There is a lot for doctors to learn about what causes premature ejaculation. However, many theories range from psychological to biological. For example, some suspect that PE may have something to do with serotonin in the brain. Serotonin is a neurotransmitter or a brain chemical that has a lot to do with feelings of pleasure. Therefore, if there is an over or undersupply of serotonin, it could be a causal factor in PE.

On the other hand, it’s thought that, for some men, premature ejaculation may have been somehow learned or conditioned into becoming a problem. For example, the theory goes that if a boy was masturbating and was doing it very fast so as not to get caught, his quickness might have caused PE. However, there is no evidence to support that theory or that it is a learned behavior. 

Another possibility is that depression or anxiety may be a causal factor, but little evidence supports that theory.

Whatever the causes, at least one out of five men experience this sexual dysfunction. It can happen to anyone at any age in life. But, contrary to popular belief, older men can experience this problem as much as younger men.

In terms of treatment, there are several approaches. Because there is the possibility that the brain’s neurotransmitters may cause PE, medications such as SSRIs can be helpful. These are among the class of drugs used to treat depression. However, one of the side effects of the SSRIs is that it is more difficult for the patient to orgasm. This negative side effect may help those with PE by delaying ejaculation.

It’s also important to know that medication treatment is helpful with behavioral therapy, commonly known as sex therapy. There are licensed sex therapists who provide this type of therapy. This therapy teaches several techniques that help the couple delay the male’s ejaculation. Therefore, sex therapy includes couples rather than men alone. For example, lovers learn one method for the female to squeeze the penis when her partner is about to ejaculate, forcing a delay of the orgasm thereby, repeated several times until penile sensitivity lessens, giving the male greater control to delay the process.

There are also self-help techniques that a couple can use. For example, the male can masturbate two to three hours before having sex, reducing penile sensitivity and, therefore, delayed ejaculation during intercourse.

In coping with this problem, couples must have patience with one another. Most certainly, PE arouses much anxiety and tension for couples struggling with this problem.