If it happens occasionally, that is not a worry. But if you regularly come earlier than you or your partner would like, then it is an issue to think about.

It is important to remember that ejaculation problems are nothing to be embarrassed or shy about. Talking to your partner or a health professional about your concerns can often help to reassure you. Your doctor will also be able to provide more advice.

This is important. Most men with premature ejaculation can be helped, which can help with developing and maintaining intimate relationships.

Causes of premature ejaculation

There is rarely a single cause of premature ejaculation. It usually occurs due to a combination of psychological factors such as anxiety, stress and relationships problems. Alcohol and recreational drugs can make premature ejaculation worse.

Some men may have physical problems tied in with premature ejaculation, such as impotence or high blood pressure. Some medicines can make it worse too.

Premature ejaculation treatments

There are a number of ways you may wish to try before seeking medical help. These include:

• masturbating an hour or two before you have sex
• using a thick condom to help decrease sensation
• taking a deep breath in order to briefly shut down the ejaculatory reflex (an automatic reflex of the body during which ejaculation occurs)
• having sex with your partner on top, as you may find this position less arousing
• taking a break and thinking of something other than sex.

If you seek medical help, there are many different options for treatment.

Couples therapy

If you are in a long-term relationship, you may benefit from couples therapy. There are two stages in couples therapy. First, couples are encouraged to explore any issues that may be affecting their relationship, and given advice on how to resolve them. Second, they are shown techniques that can help the man 'unlearn' the habit of premature ejaculation. The two most popular techniques are the 'squeeze technique' and the 'stop-go technique'.

In the ‘squeeze technique’, the woman begins masturbating the man. When he feels that he is almost at the point of ejaculation, he signals to the woman. She stops masturbating him, and squeezes the head of his penis for around 10-20 seconds. She then removes her hands, and waits for another 30 seconds, before resuming masturbating the man. This is done several times before ejaculation is allowed to happen.

The ‘stop-go’ technique is similar, except that the woman does not squeeze the penis. Once the man feels more confident about delaying his ejaculation, the couple can then begin to have sexual intercourse, stopping and starting as required.

Although the techniques sound simple, they require a lot of practice.

Medicines

Another treatment is a local anaesthetic spray that can be bought over-the-counter at your pharmacy without prescription. You spray it on the head of your penis 10 minutes before having sex. Many men have found it particularly useful when used in combination with the squeeze or stop-go techniques.

Also, antidepressants and other medicines have been used successfully to treat premature ejaculation.

Counselling

There are specialists to deal with ejaculation and other sexual problems. You may benefit from seeing one of these professionals.