Premature ejaculation

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What causes premature ejaculation?

What causes premature ejaculation?

There are lots of reasons why someone might develop premature ejaculation (PE). Sometimes the cause can be physical in nature: for example having an enlarged prostate or an overactive or underactive thyroid. In other cases, the cause might be psychological: for example having depression or being anxious about sex. Conditioning can also be a factor: an instance of this might be when someone has ‘trained’ themselves to ejaculate quickly from an early age to avoid being caught masturbating.

Daniel Atkinson
Medically reviewed by
Daniel Atkinson, GP Clinical Lead
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Reviewed on Jan 23, 2025. by Dr Daniel Atkinson GP Clinical Lead Registered with GMC (No. 4624794) Next review due on Jan 23, 2028.
Daniel

Last updated on Jan 23, 2025.

Are there different types of premature ejaculation?

There are two types of premature ejaculation. The first of these is primary (or lifelong) premature ejaculation. This is when it presents itself as you first become sexually active. Sometimes it’ll continue throughout life and can be attributed to different factors. These include traumatic experiences, such as sexual abuse. It can also occur if you have hormone imbalances, for instance, if you’ve been diagnosed with hypothyroidism .

The second type is known as secondary (or acquired) premature ejaculation. This is the most common form and happens suddenly or gradually. Often it is brought on by psychological issues such as anxiety, depression or long term stress. It can arise if there are undiagnosed issues with your prostate and be a sign of other health conditions like high blood pressure or diabetes. It’s always worth having a chat with a health professional if you’re unsure what’s causing it.

Secondary premature ejaculation often doesn’t require any treatment if it’s being caused by psychological factors. Primary premature ejaculation might need medical intervention if there are undiagnosed health issues causing it.

  • What causes primary premature ejaculation?

  • What causes secondary premature ejaculation?

This can often be caused by previous sexual trauma, such as childhood sexual abuse. In such cases, seeking counselling or talking therapy to help resolve the issues and come to terms with your past can help.

Sometimes conditioning can play a part in bringing it on. If, as a teenager, you were scared of being caught masturbating and frequently rushed to finish, this can lead to the quick release of sperm during sex as an adult.

One of the other main factors of this issue can simply be a general oversensitivity in the penis. Feeling overstimulated can be enough to bring on premature ejaculation. There are techniques you can try such as deep breathing and trying different sexual positions to help slow you down.

Secondary PE can arise due to reactive anxiety, depression and stress. These are moods and feelings that crop up due to life events or lifestyle choices. Simply taking some time out to recharge, regroup and have a rest is all that might be needed to make you feel better. Talking therapy, mindfulness and breathing exercises can help.

Performance anxiety can be another one of the causes of premature ejaculation in men. It really is perfectly normal to worry or feel anxious about your sexual ability, but it can lead to problems with ejaculation. Some men may find they climax too quickly, others may find they can’t climax at all.

There are also other physical health problems that can lead to secondary premature ejaculation. If you have high blood pressure, diabetes or are a heavy drinker, it can bring it on. If you suspect you might have any of these issues, it’s worth getting a check up and chatting to a doctor who’ll be able to help and advise you.

Psychological causes of premature ejaculation

It’s common for premature ejaculation to have psychological causes. Life stresses and worries can impact us all and this, in turn, can affect your sex drive.

For some people, there may be a loss of libido. For others, there may be no less desire to have sex, but issues like premature ejaculation occur instead.

Below are some of the issues considered to be psychological factors affecting premature ejaculation in men.

Stress

Stress, life and relationship worries are common causes of early ejaculation. If you’re struggling with stress without taking steps to manage it and care for yourself, it can have a knock on effect on your sexual performance. Having a good friend to talk to, or trying counselling can be a great way forward.

Depression

Low mood and depression can also be contributory factors in premature ejaculation. This could be down to high levels of stress or anxiety. However, anxiety can sometimes be caused by worrying about your sex life, especially if you’ve had one or two episodes of premature ejaculation already. This can cause a cycle of premature ejaculation and anxiety – which is why it’s really important to speak to your partner if you’re concerned about your sex life. They can provide reassurance, and help look for a solution that works for both of you.

Performance anxiety

It’s quite a common thing for men to worry about their sexual performance and this can lead to episodes of premature ejaculation occurring. It sometimes feels like a self-fulfilling prophecy. Once it starts, it’s normal to feel anxious about it happening again and a cycle of worry begins. This is what’s known as performance anxiety. There are self-help techniques you can use for this such as taking a deep breath during sex to help control the urge to ejaculate. It can also help to masturbate one to two hours before you have sex, which might help you last longer when you become intimate with your partner.

Physical causes of premature ejaculation

There are a few different physical causes of premature ejaculation. If you think you might have any of the symptoms of high blood pressure (blurred vision, shortness of breath, chest pain, dizziness, headaches) or diabetes (needing to urinate a lot, thirst that doesn’t go away, weight loss, slow healing, blurred vision) or diabetes, have a chat with your doctor to iron out any potential health concerns you’ve got.

There are some other physical causes too and it’s worth looking at them.

Oversensitivity

Penis oversensitivity can have a few different causes. For instance, if you’ve had a recent urinary tract infection, this can cause pain in the genital area, making it feel oversensitive to touch and stimulation. A recent circumcision might also cause the glans of the penis to become extra sensitive for a while too.

If you’ve experienced trauma or an injury to your penis in the past, from playing contact sport or even from lots of vigorous sex this can cause oversensitivity and mean that PE can develop.

There are other conditions like phimosis which can cause oversensitivity too. This is a condition where the foreskin is too tight and it can’t be pulled back from the head of the penis comfortably .

But can phimosis cause premature ejaculation? With phimosis, you’re more likely to experience discomfort and soreness. There’s the chance that you’ll need to take care with using extra lubrication and barrier protection, such as condoms to reduce the sensation you feel when you’re being intimate with anyone.

On its own, phimosis is unlikely to trigger premature ejaculation, in fact it’s more likely to increase your latency time. To treat this condition, clinicians often recommend circumcision to help with the symptoms and once you’re recovered any pain and discomfort should disappear.

Can erectile dysfunction cause premature ejaculation?

It might seem counterintuitive but erectile dysfunction can cause premature ejaculation. It often occurs when you realise you can’t always sustain an erection for long enough. When you do achieve one, it’s easy to get into the habit of ejaculating too quickly. This can turn into a cycle of repetitive sexual behaviour that’s difficult to break.

In cases like this, it’s good to catch up with a doctor as it might mean that you need to have any issues with ED treated first. Medications such as Viagra can be used to help with this as it will help increase latency time and thus assist with premature ejaculation.

Can premature ejaculation be caused by other health problems?

There are some physical health problems that can cause premature ejaculation. We’ve mentioned high blood pressure and diabetes, but there are some other wellbeing issues that can affect the condition too.

Can thyroid issues cause erectile dysfunction? If you suffer from an overactive or underactive thyroid gland, it’s because there is a hormonal imbalance affecting your body. You may need to take Thyroxine to help with this. One of the unpleasant side effects of undiagnosed thyroid issues is sexual dysfunction.

In men who have hypothyroidism, it can be common to experience difficulty in keeping an erection for very long before early ejaculation occurs.

Your genito-urinary health can play a part too and sometimes issues can arise with your bladder or prostate that are worth checking out. Does an enlarged prostate cause premature ejaculation? Well, if you have the signs and symptoms of an enlarged prostate such as frequent, painful urination, recurrent urinary tract infections and inflammation then this can cause the early release of sperm during sex.

If you think you might have either of these health concerns, you might be advised to get yourself checked out to make sure everything is as it should be.

Does porn cause premature ejaculation?

There isn’t much scientific data available to suggest that using porn can cause premature ejaculation. However, it can lead to sexual dysfunction in men and worries about their own sexual performance. This can then cause issues in the bedroom and lead to body image concerns. It may be best to avoid porn or limit your consumption where possible.

Does smoking cause premature ejaculation?

It’s unclear as to whether there are any links between smoking and premature ejaculation. There is little clinical data on it. However, it’s true that smoking can have a negative impact on your sexual health generally. It can sometimes cause erectile dysfunction in men. Just generally taking care of yourself, quitting smoking and easing up on alcohol can have the biggest impact on your sexual wellbeing.

Premature ejaculation: get expert help

If you think you might have the symptoms of premature ejaculation then there’s help and advice out there. From self help tips to help you last longer in bed to a breakdown of the different treatments for PE.

If you want to explore the different treatment options for PE then our clinical experts are ready to guide you so that you can look after your health with confidence.

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This page was medically reviewed by Dr Daniel Atkinson, GP Clinical Lead on Jan 23, 2025. Next review due on Jan 23, 2028.

Last updated on Jan 23, 2025.

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