Premature Ejaculation

Premature ejaculation (PE) is a loss of voluntary ejaculatory control that consistently occurs sooner than desired, typically within about one minute of penetration. It’s defined by:

• Short intravaginal ejaculatory latency time (IELT)—under 60 seconds
• Inability to delay ejaculation during most sexual encounters
• Marked distress or interpersonal difficulty for one or both partners

PE may be classified as:

• Lifelong (Primary): Present from the first sexual experiences, often due to innate sensitivity or neurological reflexes.
• Acquired (Secondary): Develops after a period of normal function, potentially linked to stress, hormones, or medical issues.

Identifying which subtype is present informs the treatment: primary PE often improves with SSRIs, while secondary PE may require a combined behavioral-medical approach.

Psychological Factors

• Performance anxiety & stress
• Relationship conflicts
• Early conditioned responses

Neurochemical & Neurological

• Low serotonin levels
• Penile hypersensitivity
• Genetic reflex arc sensitivity

Hormonal

• Low or high testosterone
• Thyroid dysfunction (esp. hyperthyroidism)

Anatomical & Medical

• Prostatitis or pelvic pain syndrome
• Diabetic or nerve-related neuropathy
• Medication or substance side effects

Emotional Impact

• Fear of recurrence leads to avoidance
• Disconnection, reduced intimacy
• Self-esteem and relationship strain

• History & Symptom Diary: Documenting frequency, partner input, anxiety/stress patterns
• Hormonal Panel: Testosterone, prolactin, thyroid levels
• Physical & Neuro Exam: Sensitivity and pelvic floor analysis

• Psychological Screening: Anxiety, trauma, relationship dynamics
• Customized Metrics: IELT measurement and tracking over time

• Behavioral & Pelvic Floor Therapy: Stop-start/squeeze techniques and Kegels
• Topical Anesthetics: Prescription desensitizing creams/sprays
• SSRIs: Dapoxetine and others for neurochemical balance

• Hormone Optimization: For testosterone or thyroid correction
• Couples Counseling: Licensed sex therapy and relationship support

How soon can I expect results?
Most patients notice improved latency within 4–6 weeks. SSRI users may see effects by 6–8 weeks.

Do lifestyle changes help?
Yes—exercise, stress reduction, and avoiding alcohol or smoking support nerve and hormone health.

Can I practice pelvic‑floor therapy at home?
Yes—3x daily guided Kegels are provided by our team for independent practice.

Will PE treatment improve ED?
In many cases, yes—particularly if anxiety or hormones play a role in both.

Is premature ejaculation hereditary?
Yes, certain serotonin-related gene variants correlate with lifelong PE. SSRIs + behavioral training are effective.