Premature ejaculation (PE) is one of the most common male sexual concerns, and yet, many men struggle silently because they feel embarrassed to talk about it. In reality, PE is a completely treatable condition. With the right diagnosis, evidence-based therapy, and guidance from a trained mental health or sexual-health specialist, most men see meaningful improvement.
At Dr. Vatsal’s Clinic, we follow a structured, science-backed approach to help men understand why PE is happening and what can be done to manage it, whether it’s a long-standing (lifelong) issue or something that developed recently.
What Is Premature Ejaculation?
Premature ejaculation is when ejaculation happens earlier than a man or his partner would like. Clinically, it is often defined as ejaculation within about a minute of penetration or with very little sexual stimulation.
However, the most important factor in diagnosis is loss of control and emotional distress.
If the timing of ejaculation is affecting your confidence, relationship, or sexual satisfaction, treatment can help.
PE can be:
- Lifelong (primary): Present since a man’s first sexual experiences.
- Acquired (secondary): Develops later in life, often due to stress, relationship issues, anxiety, or medical conditions.
Why Does Premature Ejaculation Happen?
There is no single cause. Most men experience PE due to a combination of biological and psychological factors, such as:
- Low serotonin activity
Serotonin is a chemical in the brain that helps regulate mood and sexual response. Lower serotonin activity can shorten the time to ejaculation.
- Psychological factors
Common contributors include:
- Performance anxiety
- Stress
- Depression
- Low confidence
- Relationship concerns
- Past negative sexual experiences
- Erectile dysfunction (ED)
Many men with ED ejaculate earlier because they are worried about losing their erection. Treating ED often improves PE automatically.
- Hormonal or medical issues
Thyroid problems, prostatitis, or neurological conditions may contribute.
How Premature Ejaculation Is Diagnosed
A proper diagnosis begins with a detailed assessment. At Dr. Vatsal’s Clinic, this usually includes:
- Understanding your sexual history & concerns
Your psychologist or psychiatrist will ask about:
- How long has PE been occurring?
- Whether it happens with all partners or situations
- Your stress levels, emotional health, and relationship factors
- Any difficulty in getting or maintaining an erection
- Physical examination (if needed)
A physical assessment is only done if a medical condition is suspected.
- Possible hormone testing
If PE occurs along with ED or low libido, tests for testosterone or thyroid function may be advised.
- Specialist referral
If required, you may be referred to a urologist or sexual-medicine specialist for further evaluation.
Premature Ejaculation Treatment Options
Evidence-based, safe, and globally recommended approaches.
There is no “one-size-fits-all” treatment. Most men improve with a combination of behavioral techniques, therapy, and medication.
1. Behavioral Techniques
These non-drug approaches help increase control and awareness of arousal levels. They are often the first line of treatment.
Start–Stop Technique
You or your partner pauses stimulation just before climax.
Once the urge decreases, stimulation begins again.
Repeating this cycle helps train your body to delay ejaculation.
Pause–Squeeze Technique
Before ejaculation, you or your partner gently squeezes the area where the head meets the shaft.
This reduces the sensation and delays climax.
Practice masturbation before sex
Ejaculating an hour or two before intercourse may temporarily help delay ejaculation.
2. Pelvic Floor (Kegel) Exercises
Many men have weak pelvic floor muscles, which play a role in ejaculation control. Strengthening them can significantly help.
Basic steps include:
- Identify the pelvic floor muscles by stopping urination mid-flow
- Tighten these muscles for 3 seconds, relax for 3 seconds
- Repeat in sets three times a day
Over time, the muscles gain better control over the ejaculation reflex.
3. Condoms for Sensitivity Reduction
Some condoms reduce sensation and help delay ejaculation.
Climax-control condoms use mild numbing agents such as lidocaine or benzocaine.
4. Topical Numbing Agents
Creams, gels, or sprays containing lidocaine or prilocaine can temporarily decrease sensation in the penis.
These are applied 10–15 minutes before intercourse.
Important notes:
- Wash off before penetration to avoid numbing your partner
- Use only as recommended to avoid reduced sexual pleasure
5. Oral Medications
Several medications, although originally created for other purposes, are widely used for premature ejaculation.
SSRIs (Selective Serotonin Reuptake Inhibitors)
These include:
- Paroxetine
- Sertraline
- Citalopram
- Escitalopram
- Fluoxetine
SSRIs are the most commonly recommended medicines for PE because they help delay ejaculation.
6. Psychological Counseling
Counseling helps address anxiety, performance pressure, relationship conflicts, and emotional factors.
It can significantly improve:
- Confidence
- Intimacy
- Sexual communication
- Stress management
Counseling works best when combined with behavioral therapy or medication.
Premature Ejaculation vs Erectile Dysfunction
Many men confuse the two conditions.
- PE: ejaculation happens too quickly
- ED: difficulty getting or maintaining an erection
When both occur together, ED is usually treated first.
In many cases, once erections improve, PE improves naturally.
When to Seek Treatment
You should reach out to a specialist if:
- PE is happening frequently
- It is affecting your relationship or confidence
- You feel stressed or ashamed about your sexual performance
- You want to understand what treatment looks like
Remember, PE is extremely common, and treatment success rates are high when you follow a structured plan.
Take the First Step Today
If premature ejaculation is affecting your confidence or your relationship, you don’t have to manage it alone. Effective, evidence-based treatments are available, and most men see improvement with the right combination of therapy, behavioral techniques, and medical support.
At Dr. Vatsal’s Clinic, we provide a safe, private, judgment-free space where you can openly discuss your concerns and get expert guidance tailored to your needs.
Your sexual health matters, and improvement is absolutely possible.
FAQs
The most effective treatment depends on the cause. Many men benefit from a combination of behavioural techniques, counselling, and medications that help improve control. A doctor evaluates your symptoms and suggests the best option.
Yes, many men achieve long-term improvement when the underlying cause is treated. Therapy, lifestyle changes, and correct medication can bring lasting results.
In most cases, a detailed consultation is enough. However, if symptoms suggest hormonal imbalance, prostate issues, or erectile dysfunction, the doctor may recommend basic tests.
No. Masturbation does not cause PE. However, certain habits like rushing or being overly sensitive can contribute to poor control, which can be corrected through treatment.
Yes. Many cases improve through therapy, relaxation techniques, and behavioural training. Medicines are only used when needed.
Good sleep, stress management, avoiding excess alcohol, and regular exercise can reduce anxiety and improve sexual performance.
Treatment duration varies. Some men improve within weeks, while others may need a few months of consistent therapy or medication.