Premature Ejaculation: Causes and Treatment Options

Premature ejaculation means ejaculating sooner than you want in most sexual encounters, often within a minute or a few minutes of penetration, without being able to delay it, and feeling upset about it. It is common and can be treated with control techniques, sex therapy and, in some cases, prescription medicines. In Spain it is called eyaculación precoz. This guide is by Dr. Pedro Yelamo Vera, a GP licensed in Spain (Colegiado No. 484814280).

What is premature ejaculation?

It is ejaculating sooner than you or your partner want, always or nearly always, without being able to delay it, and with distress or strain on the relationship. Mayo Clinic says doctors usually consider it when ejaculation happens within 1 to 3 minutes of penetration. If it happens now and then, that is normal and not a disorder.

What types are there?

• Lifelong (primary): it has happened since your first sexual experiences.
• Acquired (secondary): it starts after a time without problems. It more often has a cause that can be found, such as erection problems, anxiety or a prostate infection.

What causes premature ejaculation?

The exact cause is not known. It is usually a mix of things:

• Mind: anxiety, stress, depression, worry about performance, guilt, relationship problems or early sexual experiences.
• Body: erection problems (fear of losing the erection makes men rush), swelling or infection of the prostate or urethra, thyroid problems, or a sensitivity that runs in families.

How is premature ejaculation treated?

Treatment depends on the cause and what you want. Often several options are combined:

• Stop-start technique: stimulate yourself until you feel close to ejaculating, stop until the feeling fades, then start again.
• Squeeze technique: press the tip of the penis for a few seconds when you feel close.
• Pelvic floor exercises: these strengthen the muscles that help control ejaculation.
• Condoms, especially thicker ones, which reduce sensation.
• Sex or couples therapy with a sex therapist or psychologist, especially if there is anxiety or relationship strain.

Are there medicines for premature ejaculation?

Yes, and all the medicines approved for it in Spain need a prescription. Dapoxetine is approved for men aged 18 to 64 who meet certain criteria. These include ejaculating within 2 minutes in most encounters over the last 6 months, with distress and poor control. It is taken only before planned sex, not every day. It is not used with serious heart disease, a history of fainting, some antidepressants or certain other medicines. It can lower blood pressure and cause dizziness, especially with alcohol.

Numbing creams or sprays reduce sensation in the penis. They can pass to your partner, so a condom is often advised. Some specialists use other medicines outside their main use. If you also have erection problems, treating them can improve control. A doctor decides what suits you; the dose is set by the prescription and the leaflet.

Can premature ejaculation be cured?

Many men improve a lot with techniques, therapy and, if needed, treatment. The acquired type often improves once its cause is treated. Talking about it with your partner lowers anxiety, which often makes it worse.

In Spanish: what to say to a doctor

You can say tengo eyaculación precoz. A sex therapist is a sexólogo, and pelvic floor exercises are ejercicios del suelo pélvico. Spanish pharmacies will not supply prescription medicines for this without a prescription from a doctor licensed in Spain.

When to see a doctor

• It happens in most encounters and upsets you, or you avoid intimacy.
• It started suddenly after years without problems.
• You also have erection problems.
• You have pain when you ejaculate, blood in your semen, stinging when you pee, or a fever.
• It affects your mood or your relationship. Also seek help if you feel anxious.

When to go to A&E or call 112

Call 112 if you have chest pain, shortness of breath or faint during or after sex. Go to A&E for severe pain in the testicles, or a painful erection that lasts more than 4 hours.

Frequently asked questions about premature ejaculation

Getting a medical assessment

If premature ejaculation worries you and you want to talk to a doctor, you can book a video consultation with Dr. Pedro Yelamo Vera, a physician registered in Spain. You can also read about sexual health. A prescription is never guaranteed: it is issued only where clinically appropriate after a genuine evaluation, as a private electronic prescription under Spanish law. This service is for urgent, non-emergency care. In an emergency, call 112.

This guide is general information. It does not replace the package leaflet or the advice of your doctor or pharmacist.