Premature ejaculation.

What is premature ejaculation?

Premature ejaculation is when ejaculation happens sooner than a man or his partner would like — often within about a minute of penetration, or before it is wanted — together with a sense of little control and, importantly, some distress or frustration about it. The two features that make it a clinical concern are that it is persistent and that it bothers you. Occasional early ejaculation is extremely common and, on its own, is not a medical problem.

PE is not a sign of weakness, poor character or inadequacy. It is a recognised medical condition with identifiable contributing factors and a range of effective treatments. The reason most men never mention it has far more to do with embarrassment than with any real difficulty in treating it.

How common is it?

PE is the most frequently reported male sexual complaint and affects men of all ages. What the population data shows:

• Roughly 20–30% of men report premature ejaculation at some stage
• It occurs across every age group — it is not only a problem of younger or older men
• It is strongly linked to distress, avoidance of intimacy and relationship strain
• Most men never raise it with a clinician, often for years

You are not unusual, and you are not alone. The clinician who sees you has had this conversation many times. Once it starts, it is far easier than most men expect.

Types & causes

Understanding which type of PE you have — and what is contributing to it — is the first step to treating it effectively.

Lifelong (primary) PE

Present from a man’s first sexual experiences and consistent over time. This type is thought to be linked to how the brain’s serotonin signalling and ejaculatory reflex are set, and there may be a genetic component.

Acquired (secondary) PE

Develops later in a man who previously had normal control. Acquired PE is more likely to have an identifiable and treatable trigger — which is why a proper assessment matters.

Psychological & relationship factors

Performance anxiety, stress, depression, early sexual experiences where speed felt necessary, unrealistic expectations, and relationship or communication difficulties are all common contributors. Anxiety is both a cause and a consequence, which is how a short-term issue can become a self-reinforcing cycle.

Physical & medical factors

Contributors can include an overactive thyroid, inflammation of the prostate or lower urinary tract, heightened sensitivity, and hormonal factors. Where acquired PE appears alongside other symptoms, we check for these, because treating the underlying cause often improves the PE.

Coexisting erectile dysfunction

Some men develop PE because they are rushing to ejaculate before losing an erection. Where erectile dysfunction (ED) is also present, addressing the ED first frequently improves ejaculatory control too.

PE and erectile dysfunction — why we check both

For this reason, our assessment looks at the whole picture: ejaculatory control, erectile function, general health, medication, mood and relationship factors. For many men, an honest first consultation is the point at which the problem finally starts to be understood and addressed.

How we assess at the clinic

1. The conversation

An unhurried, discreet conversation about your symptoms and what matters to you. We’ll cover when it started (lifelong or more recent), how much control you feel you have, whether it happens in every situation, how much distress it causes, the effect on your relationship, your general health and any medication. This is the part most men dread and almost all men find easier than expected.

2. Examination if needed

A focused physical examination is not always necessary but may be appropriate — for example to check general health or where there are urinary or prostate symptoms. We follow GMC guidance on examinations and a chaperone is always offered (see our Chaperone Policy).

3. Investigations where indicated

Tests are not needed for every man. Where your history suggests it, we may arrange:

• Thyroid function (an overactive thyroid can contribute)
• Tests for prostate or urinary symptoms if present
• Blood glucose / HbA1c and morning testosterone where erectile dysfunction also features
• General baseline bloods where appropriate

Where tests are recommended, we explain why and confirm the cost before they are done. See our Blood Tests service.

4. Plan

A clear plan covering the options suited to you, what to try first, and follow-up. Many men leave the first consultation with reassurance, a practical action plan, and the sense that the problem is finally being addressed.

Treatment options

Treatment is individualised based on the type of PE, what is contributing to it, your general health and your preferences. The right combination is agreed with you in consultation, after assessment.

Behavioural techniques

Structured techniques — such as the “stop–start” and “squeeze” methods, pelvic-floor training and sensate-focus exercises — help many men build ejaculatory control over time, especially when a partner is involved. These are covered in more detail below.

Topical treatments

Treatments applied to the skin can reduce over-sensitivity and help delay ejaculation. Whether this suits you, and how to use it correctly, is discussed and guided by the clinician.

Oral medication

Certain prescription medicines can help delay ejaculation for some men. These are available only through a doctor and are discussed in detail in consultation — including how they work, who they suit, who should avoid them, and what to expect. In line with UK rules we don’t name specific medicines on this website; that conversation belongs in clinic.

Treating contributing factors

Where a treatable factor is found — coexisting erectile dysfunction, an overactive thyroid, prostate or urinary inflammation, or high stress — addressing it often improves ejaculatory control on its own.

Psychosexual support

Where performance anxiety, low mood, relationship difficulties or past experiences play a part, talking therapy — alone or alongside other treatment — is often the most effective long-term approach. We can refer to a psychologist or psychosexual therapist within Tower Bridge Hospital London.

Combining approaches

For many men, a combination — for example a behavioural technique plus a topical or oral option, with support for anxiety — works better than any single measure alone.

Behavioural techniques

Simple, learnable techniques help a lot of men and have no side effects. They take practice and patience, and work best when approached without pressure:

• Stop–start technique — pausing stimulation as you approach the point of ejaculation, then resuming, to build awareness and control.
• Squeeze technique — a gentle squeeze at the point of near-ejaculation to reduce the urge, repeated over time.
• Pelvic-floor exercises — strengthening these muscles can improve control; a clinician or physiotherapist can show you how.
• Sensate focus — structured, low-pressure exercises with a partner that reduce performance anxiety and rebuild confidence.
• Communication with your partner — often the single most helpful change; it takes the pressure out of the situation.

Psychological factors

Even where PE has a physical component, anxiety usually builds on top. Worry after a few early experiences becomes a self-fulfilling cycle. Common psychological contributors:

• Performance anxiety and fear of “failing” again
• Depression or generalised anxiety
• Relationship difficulties or communication problems
• Early experiences where speed felt necessary
• Unrealistic expectations, sometimes shaped by pornography
• Stress from work or life outside the bedroom

These are all addressable. Talking to a clinician or therapist who has helped many men with exactly this is the start.

When to see us

Consider booking if:

• Ejaculation happens sooner than you want more often than not, and it bothers you
• You feel you have little control over when you ejaculate
• It is affecting your confidence, your relationship or your mood
• Your control has changed recently (this is worth assessing)
• You also have difficulty getting or keeping an erection
• You are avoiding intimacy because of it

The earlier you come, the simpler the conversation and, usually, the better the outcome.

Frequently asked questions

Is this confidential?

Completely. Medical confidentiality applies. You can choose whether we write to your NHS GP — many men prefer we don’t initially, and that’s fine. Records are held in line with UK GDPR. See our Privacy Policy.

Is premature ejaculation treatable?

Yes — PE is one of the most treatable male sexual concerns. Depending on the cause, options include behavioural techniques, topical treatments, prescription medicines discussed in consultation, treating any contributing condition, and psychosexual support. Many men see a meaningful improvement.

How long is the appointment?

30 minutes for the initial consultation — long enough to have the full conversation without rushing.

Will I be examined?

Not always. If an examination is suggested, you’ll be told what’s involved, asked for consent, and offered a chaperone. You can decline any examination.

Can I get treatment on the first appointment?

Often yes. For many men we can discuss and start treatment where clinically appropriate at the first visit. For others, we may wait for a test result before deciding the best approach.

Does premature ejaculation happen with erectile dysfunction?

Frequently, yes — the two often coexist and one can drive the other. Part of the assessment is working out which came first, because it changes the right treatment. See our Erectile Dysfunction page.

How much does it cost?

Current consultation prices are on our Fees page. Any blood tests are quoted before they’re done, and treatment costs are discussed in consultation.

What if my partner doesn’t know I’m here?

That’s your decision. Many men come for an initial consultation alone before deciding what to share; others bring their partner from the start. Both work well.