If you have a persistent problem with ejaculation, visit your GP, who will discuss the problem with you and may examine you or refer you to a specialist.

Premature ejaculation

Premature ejaculation is the most common ejaculation problem. It's where the male ejaculates too quickly during sexual intercourse.

A study looking at 500 couples from 5 different countries found the average time taken to ejaculate during intercourse was around 5-and-a-half minutes. However, it's up to each couple to decide if they’re happy with the time taken – there's no definition of how long sex should last.

Occasional episodes of premature ejaculation are common and are not a cause for concern. However, if you're finding that around half of your attempts at sex result in premature ejaculation, it might help to get treatment.

Causes of premature ejaculation

Various psychological and physical factors can cause a man to suddenly experience premature ejaculation.

Common physical causes include:

prostate problems

thyroid problems – an overactive or underactive thyroid gland

– an overactive or underactive thyroid gland using recreational drugs

Common psychological causes include:

depression

stress

relationship problems

anxiety about sexual performance (particularly at the start of a new relationship, or when a man has had previous problems with sexual performance)

It's possible, but less common, for a man to have always experienced premature ejaculation since becoming sexually active. A number of possible causes for this are:

conditioning – it's possible that early sexual experiences can influence future sexual behaviour. For example, if a teenager conditions himself to ejaculate quickly to avoid being caught masturbating, it may later be difficult to break the habit

– it's possible that early sexual experiences can influence future sexual behaviour. For example, if a teenager conditions himself to ejaculate quickly to avoid being caught masturbating, it may later be difficult to break the habit a traumatic sexual experience from childhood – this can range from being caught masturbating to sexual abuse

– this can range from being caught masturbating to sexual abuse a strict upbringing and beliefs about sex

biological reasons – some men may find their penis is extra sensitive

Treating premature ejaculation

There are a number of things you can try yourself before seeking medical help.

Measures you can try yourself

It can sometimes help to:

masturbate an hour or 2 before having sex

use a thick condom to help decrease sensation

take a deep breath to briefly shut down the ejaculatory reflex (an automatic reflex of the body during which ejaculation occurs)

have sex with your partner on top (to allow them to pull away when you are close to ejaculating)

take breaks during sex and think about something boring

Couples therapy

If you're in a long-term relationship, you may benefit from having couples therapy. During these sessions, the therapist will:

encourage couples to explore any relationship issues they have, and give them advice about resolving them

show the couple techniques that can help you "unlearn" the habit of premature ejaculation (the 2 most popular techniques are the "squeeze" and "stop-go" techniques)

In the squeeze technique, your partner masturbates you, but stops before the point of ejaculation and squeezes the head of your penis for between 10 to 20 seconds. They then let go and wait for another 30 seconds before resuming masturbation. This process is carried out several times before ejaculation is allowed to occur.

The stop-go technique is similar, but your partner does not squeeze your penis. Once you feel more confident about delaying ejaculation, you and your partner can begin to have sex, stopping and starting as required.

These techniques may sound simple, but they require lots of practice.

Antidepressants (SSRIs)

Selective serotonin reuptake inhibitors (SSRIs) are designed to treat depression, but they also delay ejaculation. SSRIs used for this purpose include:

Some men may experience an improvement as soon as treatment begins. However, you'll usually need to take the medicine for 1 to 2 weeks before you notice the full effects.

Side effects of SSRIs are usually mild and should improve after 2 to 3 weeks. They include:

fatigue

feeling sick and being sick

diarrhoea

excessive sweating

Read more about the side effects of SSRIs.

Dapoxetine

An SSRI specifically designed to treat premature ejaculation, known as dapoxetine (Priligy), has now been licensed in the UK. Local NHS authorities can choose to prescribe it on the NHS.

It acts much faster than the SSRIs mentioned above and can be used "on demand". You’ll usually be advised to take it between 1 and 3 hours before sex, but not more than once a day.

Your response to the treatment will then be reviewed after 4 weeks (or after 6), and again every 6 months.

Dapoxetine is not suitable for all men diagnosed with premature ejaculation. For example, it is not recommended for some men with heart, kidney and liver problems. It can also interact with other medicines, such as other antidepressants.

Common side effects include:

headaches

dizziness

feeling sick

Phosphodiesterase-5 inhibitors

Phosphodiesterase-5 inhibitors, such as sildenafil (sold as Viagra), are a class of medicine used to treat erectile dysfunction. Research has found that they may also help with premature ejaculation.

Because of changes in regulations, you no longer need a prescription to get sildenafil. But you will have to have a consultation with the pharmacist to make sure it's safe for you to take it.

Read more about sildenafil including information on how and when to take it.

Topical anaesthetics and condoms

The use of topical anaesthetics such as lidocaine or prilocaine can help but may be transferred and absorbed to the vagina, causing decreased sensation. Condoms can also be used and are effective, particularly when combined with local anaesthesia.