Premature Ejaculation

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Premature Ejaculation - My Concierge MD

For males who are ejaculating too early, My Concierge MD provides individualized and private medical care. In order to identify the underlying reason for premature ejaculation, our healthcare professionals do thorough examinations that include a detailed medical history and physical examination.

When someone experiences an orgasm earlier than they or their partner would want, it is known as premature ejaculation. It can occur prior to or immediately following penetration. However, if someone experiences an orgasm before they intend to, they lose their erection and are unable to continue having sexual activity.

It can be annoying and embarrassing to ejaculate early, which might create relationship problems. You might believe that you don’t have enough time for sexual intercourse. Intimacy issues and relationship harm might result in some people from embarrassed over an early ejaculation.

Premature ejaculation that has been present for one year or more has a significant impact on the couple and tends to lead to clinical depression, relationship issues, and other problems. Overall, premature ejaculation is primarily psychological in nature. However, the precise cause of premature ejaculation remains largely undetermined.

What is the Main Cause of Premature Ejaculation?

Premature ejaculation has psychological or emotional components, but there are other elements that affect it as well. Premature ejaculation differs from erectile dysfunction (ED). But you can also have PE in addition to ED.

Some psychological elements might only last a short while. For instance, a person might have experienced sexual dysfunction during their first few sexual interactions, but as they grew older and had more sexual experiences, they picked up tricks to assist in postponing ejaculation. You may reverse your sex time and have better sex life if you pay attention to these causes of premature ejaculation.

Psychological Causes

Early Sexual Experiences:

Premature ejaculation can occur for a variety of reasons, not the least of which is early sexual experiences. Some men may ejaculate too early as a result of sexual performance-related tension or anxiety, which may have its roots in early sexual encounters.


Depression can lower sexual arousal and desire, which can make it more challenging to get or keep an erection. In rare circumstances, anxiety and stress brought on by depression might worsen premature ejaculation. Additionally, some antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), have the potential to delay ejaculation as a side effect and can be used to treat premature ejaculation.

Sexual Abuse:

Sexual Abuse can have a profound impact on a person’s psychological and emotional well-being, leading to a variety of sexual problems, including premature ejaculation.

Sexual abuse can produce anxiety, sorrow, and post-traumatic stress disorder (PTSD), all of which can impair sexual function. Survivors of sexual abuse may have heightened fear and panic during sexual engagement in particular contexts, making it more difficult to regulate ejaculation. It is vital to get treatment from a healthcare physician or mental health professional who is trained in treating sexual trauma survivors.

Relationship Problems:

In some circumstances, relationship issues might surely contribute to premature ejaculation. A lack of closeness or communication with a partner can result in emotions of detachment or even performance anxiety, which can aggravate premature ejaculation. It is critical to discuss any related concerns with your partner and collaborate on ways to increase communication and intimacy. Couples counseling or going to a sex therapist may be helpful in resolving underlying difficulties and increasing sexual performance in some circumstances.

Biological Causes

Hormone Imbalances:

In some situations, irregular hormone levels can contribute to premature ejaculation. Hormones like testosterone and serotonin regulate sexual function, including ejaculation. A hormonal imbalance might impair ejaculation control and result in premature ejaculation.

Low testosterone levels can reduce sexual desire and interfere with ejaculation control, but high serotonin levels can postpone ejaculation. Thyroid dysfunction and pituitary gland diseases, for example, can also influence hormone levels and contribute to premature ejaculation.

Premature ejaculation (PE), whose pathogenesis is yet unknown, is the most prevalent male sexual dysfunction but typically goes undiagnosed and untreated. The goals of this paper are to present a scientific and pharmacologic basis for selective serotonin reuptake inhibitors (SSRIs) and to explore how they can aid patients with Premature ejaculation.[2]

Inconsistent Amounts of Brain Chemicals:

According to some research, irregular levels of certain brain chemicals, particularly serotonin, and dopamine, may contribute to premature ejaculation. Serotonin is a neurotransmitter that regulates mood and behavior, as well as regulating ejaculation. Serotonin deficiency has been linked to an increased risk of premature ejaculation.

In some circumstances, a genetic predisposition or an underlying medical condition may contribute to these brain chemical imbalances. Additionally, drugs that raise serotonin levels in the brain, such as selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants, have been used to treat premature ejaculation.

Premature ejaculation (PE; early ejaculation or quick ejaculation) is a frequent sexual condition that affects approximately 20-30% of sexually active males. Primary, secondary, natural variable and subjective PE are the four categories of PE. There are several non-pharmacological and pharmacological treatment options for PE, including Dapoxetine, which was created exclusively for the treatment of PE. We discuss the pathogenesis and therapy of PE in this review.[3]

Prostate or Urethral Swelling and Infection:

Swelling of the prostate or urethra, as well as infection, can sometimes contribute to premature ejaculation. Prostatitis, or inflammation or infection of the prostate gland, can induce discomfort and pain during ejaculation, leading to premature ejaculation in some situations. The urethra can become swollen or inflamed, causing discomfort or agony during sexual activity and perhaps contributing to premature ejaculation.

Inherited Characteristics:

According to studies, first-degree relatives of males with premature ejaculation are more likely to develop the illness themselves, indicating that the disorder may have a genetic component. It’s also possible that inherited features just raise the risk of premature ejaculation rather than actually causing it.

If you’re experiencing premature ejaculation, it’s important to speak with a healthcare provider to determine the underlying cause and develop a treatment plan.

What are the Ways to Help with Premature Ejaculation?

There are numerous methods for assisting with premature ejaculation. The most effective treatment will be determined by the underlying cause of the disease. Among the possible treatments are:

Behavioral Therapy:

The Stop-Start Technique:

This involves stroking the penis until you feel like you’re going to ejaculate, then stopping for 30 seconds to one minute till the sensation goes away. The stimulation can then be restarted, and the process is repeated multiple times before enabling ejaculation.

Kegel Exercises:

These exercises are crucial for men’s health as it helps strengthen the pelvic floor muscles, which can help control ejaculation. To perform Kegels, contract the muscles used to stop urine flow for a few seconds, then relax them. Repeat this exercise several times a day.

Masturbation Prior to Sex:

Masturbating before sex can be beneficial for some guys who have premature ejaculation. Masturbation before sex can lower penile sensitivity, which can help postpone ejaculation during sexual activity.

The most prevalent male sexual problem is premature ejaculation. The study’s objective was to assess if pelvic floor muscle rehabilitation could be therapeutic for people who have had lifelong premature ejaculation.[4]

Further Foreplay:

Before having your genitalia handled, arouse your partner to the highest level possible. In this manner, you can ejaculate at almost the same moment that they experience an orgasm.

Squeeze Technique:

When ejaculation is about to occur, you or your sexual partner squeeze (pretty strongly) the end or tip of the penis for 10 to 20 seconds. Then, you or your partner wait for around 30 seconds before continuing the stimulation.

Ejaculatory Treatment of Premature Ejaculation

Ejaculatory treatment of premature ejaculation - My Concierge MD

Oral Medicines:

Premature ejaculation can be effectively treated with selective serotonin reuptake inhibitors (SSRIs), which are frequently prescribed to treat depression and anxiety. These drugs raise serotonin levels in the brain, which can assist in postponing ejaculation. Some examples of SSRIs used for treating premature ejaculation include:

  • Paroxetine:
  • Fluoxetine:
  • Dapoxetine:
  • Sertraline:

The sole medication approved for the treatment of PE is dapoxetine, an on-demand SSRI that increases IELT by a factor of 2.5 to 3 while having few manageable adverse effects. The topical aerosol PSD502, which can increase IELT by up to a factor of 6, yet has little local and minor systemic side effects, is scheduled to receive licensing for the treatment of PE soon.[5]

Topical Anesthetics:

These are creams or sprays that contain anesthetic agents such as lidocaine or benzocaine, which can help reduce sensitivity and delay ejaculation.

PDE-5 (Phosphodiesterase-5) Inhibitors:

In addition to being used to treat erectile dysfunction, drugs like sildenafil (Viagra) and tadalafil (Cialis) can also assist in postponing ejaculation.


This painkiller has been seen to have an off-label usage for treating early ejaculation. It functions by preventing the brain’s reuptake of serotonin and norepinephrine, which can assist in delaying ejaculation.

Premature Ejaculation Treatment Near Me

My Concierge, MD, Beverly Hills, offers the best premature ejaculation treatment near me in Beverly Hills but can also come to your home or office throughout the Los Angeles area. We serve patients near Beverly Hills, Bel Air, West Hollywood, Santa Monica, West Los Angeles, Culver City, Hollywood, Venice, Marina del Rey, Malibu, Manhattan Beach, Redondo Beach, Downtown Los Angeles, Encino, Woodland Hills, Sherman Oaks, Calabasas, Burbank, Glendale, Hidden Hills, Agoura Hills, Northridge, North Hollywood, Topanga, Canoga Park, Reseda, Valley Glen, Chatsworth, West Hills, Winnetka, Universal City, Silverlake, Echo Park, and many more.


1. Crowdis M, Leslie SW, Nazir S. Premature Ejaculation. Published February 7, 2023. Accessed April 19, 2023.

2. Giuliano F, Clément P. Serotonin and Premature Ejaculation: From Physiology to Patient Management. European Urology. 2006;50(3):454-466. doi:

3. Raveendran, A. V., & Agarwal, A. (2021). Premature ejaculation – current concepts in the management: A narrative review. International Journal of Reproductive Biomedicine, 19(1), 5-22.

4. Pastore, A. L., Palleschi, G., Fuschi, A., Maggioni, C., Rago, R., Zucchi, A., Costantini, E., & Carbone, A. (2014). Pelvic floor muscle rehabilitation for patients with lifelong premature ejaculation: A novel therapeutic approach. Therapeutic Advances in Urology, 6(3), 83-88.

5. Mohee, A., & Eardley, I. (2011). Medical therapy for premature ejaculation. Therapeutic Advances in Urology, 3(5), 211-222.

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