Premature Ejaculation Guide

1 in 3 men experience premature ejaculation, making it the most common sexual problem to affect men. [1]

The medical definition most doctors use to diagnose premature ejaculation is: 

1. Ejaculating always or nearly always within 1-minute of penetration.
2. Being unable to delay ejaculation during sex all or nearly all of the time.
3. Feeling bothered and frustrated by this and avoiding sex and intimacy as a result.[2]

There are two main types of premature ejaculation, both of which are treatable.

Type 1: Lifelong premature ejaculation.

This starts from a man’s first sexual experience and can continue throughout life if left untreated.[3]

Type 2: Acquired Premature Ejaculation.

This occurs in men who have previously had normal ejaculation times. It can begin at any time in a man’s life and is often linked to relationship troubles, stress, or erectile dysfunction.[1]

Is Premature Ejaculation Permanent? 

Ejaculating quickly is not an insurmountable problem and there are several ways you can manage it if you’re willing to talk about it and consider treatment options. Remember, despite your fears, partners can be understanding and will often be happy to work with you to overcome your challenge or find ways to enjoy sex despite it.

Testosterone and DHT - The Major Culprits of MPB 

Testosterone is converted to dihydrotestosterone (DHT) in the body by the enzyme 5-alpha reductase. DHT affects various organs, including hair follicles.[5] Hair loss is not directly caused by DHT production but rather by an inherited sensitivity to DHT. Individuals with a high genetic sensitivity to DHT are more prone to hair follicle weakening.[6] DHT shrinks hair follicles and shortens the hair growth cycle, resulting in thinner, more brittle hair that falls out faster.[7] It also delays the growth of new hairs after old ones fall out. Certain behaviours, such as using creatine supplements, resistance and weight training, or taking anabolic steroids, can increase DHT levels and exacerbate hair loss.[8]

Ageing

Hair thinning is a natural aspect of ageing, known as involutional alopecia, where hormonal changes slow hair growth and reduce the number of hair strands. This process affects both men and women, with women often experiencing it after menopause.[9]

Chronic Stress

During periods of chronic stress or trauma, temporary hair loss, termed telogen effluvium, can occur.[10]

Certain medications and illnesses

Some medications and illnesses can lead to hair loss. Common medications for conditions like acne, high cholesterol, and depression may have rare side effects such as hair loss.[11] Illnesses such as thyroid disorders, eating disorders, iron deficiency anaemia, diabetes, autoimmune diseases, and skin conditions like psoriasis and dermatitis can also cause hair loss.[12]

Psychological causes 

Your mental state can affect how long you can last in the bedroom, including: performance anxiety, stress, depression and relationship problems.[1,4,5,6]

Physical causes

For men with lifelong premature ejaculation, it could be: [7,8,9,10]

• Low serotonin levels in the brain. 
• Increased sensitivity of the penis and a lower ejaculatory threshold

For men with acquired premature ejaculation, it could be: [11,12,13,14]

• Inflammation and infection in the prostate or urethra (the tube that allows urine to pass out of the body)
• Injury to the pelvic region
• Injury to the nervous system
• Abnormal levels of certain hormones, such as too much testosterone or low thyroid levels
• Side effects from certain medications

Premature ejaculation can often be managed with some simple behavioural and lifestyle changes.

Meditation, breathing exercises and yoga can help relax the nervous system and can increase mindfulness and awareness in the moment. Even 10 minutes a day can make a difference to your mindset and your libido, which can in turn help with premature ejaculation.[15] 

Regular exercise can release hormones and trigger physiological reactions that boost libido. Additionally, the emotional awareness of being healthy and fit gives you a better outlook on life and translates into a better sex life overall.[16,17] 

Behavioural changes such as:

• Kegel exercises [18] 
• Using the ‘stop-start technique [19] 
• The pause and squeeze technique
• Masturbating before sex  
• Use a thick condom or more lube [20] 
• Watch less porn [21] 

Talking about your issue with your partner can actually help ease the shame and embarrassment of it.

Sex therapy, couples counselling and mindfulness meditation can all help get to the bottom of psychologically-rooted premature ejaculation. Couples counselling focuses on assisting couples to build better communication and strengthen their relationship. Mindfulness meditation improves understanding of sensations and emotions as they are experienced within the body. 

There are safe and effective medications available from a doctor to help manage your premature ejaculation. Lifelong premature ejaculation cannot be cured, but can be managed with psychological and/or medical treatment in 75% of cases.[22] 20 For acquired premature ejaculation, it’s possible to get rid of or manage the issue by treating the underlying causes. Treatment will of course depend on the cause

Anaesthetic spray or cream 

The main ingredients are usually lidocaine and/or prilocaine – two types of anaesthetics. One study published in the urology journal BJU International showed that men with premature ejaculation who used the anaesthetic spray lasted on average 2.4 times longer than those who didn’t use it. You simply apply the spray or cream 10-20 minutes before sex. 

Other Medication

Some other medications we can’t mention. Australian law prevents us from mentioning certain medications until you’ve spoken to a doctor, so our lips are sealed. What we can say, though, is there are evidence-based ways to manage both primary and secondary premature ejaculation with medicines, if needed.

Next steps: Mosh is here to help. We’ll get you a doctor- or psychologist-tailored treatment plan to manage your premature ejaculation. No strings attached.

1. Tell us about you 

To start, answer some simple questions about your health and medical history.

2. Hey Doc

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Why we’re different: 

• No long-term contracts: You can stop anytime if you're not satisfied.
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