What are the causes of premature ejaculation? The causes of premature ejaculation can be physiological, psychological or (more often) a combination of both.

Written by Rob Michaels
Updated 01/24/2019


Physiological Causes of Premature Ejaculation:

Physiological causes mean that your premature ejaculation has a physical component. These causes can often be addressed with products, exercises or prescription medication, when required. Physiological causes include:

  • Highly responsive nervous system – Your sympathetic nervous system uses energy and is responsible for your fight or flight response, when your body encounters stress.[1] This includes sexual stress. Your heart rate and breathing increases. Your pupils dilate and blood vessels constrict. This response also triggers the emission phase of ejaculation! If your sympathetic nervous system is highly responsive, it can lead to an early triggering of orgasm, causing premature ejaculation.
  • Overactive pelvic floor muscles causes premature ejaculation [2] – This often happens when a man first begins Kegeling, and Kegels during sex, causing premature ejaculation. When Kegels are performed correctly, it can be used to prevent ejaculation. However, pelvic muscles that contract outside your control can lead to premature orgasms.
pelvic floor muscles
Image from Researchgate.com
  • Abnormal hormone levels – Both low testosterone and thyroid hormone have been associated with lack of climax control.[3]
  • Abnormal levels of neurotransmitters – Low serotonin levels have been found in men with premature ejaculation. A study in European Urology discusses how taking selective serotonin reuptake inhibitors (SSRIs) can help patients with PE.[4]
  • Infection or inflammation of the urethra or prostate – This is an easily treatable cause of premature ejaculation. In a 2014 study in The Journal of Sexual Medicine, increased inflammation with chronic prostitis or chronic pelvic pain syndrome is directly related to premature ejaculation.[5]
  • Abnormal ejaculatory system reflex activity – This is the inability to control orgasm, due to an autonomous reflex.
  • Nervous system damage – This usually happens following a trauma or surgery.
  • Withdrawal of some mental health medications – These include SSRI drugs like Zoloft and Paxil. However, there’s also some research that shows men taking antidepressants also experience erectile dysfunction.[6]

Psychological Causes of Premature Ejaculation:

Psychological causes of premature ejaculation can include anxiety, stress, and past trauma. These causes are most often best treated by a mental health professional.

  • Early Sexual Experiences – These may include early experiences where you were rushed to climax, in order to not be discovered or feelings of guilt in early experiences that rushed you to orgasm, all setting up a pattern of quick ejaculation, for later in life.

premature ejaculation snowball effect

  • Anxiety – Oftentimes, men experiencing premature ejaculation have anxiety issues either serving as a catalyst or compounding the problem. A 2014 study in the Journal of Clinical Psychiatry notes that performance anxiety were often higher in patients with primary or lifelong premature ejaculation.[7] Anxiety puts your body in sympathetic mode — the mode that leads to orgasm. Anxiety can create a snowball effect for premature ejaculation. Your anxiety levels rise when you’re worried about orgasming too quickly. This creates a fight or flight response and triggers orgasm. This is why thinking about something like baseball stats work. It’s not that the topic is mundane, but it distracts your mind from the anxiety.
  • Relationship Problems – Premature ejaculation can be caused by problems within your relationship. If premature ejaculation is something new in your sexual experience, this may be an indicator that the underlying problem is related to your relationship.



Keep Reading: Getting Aroused Too Quickly



What is Premature Ejaculation PE2




[1] “Understanding the Stress Response.” Harvard Health Publishing, Harvard Medical School. 1 May 2018. Web. 24 Jan. 2019. Retrieved from https://www.health.harvard.edu/staying-healthy/understanding-the-stress-response
[2] Hui, Alison. “Overactive Pelvic Floor Muscles.” Sydney Pelvic Clinic. 15 Jan. 2019. Web. 24 Jan. 2019. Retrieved from https://www.sydneypelvicclinic.com.au/overactive-pelvic-floor-muscles/.
[3] Sansone, Andrea, et al. “Hormonal Correlations of Premature Ejaculation.” Endocrine, vol. 49, no. 2, 2015, pp. 333–338., doi:10.1007/s12020-014-0520-7.
[4] Giuliano, François & Pierre Clément. “Serotonin and Premature Ejaculation: From Physiology to Patient Management.” European Urology, vol. 50, no. 3, 2006, pp. 454–466., doi:10.1016/j.eururo.2006.05.055.
[5] Lee, Jun Ho, & Sung Won Lee. “Relationship between Premature Ejaculation and Chronic Prostatitis/Chronic Pelvic Pain Syndrome.” The Journal of Sexual Medicine, vol. 12, no. 3, 2015, pp. 697–704., doi:10.1111/jsm.12796.
[6] Bihari, Michael. “Is Your Antidepressant Making Your Sex Life Miserable?” Verywell Mind, Dotdash. 24 Aug. 2018. Web. 24 Jan 2019. Retrieved from https://www.verywellmind.com/can-zoloft-cause-erectile-dysfunction-1124021
[7] Rajkumar, Ravi Philip, & Arun Kumar Kumaran. “The Association of Anxiety With the Subtypes of Premature Ejaculation: A Chart Review.” The Journal of Clinical Psychiatry, Physicians Postgraduate Press, Inc., 15 Aug. 2014, www.psychiatrist.com/PCC/article/Pages/2014/v16n04/14m01630.aspx.

About Rob Michaels

Rob Michaels is the founder of PEGym.com and the author of the bestselling book, Penis Exercises: A Healthy Book for Enlargement, Enhancement, Hardness, & Health.

Rob Michaels has been featured in numerous media platforms, including Men’s HealthGQ Magazine, and Salon.com, among others. As a male enhancement expert, he has spent more than a decade researching different male enhancement techniques and reviewing products that men can use safely. He continually strives to develop effective programs that will help men gain confidence and a healthy sexuality by achieving their male enhancement goals.

No comment yet, add your voice below!

Add a Comment