Premature Ejaculation: What Causes It and How to Prevent It

“Did I ejaculate prematurely?” It’s a question you may be embarrassed to ask yourself, but in reality, it’s a common condition. About 1 out of every 3 men between 18 and 59 years old have had premature ejaculation (PE). The good news is that with certain treatment strategies, about 95% of men can delay ejaculation.

So what are those strategies? You’ll learn all about them in this article.

What is premature ejaculation and how is it diagnosed?

PE is a common, treatable condition, and it’s rather simple to diagnose. PE describes ejaculation that happens sooner than desired or intended, usually within less than one minute of penetration. Realize that a large number of men will experience PE at some point in time, but it’s generally not abnormal unless it happens consistently. To find out whether your PE is cause for concern, you can quiz yourself with these 3 questions:

  1. Do you almost always ejaculate within 60 seconds of penetration (or masturbation)?
  2. Are you rarely able to delay ejaculation during penetrative sex (or masturbation)?
  3. Do you avoid sexual encounters because of anxiety, frustration, or embarrassment about ejaculating prematurely?

Answering yes to these questions might mean it’s time for you to see a doctor for treatment, but more about that later!

What causes premature ejaculation?

PE can be caused by psychological and biological factors, but psychological causes are the most common. You might be surprised at just how much these types of issues can impact sexual performance:

  • Depression
  • Anxiety, especially anxiety about PE or sexual performance
  • Guilt
  • Stress
  • Low self-esteem or confidence
  • History of sexual abuse or repression

These biological factors can also contribute to PE:

  • Low testosterone levels
  • Low serotonin levels
  • Inflammation or infection of the prostate
  • Inflammation or infection of the urethra

Serotonin is a chemical that’s responsible for feelings of well-being and happiness. When serotonin levels are high, they can also help delay ejaculation. On the other hand, low serotonin levels can cause PE.

Many of these psychological and biological risk factors can also cause erectile dysfunction (ED), which can be an underlying cause of PE.

What are ways to treat or prevent premature ejaculation?

If you’re interested in delaying ejaculation, there are a few strategies you can try.

Psychological therapy

If psychological causes are causing PE, therapy to address those psychological causes is likely to be beneficial. You can also combine therapy with behavioral and medication-based treatment approaches.

Behavioral strategies

These techniques help some men delay ejaculation on their own:

The Squeeze Method

During intercourse, your partner stimulates you until just before the point of ejaculation. Your partner then squeezes your penis where the head meets the shaft until you no longer desire to ejaculate. Then you can continue with intercourse and repeat this pattern 2 to 4 times. This strategy helps you become familiar with your body’s sensations so that you can have more control over them.

The Start-and-Stop Method

This method is similar to The Squeeze Method, except instead of squeezing your penis, your partner just stops stimulating it. Once you’ve moved past the urge to ejaculate, you resume intercourse. Repeating this pattern 3 times and then ejaculating on the 4th time will help train your body to delay ejaculation.

Wearing Condoms

Wearing condoms can also decrease the sensations on your penis which could be useful for delaying ejaculation.


Even though the FDA hasn’t given the nod of approval for any drugs to treat PE, some drugs are used “off-label” for PE.


Remember learning that the chemical serotonin can help delay ejaculation? Well a certain type of antidepressant called a selective serotonin reuptake inhibitor (SSRI) increases serotonin levels in the brain. As a result, SSRIs have the side effect of delaying orgasm.

Sertraline is an example of an SSRI antidepressant that can be prescribed off-label for PE. Sometimes it’s used as needed before sex, but it tends to be more effective when taken daily. On a daily routine, it can take 5-10 days to start working and 2-3 weeks to have its complete effect.

ED Drugs

Even though phosphodiesterase-5 (PDE-5) inhibitors are not FDA-approved to treat PE, they are FDA-approved to treat ED. If ED turns out to be the source of PE, your healthcare provider will treat the ED first. In most cases, this will also take care of the PE. If you have PE and ED, a PDE-5 inhibitor like sildenafil may prove useful.

What type of doctor should I see for premature ejaculation treatment?

Let’s face it, you’d really rather not talk to a doctor—or anyone else, for that matter—about this. Even though this is a common condition, your feelings are valid and understandable.

That’s why Lemonaid Health’s Premature Ejaculation service allows you to get the medication you need—either sertraline or sildenafil—without seeing a doctor in-person. Instead, through our website, our US-based, US-licensed nurse practitioners and doctors are available to provide confidential diagnosis and treatment of PE when appropriate.

Any man between 30 and 72 years old can use Lemonaid’s PE service. Here’s how the 15-minute process works:

  1. Complete our simple health questionnaire.
    These questions help our providers evaluate your health status to make sure they care for you appropriately.
  2. Create an account so that you can save your answers.
  3. Place order with a credit card.
    We won’t actually charge your card until after your video consultation in the next step. Sertraline costs $1 per day for a 90 day supply when taken on an ongoing basis. A daily routine tends to be more effective than taking sertraline as needed before sex. Sildenafil costs $2/pill for a 30 day supply.
  4. Have a quick video consultation with a Lemonaid doctor or nurse practitioner.
    The doctor or nurse practitioner will ask you questions to determine whether you have PE and whether sertraline or sildenafil may be appropriate for you. He or she will also ask questions to make sure you don’t have any conditions or other medications that would negatively react with a PE medication.
  5. Receive your sertraline or sildenafil in the mail with free, fast delivery from our partner pharmacy.
    We’ll send you a secure message after your consultation to make sure the medicine is working.

Searching for a solution to premature ejaculation?

Get started with Lemonaid’s PE service today.

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Lemonaid. Frequently Asked Questions: Premature Ejaculation. Accessed online December 17, 2018 at

Mayo Clinic. Premature Ejaculation. Accessed online December 15, 2018 at

Urology Care Foundation. Premature Ejaculation. Accessed online December 15, 2018 at