Coming sooner than you want, almost every time, without feeling you can hold it back, and being bothered by it. Doctors need all three, not just a short time.
For years I had no word for it. I just knew I finished too fast, and I assumed I was built that way. Putting a name on it was the first thing that helped, so let’s start there.
The three things doctors look for
Premature ejaculation is defined by three things together.
The first is time: ejaculation comes very soon after penetration. The International Society for Sexual Medicine (ISSM) puts the line at about one minute when it has been there from the start, and the American Urological Association (AUA) at about two minutes.
The second is control: you feel you can’t delay it, or barely, even when you try.
The third is that it bothers you. Distress, frustration, avoiding sex, tension in the couple. If it doesn’t bother you or your partner, doctors don’t call it a disorder.
That third point surprised me when I read it. It means the stopwatch doesn’t decide on its own. A man who lasts two minutes and is fine with it doesn’t have a problem to fix, and a man who lasts a bit longer but feels completely out of control can still be in the picture.
Lifelong or acquired
Doctors also separate two cases. Lifelong premature ejaculation has been there since the very first times, on most occasions. That’s mine: I’ve always had it. Acquired premature ejaculation shows up later, in someone who used to be fine.
The difference matters, because when it appears suddenly after years without trouble, there’s more chance of a physical cause behind it (an erection problem, the prostate, the thyroid, a medication). In that case, a doctor is the first stop, before any training.
What it isn’t
Finishing fast once in a while isn’t premature ejaculation. Neither is finishing fast the first time with a new partner, or after a long break. Researchers even describe a “natural variable” pattern, where some men occasionally come early, and they say plainly that it shouldn’t be treated as a disorder.
What I’d tell myself back then
You’re far from the only one, and it has a name, causes, and ways out. That’s a lot better than “I’m just built wrong”, which is what I believed for a long time.
If you want to know where you stand, I wrote a page on how to tell if you have premature ejaculation.
Sources
- Disorders of Ejaculation: AUA/SMSNA Guideline, American Urological Association, 2020
- An evidence-based unified definition of lifelong and acquired premature ejaculation, International Society for Sexual Medicine, 2014 (via UroToday)
- The pathophysiology of acquired premature ejaculation, McMahon et al., Translational Andrology and Urology, 2016
- Premature ejaculation, Cleveland Clinic