What is premature ejaculation?

Imagine you’re with someone super hot. You’re about to start having sex (whatever that sex act may look like for you). You’re in the moment and are very excited to start touching each other. You get going and it’s pretty freakin’ great. Suddenly, you realize you’re actually TOO excited. Without any real warning, you’re past the point of no return. You ejaculate. Maybe you feel embarrassed. Maybe you feel ashamed. Maybe a bit of both.

Enter: Premature Ejaculation (PE). Premature ejaculation is incredibly common. It is widely considered to be one of the biggest sexual function issues amongst penis owners. One in three penis-owning people experience issues with PE in their lifetime. That’s 30 percent of people with dicks!

When online misinformation about sexual health abounds, it's difficult to know where to turn for answers. We spoke to urologists and sex therapists to get accurate answers to your burning questions.

Just because PE is common doesn’t mean it’s something that is easy to handle. Dr. Anika Ackerman, a urologist specializing in sexual medicine, says that the lack of control that comes with PE can be incredibly frustrating and distressing for those who suffer from it.

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Luckily, PE is highly treatable. "It's crucial to realize that many [people] experience this challenge, and with the appropriate guidance, it's manageable," says Dr. Nazanin Moali, a psychologist, sex therapist, and the host of Sexology podcast.

So, with all this in mind (and possibly peen), let’s break down what premature ejaculation is, why it happens, and some strategies for dealing with it.

What is premature ejaculation?

Premature ejaculation is defined as reaching ejaculation before you want to. Technical definitions usually define "before you want to" as ejaculation within 1-3 minutes of sexual activity or penetration. PE "is a condition where a penis owner does not have voluntary, conscious control or the ability to choose, in most encounters, when to ejaculate," says Dr. Lee Phillips, Ed.D, a psychotherapist and certified sex and couples therapist.

PE can be situational or ongoing. Meaning, it can be something that happens in certain contexts with certain people or during nearly every (or all) sexual encounters, regardless of the context. Ejaculating "too quickly" isn’t defined as PE unless it occurs on a regular basis. "It denotes a pattern that has been present for at least half a year and manifests almost every time, if not every single time, during sexual engagement," Moali says.

What causes PE?

Most experts believe that if no medical issues are detected, the causes for PE are largely psychological and emotional – though the exact reasons are widely undetermined. It’s important to speak with your medical provider to rule out any medical conditions that may cause PE.

One popular theory is that PE is rooted in a disconnect with your sexual response cycle. Meaning, you aren’t in-tune with the way your body responds sexually, which impacts your control over your body’s ejaculatory function during sex.

Let’s talk about something every single one of us has (probably) heard: That you should think of anything besides sex in order to last longer in bed. This widespread social narrative encourages young men and penis owners to think things like their grandma naked or a body covered in boils.

Spoiler! This is actually the opposite of what you should do if you want to last longer. When we step away from awareness of what our bodies are doing, we lose all control. Meaning, we’re much more likely to orgasm before we’re ready to. How about them apples?

Philips says that performance anxiety may also play a role – when we’re very nervous to be with a new partner, we may become overly excited too quickly, resulting in PE. This anxiety about PE can lead to more anxiety, which can perpetuate the problem.

Ironically, performance anxiety can also lead to difficulties in getting or maintaining erections. Bodies are all kinds of wild and the ways they respond vary greatly.

Understanding the sexual response cycle in relation to PE.

To understand PE, we have to understand exactly how the body responds during sex.

According to pioneering sex researchers, Masters and Johnson, the sexual response cycle takes place in four phases: excitement, plateau, orgasm, and resolution.

For our purposes, excitement and arousal are the most important phases to observe. Excitement is sexual arousal, when we begin to get turned on (whether that be from physical stimulation, dirty talk, sexting, porn etc.). Plateau is when we’re feeling super hot and bothered – coasting towards climax – when sexual play gets going and you’re feeling it big time.

In cases of PE, the issue lies in the plateau phase – namely, that is quite short and, in some cases, nonexistent. This means that you jump from being sexually aroused right to orgasm. Hence, finishing more quickly than you might want to.

(We should note that there are many other models that are used to explain the complexity of human sexual response, but Masters and Johnson’s straightforward four-phasic model is very helpful in understanding premature ejaculation).

In this same vein, we should consider how long we’re actually in the plateau phase. It’s quite common that someone might think they have premature ejaculation, but in reality, they aren’t aware of how long they’ve been coasting toward the Big O.

You may think you’re not lasting long enough in bed, when really you last quite a normal amount because you’ve been in the excitement and/or plateau phase for a prolonged period of time, pre-sex. For instance: When a penis-owning person has been thinking about sex all day, this means that the sexual response cycle has been building long before the actual sex even happens. This can lead to people believing that they have PE when, in reality, they aren’t in tune with the ways their bodies respond to sexual stimuli.

If this is all new to you, don’t worry. We have junk sex ed in general, and absolutely nothing in regards to sexual difficulties like erectile dysfunction or premature ejaculation. The more we know about our bodies, the more confident we can feel in them.

5 expert-approved strategies for dealing with premature ejaculation.

• Focus on sensation and what is happening in the body.

As we mentioned above, the socially prescribed advice for lasting longer during sex is to "think about anything else." This is incorrect. Instead, start to practice paying attention to what is happening within the body during sexual arousal, in order to build awareness. "This mindful approach can lead to a more relaxed and prolonged sexual experience," Moali says. When we’re more aware, we’re in better control.

• Start Stop Technique

Philips recommends trying the Start Stop Technique as a way to gain more control over your erections. When you’re masturbating, stop once you feel yourself starting to get close to orgasm. "Wait 30 seconds or a minute, and then repeat, masturbating until you feel the point at which ‘coming’ is imminent," he says. "Time how long it takes for you to get to this point." Repeat this process 3-4 times. This will help you get a better understanding of the sensations in your body and bring awareness to when you’re going over the edge. This should be an ongoing practice.

• The Squeeze Technique

Ackerman suggests The Squeeze Technique during solo or partnered activity. "In the squeeze method, the partner or patient will squeeze the penis to delay orgasm," she says. Do this when you’re starting to feel close to orgasm. While there isn’t a ton of scientific data to support this method, it has been found to be very useful within clinical settings.

• Take a penis-touching-break during sexual activity.

If you find that you’re getting too turned on and worry you’re going to bust before you’re ready, consider taking a break from penis stimulation, focusing on your partner instead, with oral pleasure, sex with toys, or a sensual massage. "This change of pace can help reduce your arousal, slowing the process and offering a more satisfying, longer-lasting experience for both parties," Moali says.

• Seek out professional assistance.

A sex therapist is someone who specializes in sexual wellness and sexual function issues. They can help you process underlying emotions and psychological issues that may be causing and/or perpetuating PE. They can also give you exercises to modify your behaviors around masturbation and sex. "The goal is to relax your nervous system and to be grounded in your body," Lee says. There is nothing wrong with needing a little extra assistance on your sexual health journey.

All in all, PE is a very common problem that has highly successful outcomes when treated. You’re not alone. You’re not broken. And there is help for you.