Premature ejaculation involves a persistent pattern of ejaculation occurring within around one minute of starting penetrative sex. For it to meet clinical criteria, it must cause significant distress and occur most or all of the time for at least six months.
Symptoms:
The main symptom is difficulty delaying ejaculation beyond one minute of penetrative sex. Premature ejaculation can also occur during masturbation or with some sexual partners but not others, and may be lifelong or acquired. Shame and distress around premature ejaculation can also lead some people to avoid sex altogether.
Causal factors:
There are many possible factors underlying premature ejaculation, and these are not always psychological. Common contributors include performance anxiety, negative self-image, low sexual self-esteem, sexual guilt, and relationship difficulties. Physical and biological factors can also play a role.
How Therapy Helps:
Sex therapy can help address the behavioural and psychological factors contributing to premature ejaculation. The stress and anxiety around ejaculating too quickly can sometimes create a self-perpetuating cycle, which therapy can help break by reducing shame and performance anxiety around sexual function.
Sex therapists can also provide techniques to develop greater bodily awareness and learn to delay ejaculation, such as pelvic floor exercises and edging. Therapy may also support greater erotic and emotional intimacy within a relationship.