What is ejaculation?

Ejaculation is the sudden, pleasurable release of semen through the penis. It is controlled by your brain (your central nervous system). When you are sexually stimulated, signals are sent up your spinal cord to your brain. When you reach a certain level of excitement, your brain tells your reproductive organs to let go. This causes semen to be ejected through the penis (ejaculation).

Premature ejaculation (PE) is when ejaculation happens sooner than a man or his partner would like during sex, within a defined period of time, usually less than 2 to 3 minutes.

Occasional premature ejaculation is also known as rapid ejaculation, premature climax, or early ejaculation. PE might not be a cause for worry. But, it can be frustrating if it makes sex less enjoyable and impacts relationships. If it happens often and causes problems, we can help.

Some people think premature ejaculation (PE) is a disease or a problem that cannot be fixed. Others may think certain men are born with better control than others. These ideas are simply not true.

Causes of premature ejaculation 

The exact cause of premature ejaculation is not known, but there are many reasons why a man may have premature ejaculation. There may be biological, chemical, or psychological reasons. 

Below are some more specific causes.

Psychological causes

Psychological factors that might play a role include:

• Early sexual experiences
• Sexual abuse
• Poor body image
• Depression
• Worrying about premature ejaculation
• Guilty feelings that can cause you to rush through sex
• Lack of confidence 
• Stress

Serotonin 

Serotonin is a natural substance in your body made by nerves. It helps to control the way the brain manages mood, emotion, sleep, and sexual desire. High amounts of serotonin in the brain increase the time to ejaculation. Low amounts can shorten the time to ejaculation, and lead to premature ejaculation.

Other factors;

Swelling and infection of the prostate or urethra.

Irregular hormonal levels.

Complications 

Premature ejaculation can cause issues in your personal life. They might include:

• Stress and relationship problems. A common complication of premature ejaculation is relationship stress.
• Fertility problems. Premature ejaculation can sometimes make it hard for a partner to get pregnant. This may happen if ejaculation doesn’t occur in the vagina.

Diagnosis 

The diagnosis is determined by whether ejaculation occurs early, late, or not at all. Most often, your healthcare provider will diagnose premature ejaculation after a physical exam and talking with you. Some questions he or she may ask are:

• How often does the PE happen?
• Has the PE been present lifelong, or started recently?
• Does this happen with just one partner or all partners?
• Does PE happen with each attempt at sex?
• What type of sexual activity (i.e., foreplay, masturbation, intercourse, use of visual cues, etc.) do you take part in, and how often?
• How has PE changed your sexual activity?
• How are your relationships?
• Is there anything that makes premature ejaculation worse or better (i.e., drugs, alcohol, etc.)?