Psychological and physiological causes and treatment of premature ejaculation

Premature ejaculation is the most common sexual problem in men under the age of 40. Premature ejaculation seriously reduces the quality of sexual life of men and women and even leads to divorce. Although there is no definite definition about the ejaculation time of the man, ejaculation that is less than 3 minutes and outside the will of the man or his partner can be defined as premature ejaculation. On the other hand, every man may ejaculate early from time to time for various reasons, and this time may be less than 3 minutes. However, if such ejaculation covers more than 30% of your sexual life, it can be said that you have a premature ejaculation problem that requires treatment.

The average sexting time varies from couple to couple. For example, some couples can reach orgasm within 5 minutes, while for some, this time can be up to half an hour. The important thing here is that both the man and the woman can reach orgasm. For this reason, being able to ejaculate for longer than 3 minutes may not be enough for a quality and satisfying sex life. Generally, but not always, women ejaculate later than men. For example, there is no problem of premature ejaculation in a man who ejaculates between 5-10 minutes on average. However, if this man’s partner is a woman who needs 15 minutes of vaginal intercourse to ejaculate, it will be difficult for the woman to reach orgasm and this will reduce the quality of the couple’s sexual life. For this reason, the ideal ejaculation period for men should be defined as the time when both sides reach saturation. And for this reason, the ability of a man to delay ejaculation is as important as the duration of ejaculation. In sexual therapy, it is necessary to evaluate the sexual life history of the couple rather than the individual.

There are 3 types of premature ejaculation.

a) Those who ejaculate without entering the vagina yet,

b) Vacancies during entry

c) Those vacated immediately after entering

Premature ejaculation according to DSM-IV diagnostic criteria; It is defined as the permanent and repetitive ejaculation of the person with little stimulation or in a very short time after the erection occurs and against the will of the person, and this problem causes negativities regarding the sexual life of the person. If premature ejaculation is a problem that has existed since the beginning of the person’s sexual life and continues, it is called primary premature ejaculation, and the premature ejaculation that occurs later in the person’s life is called secondary premature ejaculation. Secondary (post-occurring) premature ejaculation may have different causes such as psychological problems, sexual trauma, alcohol-substance abuse, physical health problems, and medications.

Many people are convinced that their problem will improve over time, so there is no need to seek treatment, or even that there is no cure, and there is no point in going to a specialist. These obstacles cause stress and disappointment in the person and the desire to satisfy his partner is prevented. Studies show that men with premature ejaculation problems have more problems with their partners, feel more insecure, experience suspicion of being cheated on, and are accused of being selfish and unsympathetic by their partners.

CAUSES OF EARLY ejaculation

There is a lot of misinformation about the causes of premature ejaculation, such as masturbating too much. Although premature ejaculation is a problem of psychological origin, the physiological reasons accompanying this problem are also important. And treatment requires both physiological and psychological intervention.

According to the evolutionary theory, since the main purpose of sexuality is to reproduce, the man focuses on getting the woman pregnant as quickly as possible.


Insufficient development of the musculature in the penis, prostate and testis region and therefore the inability to control the ejaculation reflex.

Problems in the testosterone level of the male bio-chemically. A high testosterone level can make it difficult to control the ejaculation reflex and lead to premature ejaculation.

High prolactin level can increase anxiety and cause premature ejaculation.


Alcohol abuse.

Substance use.

EARLY Ejaculation (2)


In adolescence or before, the musculature is conditioned to discharge in a short time as a result of the adolescent’s accustomed to masturbating quickly in order not to be caught.

The male’s arousal threshold towards the female body is low. (ejaculation as soon as you touch it)

Negative, traumatic and inadequate sexual experiences such as prostitute, general home experience.

The man is very excited (ejaculation without undressing).

Anxiety disorders (panic attacks, generalized anxiety disorder, etc.).

Being caught masturbating in the past period.

Feeling of guilt. Don’t feel dirty.

Fear of punishment.

Being sexually abused.

Other psychological problems.

Being brought up in a conservative family environment.

Misinformation and sexual myths about sexuality.

Sexual inexperience.

Problems with the partner, the partner’s reactions to sexual behavior (accusing attitude, etc.).

Performance anxiety.

Stressful life.


It is very important to take the general and sexual life history of the person with premature ejaculation problem in detail, to determine whether it is primary or secondary (secondary) premature ejaculation (delayed premature ejaculation or lifelong premature ejaculation), to choose the most appropriate method for the person. is important. The solution to the problem of premature ejaculation that occurs later is resolved in a shorter time than the premature ejaculation that exists throughout life.

Depending on the problem of premature ejaculation, erectile dysfunction (erectile dysfunction), depression, loss of self-confidence, partner relationship problems, etc. may occur in other problems. In order to prepare a treatment plan suitable for the individual, a comprehensive treatment plan should be prepared by evaluating the problem of premature ejaculation as well as other possible problems.

For this reason, it is very important that the specialist applied for the treatment of premature ejaculation is a Psychologist with special training in sexual matters.

In the treatment of premature ejaculation, after collecting information about the person’s past sexual history and life history, it is evaluated whether there is another psychological or spouse problem accompanying premature ejaculation. In some cases, the relationship may wear out due to the premature ejaculation problem experienced by the man and the couple may be on the verge of divorce. In this case, the increase in the anxiety level of the man may complicate the treatment. Or the fact that the man has such a problem may be used by his partner to punish the man. Resolving such relationship problems will facilitate treatment.

Treatment is started after other possible risk factors are identified. During the treatment phase, the couple is preferably taken together, but in cases where this is not possible, sexual therapy can be applied individually. It is treated by considering the psychological factors that feed the person’s premature ejaculation problem, as well as applying some exercises to strengthen the muscles that control the person’s ejaculation reflex.

The aim of sexual therapy is not only to prolong the ejaculation period, but also to increase the sexual life quality of the person and to have a sexual life that is more satisfied and enjoyable for both partners.

Although the duration of premature ejaculation treatment varies from person to person, this problem is completely and permanently resolved in an average of 10 sessions. As mentioned above, this problem is a problem that has both psychological and physiological dimensions. And the psychologist, who has received special training on this subject, must have the locality to be able to intervene both physiologically and psychologically. Referring to the wrong people for treatment may cause new problems in the person who has the problem, as well as discourage the person. It is recommended to ask whether the specialist you receive treatment from is a psychologist, and if he is a psychologist, from where he received his sexual therapy training, and even to examine the resume of the specialist before making an appointment with the specialist.

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