Premature Ejaculation Diagnosis, Prescriptions, & Treatment (2024)

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Premature Ejaculation Diagnosis, Prescriptions, & Treatment (7)

What is premature ejaculation?

Premature ejaculation (PE) happens when a male ejaculates sooner than he or his partner would like during sex. Premature ejaculation is a common and treatable condition that about 1 in 3 males will experience at some point in their lives.

Medically speaking, PE describes ejaculation that happens sooner than desired or intended, usually within one minute of penetration. Many men who are worried about premature ejaculation don’t meet the medical criterion for diagnosis.

PE may be primary, which refers to a condition you’ve had for your whole life. But PE may also be secondary. This means that you acquire the condition after having sexual experiences where premature ejaculation was not a problem.

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What are the symptoms?

The main symptom of premature ejaculation is that you are unable to delay orgasm during sexual stimulation. However, you may experience additional symptoms, which include the following:

  • You almost always ejaculate within 60 seconds of penetration (or masturbation).
  • You’re rarely able to delay ejaculation during penetrative sex (or masturbation).
  • You avoid sexual encounters because of anxiety, frustration, or embarrassment about premature ejaculation.

If these are experiences you often have, we encourage you to speak with a medical professional. 95% of men with PE can successfully delay ejaculation with the right treatment. Chances are, you’re one of them. It’s time to discover your premature ejaculation treatment options.

What causes premature ejaculation?

What causes premature ejaculation? The truth is that we’re not sure about the exact cause of PE. Even though medical researchers aren’t able to identify its exact cause, they can point to several contributing factors. Some of these causes are psychological (mental), and some are biological (physical).

One physical factor, serotonin, can cause mental factors that contribute to PE and make it worse. Serotonin is a chemical responsible for feelings of happiness and well-being. When your body’s serotonin levels are high, they can help delay ejaculation. But when you have low serotonin levels, they can exacerbate and even cause premature ejaculation. Unfortunately, stress and depression can also make existing PE worse.

Although doctors can’t be sure of the condition’s precise cause, there are often psychological factors present for men who suffer from PE. More often than not, these mental factors are present, with or without physical ones.

Psychological causes

Many men are surprised to learn the impact emotional and psychological issues can have on sexual performance. Some of the psychological causes of PE include

  • Depression
  • Anxiety, especially about PE or sexual performance
  • Guilt and shame
  • Stress
  • Low self-esteem or confidence
  • History of sexual abuse or repression
  • Unrealistic expectations concerning sexual performance

These emotional and psychological factors can be further exacerbated by issues like erectile dysfunction (ED) and difficulty in the relationship you have with your sexual partner.

Biological causes

Biological factors can also contribute to problems with premature ejaculation. These are issues with your physiology rather than your mental state, but they may also be connected. For instance, serotonin is a biological factor that can influence both your physiological and psychological state.

The physiological causes of premature ejaculation include

  • Low testosterone levels
  • Low serotonin levels
  • Inflammation or infection of the prostate
  • Inflammation or infection of the urethra

Many of these psychological and biological risk factors can also cause erectile dysfunction (ED). ED, in turn, can be an underlying cause of PE.

How do you treat PE?

How does treatment for premature ejaculation work? All treatments focus on the same thing: how to delay ejaculation. There are several treatments available that work well for PE, especially when used in combination. They include psychological approaches, behavioral techniques to control ejaculation during sex, condom use, topical anesthetics applied directly to the penis, and oral medications.

Many men combine 2 or more of these therapies for the best all-around treatment. For the time being, we’ll focus on the 2 most common types of premature ejaculation pills available by prescription, SSRIs and PDE5 inhibitors.

Oral medications

Certain prescription meds that can help delay ejaculation are prescribed off-label as premature ejaculation pills. There are 2 main classes of oral premature ejaculation medicine available by prescription: antidepressants, especially SSRIs, and PDE5 inhibitors. Though these oral meds are currently prescribed as a treatment for premature ejaculation, the FDA hasn’t approved any oral medication specifically for PE. As a result, any premature ejaculation pills you’re prescribed are being used off-label.

Antidepressants (SSRIs)

Certain antidepressants have the side effect of delaying orgasm. Since the chemical serotonin can help delay ejaculation, antidepressants that increase serotonin levels in your brain may be used to treat PE. This class of antidepressants is called selective serotonin reuptake inhibitors (SSRIs).

Sertraline is a common SSRI that may be prescribed off-label as a PE treatment. Research shows that this med often works well, whether it’s used daily or on an as-needed basis. Take this medication as your doctor prescribes it, either each day or as needed before sexual intercourse. When used daily, this med takes 5-10 days to start working, and it will be 2-3 weeks before you see its full effects.

ED Drugs (PDE-5 inhibitors)

Oral ED drugs are part of a class of medications known as phosphodiesterase-5 (PDE-5) inhibitors. Viagra (sildenafil) is an example of a PDE-5 inhibitor. Again, the FDA has not approved these meds as PE treatments, though they are FDA-approved to treat erectile dysfunction.

In some cases, premature ejaculation is a side effect of erectile dysfunction. When ED is the underlying cause of PE, your doctor will treat the erectile dysfunction first. For many patients, successfully treating ED will also solve the premature ejaculation problem. If you suffer from both sexual conditions, a drug like sildenafil can be a beneficial all-around treatment.

Want to get more information on your options or any of the specific meds we prescribe? We’re here for you. Talk to a Lemonaid doctor or nurse practitioner about your symptoms. When appropriate, our medical team prescribes meds like sildenafil (Viagra) and tadalafil (Cialis).

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Lemonaid Health is a national telehealth company based in San Francisco, CA.

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Up to 30% of men have PE

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Up to 30% of men have PE

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Premature Ejaculation Diagnosis, Prescriptions, & Treatment (2024)
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