Deep Dive

Too Soon? Let’s Talk About Premature Ejaculation

There’s More You Can Do and Less to Be Ashamed Of

Premature ejaculation is common. You’re not the only one.

It affects around one in three men at some point. And it’s not just in your twenties. 

It happens to men in long-term relationships, guys reentering the dating world, prostate cancer survivors, and more than a few men who haven’t said a word to anyone about it.

The problem is, most men either ignore it or quietly adapt. 

They avoid sex, skip foreplay, or rush through the encounter hoping to get it over with before something goes wrong. 

What starts as a physical issue can easily spiral into avoidance, embarrassment, or loss of confidence.

It doesn’t have to be that way.

What Counts as Premature?

It’s not about stopwatch sex. It’s about control and whether you’re finishing earlier than you want to, or earlier than your partner expects.

In clinical terms, it’s often defined as ejaculation that happens within 1–2 minutes of penetration.

But here’s the truth: if it’s bothering you or your partner, that’s reason enough to take it seriously.

Here’s a quick test. On date night, who finishes first? You or the microwave popcorn?

If it’s the popcorn, you might have PE.

Why It Happens

There’s no single cause. But here are some of the patterns I see:

• Oversensitivity

• Anxiety or performance pressure

• Pelvic floor overactivity or chronic tension

• Long gaps between sexual encounters

• Erectile dysfunction (rushing to climax before losing the erection)

• Changes after prostate treatment

• Rushed sexual patterns from years of “sprinter” style masturbation

Sometimes men come in thinking this is all psychological. Other times they assume it’s purely physical. 

But more often, it’s both layered together in subtle ways.

So What’s Your Cause?

If you’re reading this list and wondering, “How do I know which one’s me?” you’re asking the right question.

This is why the American Urological Association recommends that men with persistent or distressing PE get evaluated with a good sexual history and exam. 

That might include:

• Asking if it happens with all partners or just some

• Asking if it happens with both partnered sex and masturbation, or only in one setting

• Looking at recent stressors, relationship dynamics, and physical changes

• Ruling out conditions like ED, nerve issues, or hormonal imbalances

In my practice, I’ll often check:

• Testosterone, prolactin, estradiol, and TSH

• Sometimes a brief neurologic exam to make sure we’re not missing something mechanical

It’s not about ordering every test. It’s about matching your experience to what we know and giving you a clear picture of what’s driving it.

What Actually Helps

You don’t have to fix everything at once. But if you’re ready to do something, here’s where to start:

Try behavioral strategies

The pause-squeeze or stop-start methods help build awareness and delay climax. 

If you’ve trained yourself to finish quickly – especially during solo sex – start by practicing slowing things down. 

These techniques are free, safe, and worth a try.

Consider topical numbing agents

Lidocaine or benzocaine sprays and creams can reduce sensitivity and extend control. 

Just apply and wipe off the excess to prevent numbing your partner.

Use medication if appropriate

Low-dose SSRIs (like sertraline or paroxetine) are well-studied, often prescribed off-label, and can significantly increase time to climax. 

They’re generally well tolerated.

And here’s an important point: even if your erections are fine, medications like Viagra or Cialis may still help. 

They won’t directly treat PE, but they can give you the ability to recover quickly after an early climax. 

That allows some men to continue with sexual activity and shift the pressure off timing.

Explore pelvic floor therapy

If there’s chronic tension or poor muscular control, a trained pelvic floor physical therapist can help. This is underused in men’s health—and often very effective.

Talk to someone who understands

Sex therapy or coaching isn’t fluff. 

It’s practical, strategic help with reframing performance pressure, rewiring old patterns, and improving communication especially for couples.

Talk to Your Partner

It doesn’t have to be dramatic. Just be honest.

“This has been happening, and I want to work on it.”

“I’d love for us to figure this out together.”

When you open the door, it usually helps both of you breathe easier.

Final Word

As always, my goal is to give men and couples a framework for thinking this through. Language to use. Questions to ask. And a few options to bring to your doctor.

Premature ejaculation isn’t shameful. It’s common. It’s real. And it’s manageable.

You don’t need to be fixed, but maybe lasting longer than it takes to microwave the popcorn would be nice!