What are the causes of premature ejaculation?

7 Dec 2021

Premature ejaculation is a very frequent sexual dysfunction experienced by 20 to 30% of men. The main symptom is systematic quick ejaculation during sexual relations and the inability to delay ejaculation.
There are many potential causes and knowing how to identify them helps you choose the most adapted solution to feel the most sexually fulfilled.

Psychological factors

The causes of premature ejaculation are often linked to psychological factors: a bad experience, performance anxiety, difficult situation… What mechanisms are involved?

Reaction to change and emotions

Premature ejaculation can occur suddenly at a point in a man’s life. In this case, the cause is often psychological. Relationship problems, new partner, stress at work, social phobia, depression… Any brutal change or complicated period can activate a stress loop and have an impact on your sex life. Anxiety tends to speed up ejaculation. The stress loop activates the human body’s automatic reflexes, which indirectly stimulates the secretion of adrenalin and anaesthetises sensations prior to ejaculation. It is harder to delay ejaculation in these circumstances.

Anxiety and performance anxiety

One of the frequent causes of early ejaculation is sexual performance anxiety (8). This is a type of stress caused by fear of not being able to satisfy your partner or wanting to last longer in bed (7). These thoughts provoke a fear of failure and stimulate the secretion of adrenalin. It’s a vicious circle. A man affected by premature ejaculation worries and experiences more and more frequent episodes of premature ejaculation. This state of fear is amplified by the memory of these bad sexual experiences. Fear of failure gradually settles in and leads to avoidance of sexual relations in the most serious cases. This factor in turn reinforces the vicious circle since low sexual activity is a risk factor for premature ejaculation.

In this type of situation, do not hesitate to consult a sex therapist to work through your fears and break out of this vicious circle.

Behavioural conditioning

First sexual experiences, in particular masturbation, are often experienced with fear of being caught. In this context, a man can get used to having to “rush” to avoid any risk. This form of behavioural conditioning can also be caused by the person’s education. Feelings of fear or shame about sexual pleasure can lead to “rushed” sexual relationships. By repeating this type of experience, the man becomes conditioned to going fast during sexual relations. Fortunately, it is always possible to reverse conditioning by working on controlling ejaculation.

Some anatomical criteria cause premature ejaculation

Some anatomical criteria can cause premature ejaculation. This is the case of a short frenulum. This small band of tissue links the glans to the foreskin. The glans is partly covered and is consequently less exposed to friction during sexual intercourse. This mechanism naturally reduces the sensitivity of the glans and helps to modulate arousal. In the case of a short frenulum, such modulation is more difficult. This anatomical feature can also lead to discomfort during sexual intercourse and is consequently a frequent reason for medical consultation. Other factors such as hyperexcitability of the ejaculation reflex can also be involved.

Neurobiological vulnerability

In the case of premature ejaculation observed since the start of sexual relations, a serotonin imbalance may be the cause. This neurotransmitter inhibits ejaculation.  Some people suffer from an imbalance in brain receptors which reduces the transmission of serotonin.  The reduced level of serotonin no longer correctly acts as an inhibitor and the risk of premature ejaculation is increased.  This is the case of hereditary forms of premature ejaculation.

Disorders and illnesses triggering premature ejaculation

Some disorders and illnesses trigger premature ejaculation. They include pelvic pain syndrome, multiple sclerosis, changes in levels of sex hormones, erectile dysfunction and hyperthyroidism.

Possible solutions whatever the cause of premature ejaculation

Whatever the cause, many treatments for premature ejaculation (10) exist: condoms and penis rings, local anaesthetics, sex therapy, medical treatment… This wide range of possibilities helps you choose the solution that is best adapted to feeling the most sexually fulfilled.

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*The efficacy of Kenergon® has been shown in a clinical study conducted in 52 patients, treated during one month.

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SEREFOGLU, Ege C. et SAITZ, Theodore R., 2012. New insights on premature ejaculation: a review of definition, classification, prevalence and treatment. Asian Journal of Andrology. novembre 2012. Vol. 14, n° 6, pp. 822‑829. DOI 10.1038/aja.2012.108.

XIN, Z. C., CHUNG, W. S., CHOI, Y. D., SEONG, D. H., CHOI, Y. J. et CHOI, H. K., 1996. Penile sensitivity in patients with primary premature ejaculation. The Journal of Urology. septembre 1996. Vol. 156, n° 3, pp. 979‑981.