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Premature Ejaculation Causes

Premature Ejaculation causesPremature Ejaculation Causes

Premature ejaculation causes are a source of great concern for men who experience this sexual challenge. Premature ejaculation (PE) occurs when a man experiences climax during intercourse sooner than he or his partner desire. Also known as rapid ejaculation, premature ejaculation is the most common type of sexual problem affecting men younger than 45 years.

The average time from the initiation of intercourse to ejaculation is about five minutes. Some men ejaculate even before intercourse begins or immediately after penetration. However, what constitutes premature ejaculation varies considerably depending on the man and what he and his partner find sexually satisfying.

According to the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV), the criteria for premature ejaculation are:

  • Persistent and recurrent ejaculation with minimal sexual stimulation before, on, or shortly after penetration before the person desires it
  • Marked interpersonal difficulty or distress
  • Not exclusively due to direct effects

Who Experiences Premature Ejaculation?

According to the National Health and Social Life Survey (NHSLS), premature ejaculation affects 30% of American males. However, other surveys have shown that many men do not report PE to their doctor, and some do not believe it can be resolved. Therefore it is likely the 30% figure is low. (Benson)

Premature ejaculation can occur at any age during a man’s lifetime. However, it is most common in men aged 18 to 30, although it can also occur along with secondary impotence in men aged 46 to 65.

There may be some racial differences with respect to premature ejaculation causes. A telephone survey conducted in 2003 of 1,320 men without erectile dysfunction reported that 21% of African American men reported PE compared with 29% of Hispanics and 16% of non-Hispanic whites. An analysis of the NHSLS found that 34% of African American men, 29% of white men, and 27% of Hispanic men experienced PE. (Giuliano 2008)

Types of PE

Premature ejaculation can be primary (lifelong) or secondary (acquired). According to the International Society for Sexual Medicine, primary PE is characterized by

  • Ejaculation that always or nearly always occurs within one minute of vaginal penetration
  • An inability to delay ejaculation on nearly all or all vaginal penetrations
  • Negative personal characteristics, such as stress, frustration, or avoidance of sex

Men with secondary premature ejaculation generally have the same symptoms as the primary type. The critical difference is that their ejaculatory difficulties develop after they have had previous, satisfying sexual relationships without ejaculatory problems.

Premature Ejaculation Treatment

Risk Factors

Several factors can increase a man’s risk of developing premature ejaculation.

  • Erectile dysfunction. Men who occasionally or consistently have difficulty attaining or maintaining an erection are at increased risk of experiencing PE, likely because of the fear of losing their erection, which causes them to rush through sexual relations.
  • Stress and/or anxiety. Emotional stress and anxiety can make it difficult to relax and/or focus during sexual relations.
  • Health problems. The presence of health problems, such as heart disease or arthritis, may cause men to unknowingly rush to ejaculate.
  • Use of medications. Rarely, use of certain drugs, especially psychotropics, can influence the activity of chemical messengers in the brain and contribute to premature ejaculation.

Premature Ejaculation Causes

Premature ejaculation causes can be viewed from an evolutionary perspective. In primitive times it was likely beneficial for males to ejaculate quickly so they could successfully fertilize a female before being challenged by other males. From a societal perspective, one theory is that men are expected to reach orgasm quickly because they are afraid to get caught masturbating or having sex during their teen years.

At one time, premature ejaculation causes were believed to be psychological, but research has shown that it likely has both biological and psychological causes. Possible premature ejaculation causes include:

  • Feelings of guilt that make men tend to rush through sexual intercourse
  • Presence of or worries about erectile dysfunction
  • Anxiety regarding sexual performance or other issues
  • Relationship problems with one’s sexual partner
  • Abnormal hormone levels. Higher levels of testosterone have been found in men who experience premature ejaculation than in men without premature ejaculation. (Corona 2008)
  • Abnormal levels of neurotransmitters
  • Thyroid problems
  • Abnormal reflex activity of the ejaculatory system
  • Inflammation and infection of the prostate or urethra
  • Heredity/genetics
  • Nervous system damage due to trauma or surgery (rare)
  • Withdrawal from certain medications used to treat mental health issues (rare)

Premature Ejaculation Causes: Diagnosis

Men with premature ejaculation should consult a urologist or other knowledgeable health professional. In men who experience PE and who have no other medical problems, there are no conventional lab tests that can affect treatment. To identify premature ejaculation causes, physicians can take a detailed history of a man’s health and sex life and perform a physical exam. Men with erectile dysfunction and PE are often asked to undergo a blood test to determine their testosterone and prolactin levels to see if they may be a factor. Referral to a urologist may be made. If depression or other medical problems are present, then a physician should order the appropriate lab tests.

Read More on Premature Ejaculation Treatment

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References for Premature Ejaculation Causes

Benson A. Premature ejaculation. Emedicine

Corona G et al. Different testosterone levels are associated with ejaculatory dysfunction. J Sex Med 2008 Aug; 8:1991-98

Giuliano F et al. Premature ejaculation: results from a five-country European observational study. Eur Urol 2008 May; 53(5): 1048-57

 

 

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Created: May 27, 2011
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