Premature ejaculation

Definition:

Ejaculation that occurs prior to when a man wishes it or too quickly during intercourse to satisfy the partner.

Causes, incidence, and risk factors:

The cause of premature ejaculation is primarily biological. The normal physical response is for the man to experience climax, and therefore, ejaculate approximately 2 to 3 minutes after penetrating the vagina. The normal physical response for women is to build to a climax, or orgasm, about 12 to 14 minutes after coitus (intercourse) occurs. However, many women may not experience orgasm at all, particularly if intercourse involves only penetration of the vagina by the penis. Other methods of sexual stimulation may be necessary for the woman to attain orgasm. It is estimated that about 10% of women do not experience orgasm under any circumstances or with any type of stimulation. Premature ejaculation may also be caused or aggravated by psychological factors such as guilt (believing the activity is sinful e.g., premarital or extramarital sex); fear (associated with concerns regarding potential pregnancy, sexually transmitted diseases, or getting caught or discovered); performance anxiety (especially in the inexperienced partner or with partners new to each other); and interpersonal issues affecting the couple.

Premature ejaculation is the most frequently encountered sexual complaint of men and couples. It is most common in adolescents, young adults, and other sexually naive males. Increased risk is associated with lack of sexual experience, lack of knowledge regarding normal male and female sexual responses, and with those individuals who highly associate psychological factors (such as fear, guilt, and anxiety) with sexual activity.