Premature Ejaculation  

PE – Modern disease review                                                                                                   

Premature Ejaculation (PME or PE) occurs when a man Experiences orgasm and ejaculates (expels semen) sooner during sexual intercourse than he or his partner would like Ejaculates within a small duration (may be a few seconds) after starting sexual activity or with minimal stimulation of penis

PE is defined as – Ejaculation which always or nearly always occurs prior to or within about one minute (International Society for Sexual Medicine) Ejaculation occurring within 15 seconds from the beginning of sexual intercourse (International Classification of Diseases – ICD-10)

  • Early ejaculation, quick ejaculation,
  • Rapid ejaculation
  • Rapid climax
  • Premature climax
  • Ejaculatio praecox


Exact cause of PE is not known. It occurs due to a complex interaction of psychological and biological factors.
Psychological Causes: You may have some early sexual experiences. These experiences tend to establish a pattern which becomes difficult to change in later part of life. These include: To avoid being caught in the act – Hurry to reach climax (masturbating quickly during adolescence) and finish off with oomph factor (ejaculating) while trying to avoid being discovered in the act Guilty feelings that make you to rush through sexual encounters Unresolved Oedipal conflict / complex – Emotions and ideas that the mind keeps in the unconscious via dynamic repression that concentrates upon a child’s desire to have sexual relations with the parent of the

opposite sex (i.e. males attracted to their mothers and females attracted to their fathers)

  • Erectile dysfunction – Some men may be anxious or develop a fear of getting an erection and also to maintain it during intercourse. Such men may develop a pattern of ejaculating in a hurry. Over a period of time it becomes difficult to change the pattern.
  • Anxiety – either about sexual performance (performance anxiety) or related to any other issues
  • Relationship problems between you and your partner
  • Passive aggression (indirect expression of hostility)
  • Depression

  • Biological causes:
  • Abnormal hormone levels
  • Abnormal levels of neurotransmitters (brain chemicals)
  • Abnormal reflex activity of the ejaculatory system
  • Thyroid problems
  • Prostatitis
  • Inflammation and infection of the prostate gland and / or urethra
  • Inherited traits
  • Nerve damage from surgery or trauma (rare)
  • Having too little sex
  • Physiological mechanisms: Serotonin receptors Genetic predisposition Elevated penile sensitivity Nerve conduction atypicalities Others: Side effects of some drugs and medications New partner Long time since last ejaculation

Symptoms – Uncontrolled ejaculation either before or shortly after intercourse begins

  • Ejaculation occurs before the person wishes it (inability to delay or control ejaculation for more than 1 minute after penetration, can occur even during masturbation and other sexual situations also)
  • Ejaculation occurs with minimum stimulation
  • Lifelong (primary)PE occurs all or nearly all of the times beginning with your first sexual encounters
  • Acquired PE has the same symptoms but develops after you have had previous sexual experiences without ejaculatory problems
  • Natural variable PE – characterized by periods of rapid ejaculation as well as periods of normal ejaculation


Diagnosis is usually made on the basis of clinical symptoms.
PE is caused due to different causes. Your doctor may order some lab tests to rule out any other medical problems. Your doctor will conduct a thorough medical examination and discuss sexual history with you. He or she may also want to talk to your partner.
Diagnostic criteria –
You are sure to be suffering from PE if you:
Always or nearly always ejaculate within one minute of penetration
Are unable to delay ejaculation during sexual intercourse all or nearly all of the time
Feel distressed and frustrated, and tend to avoid sexual intimacy as a result
Risk Factors:
The below said factors may increase
r risk of PE – Erectile dysfunction – ED is trouble getting or maintaining an erection (occasional or consistent). Fear of losing erection may cause you to consciously or unconsciously hurry through sexual encounters. Health problems – If you have a serious or chronic medical condition, such as a heart disease, you may feel anxious during sex and may unknowingly rush to ejaculate Stress – emotional or mental strain limits your ability to relax and focus during sexual encounters Complications:
PE alone doesn’t increase your risk of health problems. It can on the other hand cause many problems in your personal life – Stress and relationship problems Fertility problems

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