Premature ejaculation refers to a sexual dysfunction in men in which the individual reaches orgasm and ejaculates sooner than either he or his partner would like, typically before or shortly after penetration.
This condition is quite common: studies suggest it affects about 30-40% of men. The American Urological Association identifies premature ejaculation as the most prevalent sexual dysfunction among men.
The primary symptom is simply the occurrence of ejaculation sooner than desired, either just before penetration or shortly after, causing dissatisfaction for one or both partners.
The causes can be grouped into three broad categories:
Physical or chemical issues:
Problems with erectile function
Hormonal abnormalities (for example, involving oxytocin, luteinising hormone, prolactin, or thyroid-stimulating hormone)
Issues with the prostate or thyroid
Low levels of certain brain chemicals (like serotonin or dopamine)
A penis with unusually high sensitivity to stimulation
Emotional or psychological factors:
Anxiety about sexual performance (for example, being with a new partner, having abstained for a while, lacking sexual confidence)
Stress
Relationship difficulties
Depression
A history of traumatic sexual experience
Other contributing factors:
Use of illicit drugs (such as cocaine or amphetamines)
Certain medications (for instance, cabergoline, used for Parkinson’s disease)
Smoking. Studies show that smoking may lead to premature ejaculation, and it can also reduce libido and affect fertility.
To reach a diagnosis, a doctor will usually take a comprehensive medical and sexual history, asking how long the problem has lasted, under what circumstances it occurs, how frequently, whether all sexual encounters are affected, which medical conditions are present, and what medications are being taken.
Laboratory tests (blood or urine) may be ordered to rule out physical conditions.
Treatment may include:
Antidepressants (such as sertraline, citalopram, fluoxetine): To help delay premature ejaculation.
Topical anaesthetic creams or sprays: To be applied to the head and shaft of the penis to reduce sensitivity and thus delay ejaculation.
Drugs for erectile dysfunction (for example, sildenafil, tadalafil, vardenafil).
“Start‐stop” technique: Stimulation is paused when nearing orgasm, held for around 30 seconds, then resumed; repeated several times before allowing ejaculation.
“Squeeze” therapy: Stimulation proceeds until just before orgasm, then the partner or person gently squeezes the penis head for ~30 seconds, reducing erection; repeated before eventual ejaculation.
Distractive thinking: Focusing on non-sexual thoughts while stimulated to delay orgasm.
A psychologist, psychiatrist, couples therapist or sex therapist may assist in addressing psychological, emotional or relational contributors to the condition.
Some ways to reduce the risk of premature ejaculation include:
Quitting smoking
Taking prescribed medications appropriately
Seeking counselling if needed
Increasing sexual frequency (intercourse or masturbation)
Using a condom
Having sexual intercourse with the partner in the top (‘on top’) position
When to See a Urologist at Prince Court Medical Centre
You should see a doctor if premature ejaculation happens frequently, affects your relationship, or causes stress, anxiety, or reduced confidence. Although it may feel embarrassing to talk about, premature ejaculation is often treatable with straightforward and effective approaches. Seeking advice early from a urologist or the appropriate medical professional is recommended.
At Prince Court Medical Centre in Kuala Lumpur, our experienced urologists and men’s health specialists provide comprehensive evaluation and treatment for premature ejaculation and other sexual health conditions.
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