Premature Ejaculation: How Common It Is, What Actually Helps, and Who to See

It is one of the most common reasons men see a urologist, and one of the least talked about. Most men who have it never mention it to a doctor. Some wait years. Many spend money on "timing" products from the internet or a roadside clinic before they ever see one.

The short version: premature ejaculation is common, it is a recognised medical condition, and there are treatments with real evidence behind them. It is not a sign that something is wrong with you as a man, and it is not caused by anything you did when you were younger. This page explains what doctors mean by the term, what tends to cause it, what helps, what does not, and what a consultation here involves and costs.

What counts as premature ejaculation

Most men ejaculate sooner than they would like at some point, especially with a new partner, after a long gap, or when they are anxious. That on its own is not a medical problem.

Doctors use the term when three things are true together:

- It happens quickly, nearly every time. In medical guidelines, that usually means within about one to two minutes of penetration, or before it.

- You cannot delay it, or can hardly delay it, when you try.

- It bothers you or your partner. Distress, frustration, or avoiding intimacy because of it.

For context, a study that timed this in 500 couples across five countries found the middle figure was about five and a half minutes, with a very wide normal range from under one minute to over forty. Films and the internet give a much longer impression. Many men who worry about this are well within the normal range.

There are two main patterns, and they are handled differently:

- Lifelong. It has been this way since your first sexual experiences, with every partner.

- Acquired. Things used to be fine, and it changed. This is the pattern most likely to have a cause a doctor can find and treat, such as a problem with erections, a prostate infection, an overactive thyroid, or a period of stress or relationship difficulty.

What it sounds like when men describe it

- "It is over before it has really started"

- "I cannot control it, however hard I try"

- "It has been like this since I got married" or "It started a few months ago"

- "I have started avoiding intimacy because of it"

- "My partner says it does not matter, but it matters to me"

- "I have tried the pills and sprays from the chemist and nothing works"

Go to a hospital, not a clinic, if

None of these is common, but they need help the same day:

- An erection that lasts more than four hours, painful or not. This can happen after unlabelled "power" or "timing" pills, which sometimes contain prescription medicines nobody declared. Go to a hospital emergency department straight away.

- Sudden, severe pain in a testicle, with or without swelling

- Fever and shivering with pain between the legs, low in the back, or when passing urine

- Chest pain, breathlessness or fainting during or after sex

Call 112 or go to the nearest hospital emergency department.

See a doctor soon, rather than waiting, if

- It has changed recently, after years of being fine

- You also have trouble getting or keeping an erection. This is checked first, because treating it can help early ejaculation as well

- Ejaculation is painful

- There is blood in your semen more than once, or once if you are over 40

- You have burning, a weak stream, or a feeling of not emptying when you pass urine

- It is affecting your mood, your sleep, or your relationship

## What actually helps

Medical guidelines from the American Urological Association, the European Association of Urology and the International Society for Sexual Medicine broadly agree. A doctor will usually talk you through some combination of these.

Techniques you practise. The "stop-start" and "squeeze" methods teach you to recognise the point just before ejaculation and to pause. They take practice, ideally with a partner, and they work better alongside other treatment rather than on their own.

Pelvic floor exercises. Training the muscles you use to stop the flow of urine. In one small study of men with lifelong premature ejaculation, most had improved after 12 weeks of daily exercises. The evidence is still thin, but the exercises are free and safe.

A numbing cream or spray, used before sex. A doctor will explain how much to use and when, and why a condom is usually advised with it, so that your partner is not numbed as well.

Medicine by mouth. Some medicines from the group also used for anxiety and depression delay ejaculation. Depending on the medicine, it is taken daily or a few hours beforehand. These are prescription medicines with side effects, and they do not suit everyone. A doctor needs to check what else you take before prescribing one.

Talking it through. Anxiety about performance can keep the problem going, even after the original cause has passed. Counselling, on your own or with your partner, helps many men, and guidelines recommend it alongside other treatment.

Combining approaches. Guidelines say a combination of a technique and a medicine tends to work better than either alone.

What does not help, or is not recommended.

- Circumcision does not change how long it takes to ejaculate. Guidelines advise against surgery for this.

- "Herbal" or "natural" timing products have no good evidence behind them. Some sold without a prescription have been found to contain hidden prescription medicines, which can drop your blood pressure dangerously if you also take heart medicines.

- Numbing products bought without advice, used heavily, can numb so much that sex is no longer enjoyable, and can affect your partner.

- Drinking alcohol before sex to "slow things down" is not a treatment and often makes erections worse.

One more thing worth saying plainly, because many men are told otherwise: losing semen, through masturbation or at night in your sleep, does not weaken the body. It is not the cause of this problem.

What a consultation involves

The conversation is the most important part. Dr. Ali will ask how long this has been going on, whether it has always been this way or has changed, whether erections are also a problem, about any medicines you take, and about stress and your relationship. There is no need to have the words ready; doctors hear this every week, and the questions are routine.

For most men, no tests are needed. If the pattern is lifelong and you are otherwise well, guidelines advise against testing for the sake of it. If it has changed recently, or if there are other symptoms, a urine test or a blood test may be worth doing to look for a cause. We will tell you why a test is needed and what it costs before anything is done.

A short examination may be suggested to check for a prostate or other urological problem. A chaperone can be present, and you can ask for one.

The consultation is private. You can come on your own, or with your partner if you would both find that useful. Many men find it helps for a partner to hear the same explanation.

## What we will not do

- We will not sell you a "timing" product, a supplement or a course of tablets without a consultation.

- We will not promise you a number of minutes. Treatment helps many men, and how much it helps varies from person to person.

- We will not prescribe a medicine without explaining its side effects, and if a technique is worth trying first, we will say so.

- We will not recommend circumcision or any operation for this.

- We will not order a long list of tests for a problem that can usually be understood from a conversation.

Who you will see, and what it costs

Dr. Irsad Ali is our urologist: MBBS, MS (General Surgery), MCh (Urology), with 7+ years' experience. He sees patients Monday to Saturday, 5:00 PM to 7:00 PM. Please call and we will give you a time.

If anxiety or low mood is a large part of the picture, our psychiatrist Dr. Abhishek Kalra, MBBS, MD (Psychiatry), also sees patients Monday to Saturday, 5:00 PM to 7:00 PM.

| | Fee |

|---|---|

| Urology consultation, Dr. Irsad Ali | ₹1,000 |

| Psychiatry consultation, Dr. Abhishek Kalra | ₹1,200 |

| Urine test (routine and microscopy), if needed | ₹110 |

Fees are for booking directly with us; fees for appointments booked through third-party platforms are set on those platforms and may differ.

Frequently asked questions

Is premature ejaculation common?

Yes. In surveys, between a fifth and nearly a third of men say they ejaculate sooner than they would like. Far fewer meet the medical definition, and for those who do, there are treatments with good evidence behind them.

How long is normal?

There is no single right number. In a study of 500 couples in five countries, the middle figure was about five and a half minutes, with a very wide normal range. What matters medically is whether it happens almost every time, whether you can delay it at all, and whether it is causing you or your partner distress.

Will it go away on its own?

Sometimes, especially if it started during a stressful time or with a new partner. If it has lasted for months, or has been there from the start, it is worth seeing a doctor rather than waiting.

Are the "timing" pills and sprays sold on the internet safe?

Not reliably. Some products sold without a prescription have been found to contain hidden prescription medicines, and nobody can tell you the dose. A doctor can prescribe something with a known content and dose, and check it is safe with anything else you take.

Should my partner come with me?

It is your choice. You are welcome to come alone. Some couples find it helpful to come together, especially if they want to try techniques or counselling as a pair.

Can I come without an appointment?

Please call first and we will give you a time. Dr. Ali sees patients between 5:00 PM and 7:00 PM, Monday to Saturday.

All Is Well Medical Centre

Shop no. 1, Central Market, Sector B Rd, opposite Vasant Square Mall, Masoodpur, Sector B, Vasant Kunj, New Delhi, Delhi 110070

Clinic hours: Monday to Saturday, 8:00 AM – 9:00 PM. Closed Sunday.

Phone: 8800844793 · WhatsApp: https://wa.me/918800844793 · Book an appointment: https://alliswellmedicalcentre.com/doctors-appointments

Rated 4.9★ by patients on Google.

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Medically reviewed by Dr. Irsad Ali, MBBS, MS (General Surgery), MCh (Urology) — urologist, All Is Well Medical Centre.

This article is general information and is not a substitute for a consultation with a doctor. If you are worried about your symptoms, please see a doctor. In an emergency, call 112 or go to the nearest hospital.

Contact

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