5 MAIN Causes of Premature Ejaculation

Worldwide, around 30% of men suffer from premature ejaculation. 

And if you too finish in bed in under 2 minutes, then it’s usually due to one or several of the following causes:

  1. PHYSICAL CAUSES   🍆 

    For example, a shortened frenulum. It can significantly shorten your stamina because it pulls on the glans during an erection and can overstimulate it. ⁣⁣⁣⁣⁣If this is the only cause of your premature ejaculation, then your stamina should normalize after a short surgery.⁣⁣⁣⁣⁣⁣

  2. PSYCHOLOGICAL CAUSES   😵‍💫 ⁣

    Performance pressure, chronic stress, relationship problems - all of this creates psychological tension. It builds up and overstimulates your central nervous system - speeding up your climax.⁣⁣⁣⁣⁣⁣

  3. DISEASES   🤒 ⁣

    Inflammation can make the prostate or urethra very sensitive, where even the slightest stimulation can cause your orgasm. ⁣⁣⁣⁣Prostatitis and urethritis can be easily treated with antibiotics.

  4. MEDICATION OR DRUG ABUSE   💊⁣

    Amphetamines, ADHD and Parkinson's medications, as well as long-term effects of ecstasy or cocaine abuse, can be the cause of premature ejaculation.⁣

  5. YOUR GENETIC MAKE UP (BLUEPRINT)   🧬 ⁣

    Most of my clients in my sex coaching come to me with a lifelong premature ejaculation.⁣⁣⁣⁣⁣⁣

    They are mentally and physically healthy 💪, do not abuse drugs, do not have a shortened frenulum, but their lasting time has always been under 2 minutes on average, from the first sexual experience onwards.⁣⁣⁣⁣⁣⁣

    It's just their genetic make up  🤷‍♂️  🧬⁣⁣⁣.

    Just as some people are born with a huge appetite 🤤 and tendency to obesity, while others are satisfied with a bagel and are always slim...

    ....so there are men who are born with the ability to last longer in bed, while most premature ejaculators are born with a short stamina ⌛️.⁣⁣⁣⁣⁣⁣

    But that doesn't mean you have to accept the short stamina, even if you're born with it  🙅‍♂️.

    I have already helped hundreds of men with lifelong premature ejaculation to achieve lasting times like 20-40-60 minutes in bed with my 5 Steps Lover Stamina System.
    ⁣⁣⁣⁣⁣
    There is no reason why you could not do the same 🤘.⁣⁣⁣ ⁣⁣⁣
    ⁣⁣⁣⁣⁣
    If you are interested, then click here and book your free consultation call with me personally.

Wanna find the cause of your PE and finally start lasting longer in sex?

David, your Stamina Coach

My recommendation: just book a free consultation call with me and you won't need any of these fancy yet inefficient remedies...

Click the button above to book your free consultation call with me (personally)

Now back to the causes of your PE.

As you can see, premature ejaculation can be caused by psychological factors such as stress, depression, relationship problems or performance-related anxiety, but also by physical factors such as frenulum breve, prostatitis, high blood pressure, thyroid problems or diabetes. The strongest factor, however, is the genetic predisposition to premature ejaculation.

It is rare for just one of these causes to be responsible for premature ejaculation. More often it is a combination of the contributing factors.

Let's dive in and explore each of these causes in detail below.

1. Physical (biological) Causes  🍆

Physical or organic causes are those that are directly related to the body, the brain or the penis.

These include, for example, the foreskin frenulum being too short:

Too short foreskin frenulum (frenulum breve)

The frenulum is the little ligament that connects the foreskin of the penis to the underside of the glans.

If it is too short (frenulum breve), the penis may be overstimulated when erect because it is constantly "pulling" on the glans, like in the picture:

  • The frenulum is shortened and pulls on the glans during an erection
  • Excessive stimulation of the penis occurs, which can lead to premature ejaculation

The frenulum can be lengthened during a frenulotomy (also known as frenuloplasty) or removed completely, which can normalize the stamina if this was the only reason for premature ejaculation.

A urologist can examine you and if your frenulum is indeed too short, it can be removed or lengthened via the frenuloplasty surgery. This can lead to increased stamina as long as it was the single or partial cause of rapid ejaculation.

In the study by Gallo L et al, a whopping 43% of the 137 men with premature ejaculation had a frenulum that was too short. After it was surgically removed, their stamina increased by about 2.5 minutes. 1 Gallo L et al. The role of short frenulum and the effects of frenulectomy on premature ejaculation. PubMed

The complete removal of the penile frenulum can be carried out together with the radical circumcision. I had it done when I was 26 and the result was an additional 1-2 minutes of stamina.

If the frenulum is really too short in your case, a frenulotomy may make sense. Decide for yourself whether the time and effort is worth it for you. Read this for more info on surgical treatments for premature ejaculation.

Tight foreskin (phimosis)

If you're uncircumcised and can't pull back your forskin (open the glans), it's called phimosis. In that case the glans always remains hidden.

An erection can therefore lead to an overstimulation of the penis - similar to a frenulum breve - which can theoretically cause an accelerated orgasm.

However, there is no link between phimosis and premature ejaculation in the scientific literature.

I personally also had phimosis, but after I had both the penis frenulum and the foreskin removed, my stamina changed only a little (about 1-2 minutes more).

Only years later did I gain real control over my ejaculation when I started using the right techniques during sex. So 2 minutes became 10, 20, 30, then 40, then over an hour.

Can an oversensitive glans be a reason for cumming too early? Yes and no.

Many men with premature ejaculation think that their hypersensitive glans is the reason why they orgasm too quickly. They then often resort to numbing delay sprays, gels or wipes and run into sudden erection problems.

In reality though, premature ejaculation due to a sensitive glans is very rare. In extreme cases, the glans can become oversensitive due to inflammation (e.g. balanitis), so that the arousal increases quickly even with minor penile stimulation and thus ejaculation can no longer be controlled.

But if there is no such inflammation, then the early ejaculation most likely has nothing to do with the hypersensitivity of the penis. Paick JS et al. came to this conclusion in the 1998 study.  2 Paick JS et al. Penile sensitivity in men with premature ejaculation. PubMed 

From my 10+ years experience as a sex & stamina coach, I can definitively say that there is no benefit whatsoever in trying to make your glans less sensitive to last longer in bed.

Can premature ejaculation be caused by hyperthyroidism?

Hyperthyroidism is a condition that is sometimes associated with premature ejaculation. 3 Cihan A, Demir O, Demir T, Aslan G, Comlekci A, et al. The relationship between premature ejaculation and hyperthyroidism. J Urol 2009; 181: 1273–80.

Interestingly, not only patients with hyperthyroidism (too much thyroid hormones) but also those with hypothyroidism (too littel thyroid hormones) can be troubled by sexual disorders such as premature ejaculation. There is also evidence that normalizing thyroid hormones can improve stamina. 4 Carani C, Isidori AM, Granata A, Carosa E, Maggi M, et al. Multicenter study on the prevalence of sexual symptoms in male hypo- and hyperthyroid patients. J Clin Endocrinol Metab 2005; 90: 6472–9.  

However, we don't hear much about great success in this context.

When I was looking for a solution for rapid ejaculation, I also wanted to have my thyroid gland operated on - because the values were slightly elevated.

Fortunately, I didn't do it.

Firstly, you can learn to last longer without messing around with your thyroid.

Secondly, if you have either hyperthyroidism or hypothyroidism, hormonal treatment is mostly just a money-making scheme by doctors and the pharmaceutical industry. They want to sell you pills for everything. Thyroid dysfunction can be wonderfully regulated by exercise, sufficient sleep and a good diet (plenty of meat, no fast food).

2. Psychological Causes  😵‍💫

Unresolved psychological issues can have a devastating impact on stamina and potency.

It happens because they force the body into a constant "fight and flight" state, making the central nervous system work in overdrive.

The main goal in this "fight and flight" state is to SURVIVE and NOT make love.

Thus, the body preserves all available resources for SURVIVAL, leaving nothing left for making LOVE and procreate. 

The result of it is usually constantly elevated levels of stress hormones like adrenaline, noradrenaline and cortisol, which overstimulates the central nervous system. 

Bottom line is:  If you're constantly in a "fight and flight" mode, you can't be in the "love making" mode at the same time.

The following mental problems are well known to put you into the "fight and flight" state, often resulting in erection problems and premature ejaculation:

  • Performance anxiety, fear of failure during sex
  • Being too nervous with a new partner
  • Nervousness during the "first time" (virgin men)
  • Feeling being rejected or "being broken up with any time soon" in a relationship
  • Constant stress at work or fear of losing your job

Such mental issues must be resolved if your goal is having a good erection, stamina and fulfilled love life.

This should be done either with an experienced sex coach or a psychiatrist.

Without addressing these issues first, no techniques or last longer home remedy will have any satisfying effects on a man's performance


3. Diseases   🤒 ⁣

Sudden and recurrent premature ejaculation is often caused by inflammation in the genital area (acquired premature ejaculation).

Either the urethra (urethritis) or the prostate (prostatitis) can be inflammated. There is also evidence that diabetes can promote premature ejaculation.

If the inflammation is caused by an infection, then it is treated with antibiotics. If this was the cause of the sudden onset of premature ejaculation, then the old lasting time is usually restored.

Prostatitis

Prostatitis is the inflammation of the prostate gland.

The prostate is a walnut-sized gland that surrounds the urethra in a ring below the bladder (see picture) and produces around 10-30% of seminal fluid.

Stimulation of the prostate via the rectum with fingers or sex toys can quickly lead to orgasm in most men.

This is why the prostate has been discovered by many men as a new pleasure center and referred to as the "man's G-spot".

Now it's easy to imagine what happens when the prostate is inflamed and enlarged (prostatitis) - it becomes highly sensitive and contributes to the rapid increase in arousal from normal stimulation, which can lead to premature orgasm.

Proven link between prostatitis and premature ejaculation

In a study with 253 participants (153 with premature ejaculation and 100 healthy men as a control group), 64% of PE men had prostatitis. Of these, 52% had a bacterial prostatitis.  5 Chronic prostatitis in premature ejaculation: a cohort study in 153 men. PubMed In another study, 39% of the 623 patients had chronic prostatitis and premature ejaculation. 16.9% of these 623 men also suffered from erectile dysfunction.  6 Qiu YC et al. [Investigation of sexual function in 623 patients with chronic prostatitis]. PubMed

Bacterial prostatitis can be caused by chlamydia, for example. According to studies, this can to lead to premature ejaculation. 7 Chlamydia trachomatis infection is related to premature ejaculation in chronic prostatitis patients: results from a cross-sectional study. Cai T et al. PubMed

Treatment of prostatitis with antibiotics can increase stamina in bed

If bacterial prostatitis is the cause of premature ejaculation, then treatment with the antibiotic ciprofloxacin increases the sex duration. 8 Brown AJ. Ciprofloxacin as cure of premature ejaculation. J Sex Marital Ther 2000; 26: 351–2.

A study from 2017 investigated the influence of treatment for chronic prostatitis (CP) on the lasting time of men with premature ejaculation. 9 Dr. Md. Shafiqul Islam, M. S. (2017). Premature Ejaculation and Chronic Bacterial Prostatitis. Medicine Today29(2), 21-25. study 

In this study, 64 patients with chronic prostatitis and premature ejaculation were treated with antibiotics for 1 month (quinolone patients, doxycycline and cephalosporin in 53, 6 and 5 patients, respectively). 20 patients with PE and CP did not receive antibiotics and served as a control group.

In 80% of the treated men, the IELT time (Intravaginal ejaculation latency time) increased from approx. 1 minute to 3 minutes. In the 20 men from the control group, the time remained unchanged (1 min).

Urethritis

Urethritis is the inflammation of the urethra (the tube that lets urine leave your bladder and your body).

Just like prostatitis, urethritis is associated with premature ejaculation and can be caused by a gonorrhea or chlamydia infection.

Diabetes

Diabetes is the "sugar disease" where the body is unable to lower blood sugar levels, which can be very dangerous.

And surprisingly, type 2 diabetes can also be a cause of premature ejaculation.

In a study of 199 type 2 diabetic men, it was found that 78.9% of them suffered from premature ejaculation. In the control group (289 healthy men), only 47.4% reported premature ejaculation. The healthy men had an average of 19.4% higher lasting time than men with type 2 diabetes. 10 Ahmad Majzoub et al. Premature ejaculation in type II diabetes mellitus patients: association with glycemic control PubMed

4. Drug abuse and side effects of medication that cause premature ejaculation   💊⁣

Many medications and recreational drugs can cause premature ejaculation. 11 Piediferro G, Colpi EM, Castiglioni F, Nerva F. Premature ejaculation. 1. Definition and etiology. Arch Ital Urol Androl 2004; 76: 181–7.

These include:

  • Parkinson's medications
  • opiates
  • Ritalin (methylphenidate), atomoxetine and other ADHD medications
  • amphetamines
  • Sympathomimetics (ephedrine, MDMA)
  • Bupropion (smoking cessation)

If one of the above medications is causing your premature ejaculation, then I hope that you will soon be in good health and can stop taking them. In most cases, the right lifestyle and diet can make the medication unnecessary.

A few words about recreational drugs...

Ecstasy (MDMA or Molly), cocaine

Recreational drugs such as cocaine or ecstasy have a short-term and long-term effect on your stamina.

In the short term, they can certainly extend your stamina. The "problem" with this, however, is that it is very difficult to maintain an erection while using them. It is also often reported that erectile dysfunction caused by such recreational drugs can last for several weeks.

In the long term, however, taking these recreational drugs leads to erectile dysfunction as well as increasingly orgasming too soon. This can "suddenly" result in a lasting time of less than 1-2 minutes, even though you previously had full control.

One reason for this is that these drugs deplete all your serotonin and dopamine reserves, which play a central role in sex.

Taking drugs " occasionally" can also cause long-term problems. There are numerous reports where as little as 1 ecstasy per month has led to long-term sexual damage.12 Internet repost from an MDMA/ Ecstasy user: MDMA & Premature Ejaculation

I personally also took some drugs many years ago and can testify to this negative effect first hand.

Alcohol

The same applies to alcohol consumption: in the short term, it can increase stamina (albeit with poor erection quality), and in the long term, it causes problems in bed (shorter stamina and erection problems).

One study investigated the link between alcoholism and sexual dysfunction. It was found that 72% of alcoholics have at least one sexual disorder. 37.5% of the alcoholics studied reported suffering from premature ejaculation and 33% had erectile dysfunction 13 Bijil Simon Arackal and Vivek Benegal, Prevalence of sexual dysfunction in male subjects with alcohol dependence PubMed

A user of my Lover Stamina system initially suffered from both premature ejaculation and erectile dysfunction.

At some point, he revealed to me that he regularly consumes a lot of alcohol, Friday-Saturday-Sunday full blast, every week.

I immediately realized what the problem was and advised him not to touch alcohol for at least two weeks.

Two weeks later, he came back and reported about the incredible weekend of sex where his girlfriend had countless orgasms. He could hardly believe how well all the lasting longer techniques suddenly worked and how rock hard his erection was.

Cheers!

5. Genetics: it's NOT just "all in your head". It's your GENETIC MAKE UP

Previously, it was assumed that premature ejaculation was just a mental thing, e.g. "all in your head". Today, we know that short sexual stamina is very much genetically determined.

Your genetic make-up not only determines whether you are "by nature" rather slim, rather muscular or rather obese, but also your penis size and also it determines your "natural" stamina in bed.

At least 3 different serotonin genes have already been identified as being responsible for short stamina:

Since 2009, several studies have investigated the relationship between genetic polymorphisms and premature ejaculation (PE).

1) The Serotonin Transporter Gene 5-HTT

In a stopwatch study, Janssen et al. 14 Janssen PK, Bakker SC, Rethelyi J, Zwinderman AH, Touw DJ, Olivier B, et al. Serotonin transporter promoter region (5-HTTLPR) polymorphism is associated with the intravaginal ejaculation la-tency time in Dutch men with lifelong premature ejaculation. J Sex Med 2009;6:276-84. found that in men with lifelong PE, the 5-HT transporter gene-linked promoter region polymorphism (5-HTTLPR) had a statistically significant effect on the latency to ejaculation. Men with the LL genotype ejaculate 100% faster than men with the SS genotype. Chinese researchers Zhu L. et al. 15 Zhu L, Mi Y, You X, Wu S, Shao H, et al. A meta-analysis of the effects of the 5-hydroxytryptamine transporter gene-linked promoter region polymorphism on susceptibility to lifelong premature ejaculation. PLoS One 2013; 8: e54994. had similar findings.

2) The Serotonin 5-HT1A-Receptor Gene

In addition, men with lifelong PE and with the CC genotype of the C(1019)G polymorphism of the 5-HT1A receptor also ejaculate statistically significantly faster than men with the GC and GG genotypes 16 Janssen PK, van Schaik R, Zwinderman AH, Olivier B, Waldinger MD. The 5-HT1A receptor C(1019)G polymorphism influences the intravaginal ejaculation latency time in Dutch Caucasian men with lifelong premature ejaculation. Pharmacol Biochem Behav 2014 Jan 15 [Epub]. Link 

3) The Serotonin 5-HT2C-Receptor Gene

Janssen et al. also showed that men with lifelong PE and with the Cys/Cys genotype of the Cys23Ser polymorphism of the 5-HT2C receptor ejaculate statistically significantly faster than men with the Ser/Ser genotype 17 Janssen PK, van Schaik R, Olivier B, Waldinger MD. The 5-HT2C receptor gene Cys23Ser polymorphism influences the intra-vaginal ejaculation latency time in Dutch Caucasian men with lifelong premature ejaculation. Asian J Androl Forthcoming 2014

In simple terms, this means that genes largely determine whether you are "naturally" in the 1-2 minute, 3-5 or 5-10 minute range when it comes to sexual stamina.

And that's why there is no real "cure" lifelong premature ejaculation in that sense, the condition is just a genetic trait like height or eye color.

Men who are naturally in the 10-15 minute range like to give "valuable" tips: "just think about something else" or "just practise when you masturbate, that's how I did it back then and now I can do it for a very long time!".

But of course, these tips will have zero effect on men who are "naturally" in the 1-2 minute range or below, because they most likely have those unfavorable variations in the serotonin genes mentioned above.

What should you do if you have inherited an unfavorable variation of the serotonin genes and can only last for 1-2 minutes in bed?

In principle, there are two options here.

You can either artificially increase your serotonin levels with antidepressants (bad idea), or you can use methods to last longer in bed which do NOT rely on increasing serotonin whatsoever.

Beware: medications such as antidepressants can increase serotonin and stamina, yes, but with a major side effect: erectile dysfunction and loss of libido. Other side effects include anhedonia, constant fatigue, loss of appetite, indigestion and others. You can find out more about medication for premature ejaculation here: Drugs that delay ejaculation.

Wanna find the cause of your PE and finally start lasting longer in sex?

David, your Stamina Coach

My recommendation: just book a free consultation call with me and you won't need any of these fancy yet ineffecient remedies...

Click the button above to book your free consultation call with me (personally)

Frequently asked questions

Premature ejaculation due to serotonin deficiency - true or false? 

Once the link between short stamina and the serotonin genes was discovered, people started talking about "serotonin deficiency". However, the term "deficiency" is incorrect. Your serotonin is still in the normal range - even if you orgasm quickly. Just as one cannot speak of a leptin (satiety hormone) deficiency simply because a person has a predisposition to obesity. Find out more about how to increase serotonin and last longer in bed here.

Can premature ejaculation be acquired through bad masturbation habits?

This myth persists from the time when it was still assumed that short stamina was a "mental thing". It was thought that men "trained" themselves to ejaculate quickly when masturbating, for example because they were afraid of being caught. Today we know that people are usually born with premature ejaculation (unless it is secondarily acquired through drugs or similar), and "training" played absolutely no role here.

Can vasectomy cause premature ejaculation?

Vasectomy is not known to cause premature ejaculation.

Can testosterone deficiency cause premature ejaculation?

Lack of testosterone can indeed lead to weak erections, but it is not known to cause premature ejaculation. It's actually the other way around: men who come quickly in bed are more likely to have slightly higher testosterone levels (free testosterone). 18 Mohammad G. Mohseni et al. Serum testosterone and gonadotropins levels in patients with premature ejaculation: A comparison with normal men PubMed  19 Corona G1 et al. Different testosterone levels are associated with ejaculatory dysfunction. PubMed

REFERENCES

  • 1
    Gallo L et al. The role of short frenulum and the effects of frenulectomy on premature ejaculation. PubMed
  • 2
    Paick JS et al. Penile sensitivity in men with premature ejaculation. PubMed 
  • 3
    Cihan A, Demir O, Demir T, Aslan G, Comlekci A, et al. The relationship between premature ejaculation and hyperthyroidism. J Urol 2009; 181: 1273–80.
  • 4
    Carani C, Isidori AM, Granata A, Carosa E, Maggi M, et al. Multicenter study on the prevalence of sexual symptoms in male hypo- and hyperthyroid patients. J Clin Endocrinol Metab 2005; 90: 6472–9.  
  • 5
    Chronic prostatitis in premature ejaculation: a cohort study in 153 men. PubMed
  • 6
    Qiu YC et al. [Investigation of sexual function in 623 patients with chronic prostatitis]. PubMed
  • 7
    Chlamydia trachomatis infection is related to premature ejaculation in chronic prostatitis patients: results from a cross-sectional study. Cai T et al. PubMed
  • 8
    Brown AJ. Ciprofloxacin as cure of premature ejaculation. J Sex Marital Ther 2000; 26: 351–2.
  • 9
    Dr. Md. Shafiqul Islam, M. S. (2017). Premature Ejaculation and Chronic Bacterial Prostatitis. Medicine Today29(2), 21-25. study 
  • 10
    Ahmad Majzoub et al. Premature ejaculation in type II diabetes mellitus patients: association with glycemic control PubMed
  • 11
    Piediferro G, Colpi EM, Castiglioni F, Nerva F. Premature ejaculation. 1. Definition and etiology. Arch Ital Urol Androl 2004; 76: 181–7.
  • 12
    Internet repost from an MDMA/ Ecstasy user: MDMA & Premature Ejaculation
  • 13
    Bijil Simon Arackal and Vivek Benegal, Prevalence of sexual dysfunction in male subjects with alcohol dependence PubMed
  • 14
    Janssen PK, Bakker SC, Rethelyi J, Zwinderman AH, Touw DJ, Olivier B, et al. Serotonin transporter promoter region (5-HTTLPR) polymorphism is associated with the intravaginal ejaculation la-tency time in Dutch men with lifelong premature ejaculation. J Sex Med 2009;6:276-84.
  • 15
    Zhu L, Mi Y, You X, Wu S, Shao H, et al. A meta-analysis of the effects of the 5-hydroxytryptamine transporter gene-linked promoter region polymorphism on susceptibility to lifelong premature ejaculation. PLoS One 2013; 8: e54994.
  • 16
    Janssen PK, van Schaik R, Zwinderman AH, Olivier B, Waldinger MD. The 5-HT1A receptor C(1019)G polymorphism influences the intravaginal ejaculation latency time in Dutch Caucasian men with lifelong premature ejaculation. Pharmacol Biochem Behav 2014 Jan 15 [Epub]. Link 
  • 17
    Janssen PK, van Schaik R, Olivier B, Waldinger MD. The 5-HT2C receptor gene Cys23Ser polymorphism influences the intra-vaginal ejaculation latency time in Dutch Caucasian men with lifelong premature ejaculation. Asian J Androl Forthcoming 2014
  • 18
    Mohammad G. Mohseni et al. Serum testosterone and gonadotropins levels in patients with premature ejaculation: A comparison with normal men PubMed
  • 19
    Corona G1 et al. Different testosterone levels are associated with ejaculatory dysfunction. PubMed

David

About 30% of all men suffer from premature ejaculation. That's why I've developed a simple 5 Step Process that helps you last longer and give your partner the best sex of her live. If you're interested in 1-1 Coaching with me, then click this link and find out more.

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