treatments tailored to your unique health profile. Rediscover vitality and well-being with ReUP Men’s Clinic – your trusted partner in men’s health.

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