Doctors often classify premature ejaculation as either primary or secondary:
You have primary premature ejaculation if you've had the problem for as long as you've been sexually active.
-OR-
You have secondary premature ejaculation if you developed the condition after having had previous, satisfying sexual relationships without ejaculatory problems.
Experts are still trying to determine exactly what causes premature ejaculation. While it was once thought to be only psychological, we now know premature ejaculation is more complicated and involves a complex interaction of both psychological and biological factors.
Psychological causes
Some doctors believe that early sexual experiences may establish a pattern that can be difficult to change later in life such as:
-Situations in which you may have hurried to reach climax in order to avoid being discovered
-Guilty feelings that increase your tendency to rush through sexual encounters
Other factors that can play a role in causing premature ejaculation include:
Erectile dysfunction. Men who are anxious about obtaining or maintaining their erection during sexual intercourse may form a pattern of rushing to ejaculate which can be difficult to change.
Anxiety. Many men with premature ejaculation also have problems with anxiety — either specifically about sexual performance, or caused by other issues.
Biological causes
Experts believe a number of biological factors may contribute to premature ejaculation, including:
-Abnormal hormone levels
-Abnormal levels of brain chemicals called neurotransmitters
-Abnormal reflex activity of the ejaculatory system
-Certain thyroid problems
-Inflammation and infection of the prostate or urethra
Inherited traits
Rarely, premature ejaculation is caused by:
Nervous system damage resulting from surgery or trauma
Withdrawal from narcotics or a drug called trifluoperazine (Stelazine), used to treat anxiety and other mental health problems
Although both biological and psychological factors likely play a role in most cases of premature ejaculation, experts think a primarily biological cause is more likely if it has been a lifelong problem (primary premature ejaculation).
Risk factors
Various factors can increase your risk of premature ejaculation, including:
Impotence. You may be at increased risk of premature ejaculation if you occasionally or consistently have trouble getting or maintaining an erection. Fear of losing your erection may cause you to rush through sexual encounters.
As many as one in three men with premature ejaculation also have trouble maintaining an erection.
Health problems. If you have a medical concern that causes you to feel anxious during sex, such as a heart problem, you may have an increased likelihood of hurrying to ejaculate.
Stress. Emotional or mental strain in any area of your life can play a role in premature ejaculation, often limiting your ability to relax and focus during sexual encounters.
Certain medications. Rarely, drugs that influence the action of chemical messengers in the brain (psychotropics) may cause premature ejaculation.
Talk with your doctor if you ejaculate sooner than you and your partner wish during most sexual encounters. Although you may feel you should be able to fix the problem on your own, you may need treatment to help you achieve and sustain a satisfying sex life.
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