Mostly, ejaculation and orgasm climax happen at the same time. Some men climax without ejaculating. In most cases, erections go away after this step. Sometimes PE is a problem for men who have erection problems erectile dysfunction or ED.
This is when men are not able to get or keep an erection that's firm enough for sex. Since an erection goes away after ejaculation, it can be tough to know if the problem is PE or ED. ED should be treated first. Premature ejaculation may not be a problem once the ED is treated. Though the exact cause of PE is not known, serotonin may play a role. Serotonin is a natural substance in your body made by nerves. High amounts of serotonin in the brain increase the time to ejaculation.
Low amounts can shorten the time to ejaculation, and lead to PE. PE can happen at any age. Aging is not a direct cause of PE, though aging does cause changes in erections and ejaculation.
For older men, erections may not be as firm or as large. Erections may not last as long before ejaculation occurs. The feeling that ejaculation is about to happen may be shorter. These changes can lead to an older man ejaculating earlier. With PE, you may feel you lose some of the closeness shared with a sexual partner.
You might feel angry, ashamed or upset, and turn away from your partner. Premature ejaculation may not only affect you, it may also affects your partner.
PE can cause partners to feel less connected or feel hurt. Talking about the problem is an important step. Couples counseling or sex therapy can be helpful. Exercises, such as the squeeze technique, may be helpful for you and your partner to prolong an erection see the treatment section of this article for details.
Most importantly, a couple should learn ways to relax. Worry such as performance anxiety can make PE worse. It is typical for men to be able to have at least some control of if and when they ejaculate during partnered sex and masturbation. If a man does not feel that he has control of when ejaculation occurs, and if there is worry by the man or his sexual partner s , PE may be present. When PE gets in the way of your sexual pleasure, you should see your health care provider.
The diagnosis is determined by whether ejaculation occurs early, late, or not at all. Most often, your health care provider will diagnose PE after a physical exam and talking with you.
Some questions he or she may ask are:. Lab testing is only needed if your health care provider finds something during your physical exam. Psychological therapy, behavioral therapy and drugs are the main treatments for PE. You can talk with your health care provider to decide the best choice for you. More than one type of treatment may be used at the same time.
Psychological therapy is a way to work through the feelings and emotions that may lead to problems with sexual relationships. Instead these men might have natural variable premature ejaculation, which includes periods of rapid ejaculation as well as periods of normal ejaculation.
Talk with your doctor if you ejaculate sooner than you wish during most sexual encounters. It's common for men to feel embarrassed about discussing sexual health concerns, but don't let that keep you from talking to your doctor. Premature ejaculation is a common and treatable problem. For some men, a conversation with a doctor might help lessen concerns about premature ejaculation.
For example, it might be reassuring to hear that occasional premature ejaculation is normal and that the average time from the beginning of intercourse to ejaculation is about five minutes. The exact cause of premature ejaculation isn't known. While it was once thought to be only psychological, doctors now know premature ejaculation involves a complex interaction of psychological and biological factors.
Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. This content does not have an English version. This content does not have an Arabic version. Overview Premature ejaculation occurs when a man ejaculates sooner during sexual intercourse than he or his partner would like.
Request an Appointment at Mayo Clinic. Share on: Facebook Twitter. Show references Ferri FF. Ejaculation and orgasm disorders. In: Ferri's Clinical Advisor Elsevier; Accessed August 19, Saitz TR, et al. Because of changes in regulations, you no longer need a prescription to get sildenafil. But you will have to have a consultation with the pharmacist to make sure it's safe for you to take it. Read more about sildenafil including information on how and when to take it.
The use of topical anaesthetics such as lidocaine or prilocaine can help but may be transferred and absorbed to the vagina, causing decreased sensation. Condoms can also be used and are effective, particularly when combined with local anaesthesia. Like premature ejaculation, delayed ejaculation can be caused by psychological and physical factors.
Possible psychological causes of delayed ejaculation are similar to those of premature ejaculation — for example, early sexual trauma, strict upbringing, relationship problems, stress or depression.
Delayed ejaculation can suddenly start to happen after previously having no problems, or less commonly the man may have always experienced it. It can occur in all sexual situations, or only in certain situations.
For example, you may be able to ejaculate normally when masturbating, but not during sex. When ejaculation only occurs in certain situations, there's usually a psychological cause. Sex therapy is a form of counselling that uses a combination of psychotherapy and structured changes in your sex life. This can help to increase your feeling of enjoyment during sex, and help make ejaculation easier. Availability can vary widely depending on where you live. You can also pay privately. The College of Sexual and Relationship Therapists website provides information about private sex therapists and how to find a therapist in your local area.
The relationship counselling service Relate also offers sex therapy at a number of its centres. You'll need to pay for each session.
During sex therapy, you'll have the opportunity to discuss any emotional or psychological issues related to your sexuality and relationship, in a non-judgemental way. Activities may also be recommended for you to try at home while you're having sex with your partner you should never be asked to take part in any sexual activities during a session with the therapist.
Read more information about what a sex therapist can do. There are a number of medicines that can be used if it's thought SSRIs are responsible for causing delayed ejaculation. These include:. These help block some of the chemical effects of SSRIs that may contribute towards delayed ejaculation. Alcohol misuse and drug use can be separate underlying causes of delayed ejaculation, so addressing these problems may help. Read more about getting help with alcohol misuse and drug use.
Pseudoephedrine tablets may be tried, but these will need to be prescribed "off-label". This means the medicine shows promise in treating delayed ejaculation but it has not been licensed for this particular use pseudoephedrine is normally used as a decongestant. Retrograde ejaculation is a rarer type of ejaculation problem. It happens when semen travels backwards into the bladder instead of through the urethra the tube that urine passes through.
Men with retrograde ejaculation still experience the feeling of an orgasm and the condition does not pose a danger to health. However, it can affect the ability to father a child. Retrograde ejaculation is caused by damage to the nerves or muscles that surround the neck of the bladder the point where the urethra connects to the bladder. Usually when you ejaculate, semen is pushed out of your urethra. It is prevented from entering your bladder by the muscles around the neck of the bladder, which close tightly at the moment of orgasm.
However, damage to the surrounding muscles or nerves can stop the bladder neck closing, causing the semen to move into the bladder rather than up through the urethra. Prostate gland surgery or bladder surgery is the most common cause of retrograde ejaculation. Other causes are diabetes , multiple sclerosis , and a class of medicines known as alpha blockers, which are often used to treat high blood pressure hypertension.
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