How to Overcome Premature Ejaculation: Causes and What Can Help

Premature ejaculation can be an embarrassing subject to talk about, but it is a common sexual problem.

For some men, it happens occasionally. For others, it becomes a recurring problem that begins to affect sexual confidence, intimacy and relationships.

And once you start worrying about ejaculating too quickly, that worry itself can become part of the problem.

I'm Sharon Shinwell, a relationship counsellor, psychotherapist and clinical hypnotherapist with more than 25 years' professional experience. During my years working with people experiencing relationship and sexual difficulties, I saw how easily sexual performance concerns could become wrapped up with anxiety, embarrassment and loss of confidence.

Premature ejaculation isn't always psychological, however. Physical factors can sometimes contribute too, so persistent or recurring problems shouldn't simply be assumed to be “all in your head”.

The encouraging part is that there are several recognised approaches that may help.

What Is Premature Ejaculation?

Premature ejaculation generally means ejaculating sooner during sexual activity than you or your partner would like.

There isn't one ideal length of time that sex is supposed to last.

Occasionally ejaculating sooner than you wanted is also very common and doesn't necessarily indicate a problem.

It becomes more important to address when it happens repeatedly, you feel you have little control over ejaculation, and it is causing you distress or difficulties within your relationship.

Why Does Premature Ejaculation Happen?

There isn't one single cause.

Psychological factors can include:

• performance anxiety

• stress

• depression

• relationship difficulties

• previous worries about sexual performance

• learned sexual habits or conditioning

Physical factors can also contribute, including prostate or thyroid problems and recreational drug use. Erectile difficulties can sometimes occur alongside premature ejaculation as well.

That's why I would be wary of anybody claiming that premature ejaculation is always caused by anxiety or that one psychological technique can solve every case.

Understanding what may be contributing to your problem is an important first step.

Lifelong and Acquired Premature Ejaculation

There's also an important difference between a problem that has been present since you became sexually active and one that develops after previously having satisfactory control.

If you've always experienced premature ejaculation, the factors involved may be different from somebody who suddenly develops it later.

With acquired premature ejaculation, it can be particularly important to consider whether anything else has changed.

Have you become more anxious?

Are there relationship difficulties?

Have you developed erectile problems?

Are you under unusual stress?

Has anything changed physically?

Current European guidance recommends identifying and addressing underlying causes in acquired premature ejaculation rather than simply treating the symptom in isolation.

The Premature Ejaculation and Performance-Anxiety Cycle

Anxiety can play a particularly important role for some men.

Perhaps you ejaculated sooner than you wanted on one occasion.

The next time you have sex, you remember what happened.

Now part of your attention is monitoring your performance.

How long have I lasted?

Am I getting too aroused?

Is it going to happen again?

What is my partner thinking?

Instead of being absorbed in intimacy, you're monitoring yourself.

If you ejaculate quickly again, the fear becomes stronger.

Next time there is even more pressure.

Eventually, sex can begin to feel like a test you expect to fail.

Psychosexual approaches to premature ejaculation therefore often include work on anxiety, sexual confidence and communication as well as techniques aimed specifically at ejaculatory control.

Stop Measuring Every Sexual Experience

Once premature ejaculation becomes a concern, it's very easy to become obsessed with time.

How many minutes?

Was that longer than last time?

Did I improve?

But turning every sexual experience into a stopwatch exercise can increase the sense of performance.

Sex isn't an examination with a required passing time.

Your partner may also care far more about affection, communication, attention and mutual pleasure than the precise number of minutes before ejaculation.

Working on control can be useful.

Constantly judging yourself usually isn't.

Talk to Your Partner

Embarrassment often makes men avoid discussing premature ejaculation.

Unfortunately, silence allows both people to make assumptions.

You may assume your partner is disappointed.

Your partner may assume you're avoiding intimacy because you're no longer attracted to them.

You may start initiating sex less often because you're frightened of what will happen.

Now a sexual difficulty is beginning to create a relationship difficulty as well.

Talking openly can remove some of that pressure.

You don't need to turn every sexual encounter into a serious discussion about premature ejaculation, but letting your partner know how you're feeling can make the problem something you're addressing together, rather than something you're secretly trying to hide.

The NHS also recommends involving a partner where possible when seeking help for sexual problems.

Take the Focus Away From Penetration

When premature ejaculation becomes the central concern, couples can start treating penetration as the entire sexual experience.

That creates enormous pressure on one particular part of intimacy.

Sexual pleasure doesn't begin with penetration and end with ejaculation.

Affection, touch and other forms of sexual intimacy can all be important.

Taking some of the emphasis away from “how long did I last?” can help reduce the sense that everything depends upon one moment.

This can be especially valuable when anxiety has started to dominate sex.

The Stop-Start Technique

One recognised behavioural approach is the stop-start technique.

The principle is to become more aware of your level of arousal and stop stimulation before reaching the point where ejaculation feels inevitable.

You then allow arousal to reduce before stimulation begins again.

With practice, the aim is to become better at recognising the sensations that occur as you approach ejaculation and develop greater control over how you respond to them.

The NHS includes the stop-go technique among approaches that may be taught through psychosexual counselling.

This isn't necessarily something you master immediately.

Like most behavioural techniques, it can require repeated practice.

What About the Squeeze Technique?

Another recognised approach is the squeeze technique.

It works on a similar principle: stimulation is interrupted as ejaculation approaches, with pressure applied to the penis before allowing arousal to settle and beginning again.

The NHS describes both squeeze and stop-go techniques as methods that can be used to help “unlearn” the pattern of premature ejaculation.

Some men find one technique more comfortable or practical than another.

If you're unsure how to use these approaches, psychosexual counselling can provide guidance rather than relying on trial and error.

Learn to Recognise Your Arousal Earlier

A common difficulty is noticing what's happening only when ejaculation is already inevitable.

Imagine arousal increasing gradually rather than simply being either “not aroused” or “about to ejaculate”.

Start paying attention to the earlier stages.

What physical sensations tell you that arousal is increasing?

Can you notice tension developing?

Can you slow down or pause earlier?

The objective isn't to remain mentally detached from sex.

It's to become familiar enough with your own responses that you recognise the point at which changing pace or taking a pause is still useful.

Don't Turn Distraction Into the Whole Strategy

You may have heard suggestions such as thinking about something completely unrelated during sex.

Although distraction is sometimes suggested as a self-help strategy, there's an obvious downside if it becomes your main approach.

You're trying to enjoy intimacy while mentally taking yourself somewhere else.

For men whose difficulty is strongly connected with anxiety, learning to remain calmer and more comfortable with arousal may ultimately be more useful than spending every sexual encounter desperately trying not to experience it.

What If Erectile Dysfunction Is Part of the Problem?

Premature ejaculation and erectile difficulties can sometimes become connected.

A man who is worried about losing his erection may rush sexual activity.

Or anxiety about premature ejaculation may contribute to broader sexual performance worries.

If you're experiencing both difficulties, don't simply assume you need to learn to delay ejaculation.

Current clinical guidance recommends identifying and treating erectile dysfunction or other relevant sexual or medical problems where they are present.

I've written separately about erectile dysfunction and sexual performance anxiety, including why medical causes should be considered as well as psychological ones.

Can Condoms Help With Premature Ejaculation?

For some men, reducing penile sensation can help delay ejaculation.

The NHS notes that thicker condoms may help decrease sensation. Topical anaesthetic products containing ingredients such as lidocaine or prilocaine may also be used in some cases.

These products need to be used correctly, because anaesthetic can potentially transfer to a partner and reduce their sensation too.

If you're considering medication or topical treatment, speak to a GP, pharmacist or other appropriate healthcare professional about what is suitable for you.

Are There Medicines for Premature Ejaculation?

Yes.

Medication may be considered for some men.

The NHS lists several options, including certain selective serotonin reuptake inhibitors (SSRIs), which can delay ejaculation. Dapoxetine is a short-acting SSRI specifically licensed in the UK for premature ejaculation and can be taken on demand, although it isn't suitable for everyone.

Topical anaesthetics are another option.

Treatment depends on your circumstances, health and the type of premature ejaculation you're experiencing, so medication is something to discuss with an appropriate healthcare professional rather than trying to diagnose or prescribe for yourself.

Can Psychosexual Counselling Help?

Yes, particularly when anxiety, relationship difficulties or learned sexual patterns are contributing.

Psychosexual counselling can explore the emotional and relationship side of the problem while also introducing practical behavioural techniques.

The NHS specifically mentions exploring relationship issues and learning squeeze and stop-go techniques as possible elements of psychosexual counselling for premature ejaculation.

European clinical guidance also recognises behavioural, cognitive and couple-based approaches, particularly alongside appropriate medical treatment.

Stop Treating Every Setback as Failure

Progress isn't necessarily linear.

You might feel more in control several times and then ejaculate quickly again.

That doesn't mean you're back at the beginning.

Sexual responses vary.

Stress, tiredness, excitement, how long it has been since you last had sex and many other factors can affect an individual experience.

If every setback produces:

“Nothing works. I'm hopeless.”

the performance-anxiety cycle begins again.

Look for the broader pattern rather than judging yourself on one occasion.

Rebuild Sexual Confidence as Well as Control

Premature ejaculation can gradually affect how you see yourself sexually.

You may begin approaching intimacy expecting embarrassment.

You become hesitant about initiating sex.

You may even avoid relationships because you're worried about what a future partner will think.

This is why simply adding a few minutes isn't always the whole answer.

If the problem has affected your confidence, that may need rebuilding too.

Try separating:

“I sometimes ejaculate sooner than I want”

from:

“I'm bad at sex.”

They are not the same statement.

How Self-Hypnosis May Help With Premature Ejaculation

Self-hypnosis isn't a substitute for medical assessment or recognised treatment, and I wouldn't suggest using it to try to treat an underlying physical cause.

Where it may have a role is in the psychological side of sexual performance.

If anxiety, anticipation and loss of confidence have become part of the pattern, relaxation and mental rehearsal may help you approach intimacy differently.

I've created my Premature Ejaculation Self-Hypnosis MP3 specifically to support men who want to feel calmer, reduce performance anxiety and develop a greater sense of control during intimacy.

The session focuses on relaxation, confidence and mentally rehearsing a calmer response rather than promising an instant physical cure.

You can also explore my wider collection of Relationship Self-Hypnosis MP3 Downloads, covering areas including intimacy anxiety, erectile dysfunction and sexual confidence, relationship insecurity and communication.

When Should You Speak to Your GP?

If premature ejaculation happens occasionally, it usually isn't a cause for concern.

But if it happens persistently, has developed suddenly, is causing you significant distress or is affecting your relationship, speak to your GP.

This is particularly important because physical as well as psychological factors can contribute.

A GP can discuss what's happening, consider whether there may be an underlying cause and talk through appropriate treatment options.

Don't allow embarrassment to prevent you seeking help.

Healthcare professionals deal with sexual difficulties regularly.

Final Thoughts

If you're trying to overcome premature ejaculation, don't reduce the problem to simply “lasting longer”.

First consider what may be contributing.

For some men, anxiety and pressure are major factors.

For others, learned patterns, relationship difficulties or physical factors may play a part.

Often more than one thing is involved.

Recognised approaches include behavioural techniques such as stop-start, psychosexual counselling and, where appropriate, medical treatments.

And if performance anxiety has become part of the cycle, working on relaxation and sexual confidence can be important alongside addressing the ejaculation problem itself.

During my years working with relationship difficulties, one thing became very clear: the more sex becomes a test of performance, the harder it can be to relax and enjoy intimacy.

The goal isn't perfection.

It's greater understanding, greater confidence and, where possible, a more relaxed and satisfying sexual relationship.