Ejaculation is the release of semen from the body. Premature ejaculation (PE) is when ejaculation happens sooner than a man or his partner would like during sex. Occasional PE is also known as rapid ejaculation, premature climax or early ejaculation. PE might not be a cause for worry. It can be frustrating if it makes sex less enjoyable and impacts relationships.

HOW DOES EJACULATION WORK?

Ejaculation is controlled by the central nervous system. When men are sexually stimulated, signals are sent to your spinal cord and brain. When men reach a certain level of excitement, signals are then sent from your brain to your reproductive organs. This causes semen to be released through the penis (ejaculation). Ejaculation has 2 phases: emission and expulsion.

Phase 1: Emission

Emission is when sperm moves from the testicles to the prostate and mixes with seminal fluid to make semen. The vasa deferentia are tubes that help move the sperm from the testicles through the prostate to the base of the penis. (When you are talking about just 1 of these tubes, it is called a vas deferens.)

Phase 2: Expulsion

Expulsion is when the muscles at the base of the penis contract. This forces semen out of the penis. Usually, ejaculation and orgasm (climax) happen at the same time. Some men climax without ejaculating. In most cases, erections go away after this step.

PREMATURE EJACULATION AND ERECTILE DYSFUNCTION (ED)

Sometimes PE is a problem for men who have erection problems (erectile dysfunction or ED). This is when men are not able to get or keep an erection that’s firm enough for sex. Since an erection goes away after ejaculation, it can be difficult to know if the problem is PE or ED. ED should be treated first. Premature ejaculation may not be a problem once the ED is treated. CAUSES OF PREMATURE EJACUTION Though the exact cause of PE is not known, serotonin may play a role. Serotonin is a natural substance made by nerves. High amounts of serotonin in the brain increase the time to ejaculation. Low amounts can shorten the time to ejaculation, and lead to PE.

PSYCHOLOGICAL ISSUES

Mental health issues can be involved in PE such as:

• temporary depression
• stress
• guilt
• unrealistic expectations about sexual performance
• history of sexual repression
• overall lack of confidence
• relationship problems

Managing emotional problems often helps.

RELATED ISSUES

PE and Age

Premature ejaculation can happen at any age. Aging is not a direct cause of PE, though aging does cause changes in erections and ejaculation. For older men, erections may not be as firm or as large. Erections may not last as long before ejaculation occurs. The feeling that ejaculation is about to happen may be shorter. These changes can naturally lead to an older man ejaculating earlier.

PE and Your Partner

With PE, you may feel you lose some of the closeness shared with a sexual partner. You might feel angry, ashamed and upset, and turn away from your partner. Premature ejaculation doesn’t only affect you, it also affects your partner. Your partner may be upset with the change in sexual intimacy. PE can cause partners to feel less connected, or feel hurt or distant.  

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