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The Blog Premature Ejaculation: What Causes It and How It’s Treated

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In brief

  • Premature ejaculation is a common and treatable men’s health concern
  • Causes may be physical, psychological or both
  • Effective management involves behavioural, medical and supportive strategies
  • Always seek professional medical assessment before starting any treatment

Premature ejaculation (PE) is a common medical concern that can affect wellbeing and relationships. Non-surgical premature ejaculation treatments focus on identifying underlying causes and providing individualised solutions.

Treatment options for PE therapy should always be discussed privately with a qualified doctor to ensure safety, suitability and realistic expectations.

Penile anatomy showing flaccid and erectile states

What Causes Premature Ejaculation?

Understanding the potential causes of premature ejaculation helps ensure the right combination of medical and behavioural management.

Premature ejaculation is defined by the International Society for Sexual Medicine as a male sexual dysfunction in which ejaculation always or almost always occurs prior to or within about one minute of penetration. It is a condition characterised by the inability to delay ejaculation during sexual activity all (or nearly all) of the time that causes personal distress and may lead to the avoidance of sexual intimacy. 

There are two main types of causes of premature ejaculation: 

  1.  Lifelong, present from first sexual experiences
  1. Acquired, which develops after a period of normal sexual function in which there is lack of control and associated distress

Premature ejaculation may be caused by multiple factors, so understanding which are affecting you can help guide further assessment and the right management approach.

Key physical factors influencing erectile function

Physical Factors Contributing to Premature Ejaculation

  • Hormone imbalance, particularly abnormal levels of testosterone, prolactin, or thyroid hormones
  • Low serotonin levels linked to shorter latency
  • Hypersensitivity of glans or penile nerves
  • Erectile dysfunction – fear of losing an erection can cause a man to rush to intercourse leading to premature ejaculation
  • Genetic predisposition – tendency towards rapid ejaculation
  • Certain medications or recreational drugs that can influence control

Psychological factors include

 

  • Performance anxiety
  • Relationship issues – often relating to poor communication, lack of emotional intimacy, or tension with a partner
  • Depression
  • Low self-esteem
  • Early conditioning (habits formed during adolescence, such as hasty masturbation due to fear of being caught)
  • Stress (general life stress or fatigue can impair control)
  • Guilt or cultural/religious attitudes internalised guilt about sex can contribute to tension and reduced arousal control

For many men, physical and psychological factors overlap. That is one reason a doctor-led assessment is important rather than assuming there is a single cause.

Our Approach to Erectile Dysfunction - Contour Clinics

How Premature Ejaculation Is Assessed

Most sexual performance control cases we see at Contour Clinics are multifactorial. Effective treatment often combines medical, behavioural and psychological approaches. 

“Premature ejaculation is more common than most men realise,” says Dr Gavin Scriven, men’s sexual health doctor at Contour Clinics. “It’s rarely just one cause – and often a mix of physical, psychological and behavioural factors. The key is an open, informed discussion with your doctor to find the right approach for you.”

PE therapy assessment begins with a private discussion about your symptoms, how long the issue has been present, how often it occurs, and how it is affecting you. Your doctor may also ask about:

  • Whether the concern is lifelong or acquired
  • Erectile function
  • General health and medications
  • Mental health and stress levels
  • Relationship context
  • Lifestyle factors that may be relevant

This process helps determine whether the concern appears to be primarily behavioural, psychological, medical, or a combination of these. It also helps identify when further medical review or referral may be appropriate.

Contour Clinics' approach to erectile dysfunction treatment

Treatment Options That May Be Discussed

Management depends on each individual, the likely contributing factors, and what is clinically appropriate after assessment. In many cases, management may involve a combination of strategies rather than one single solution.

Options that may be discussed include:

  • Behavioural techniques
  • Support around stress, anxiety, or relationship factors
  • Review of contributing medical issues
  • Medical management where appropriate
  • Referral for further assessment when needed

Behavioural techniques may discussed as part of premature ejaculation treatment including:

  • The stop-start technique – stopping at just before the point of inevitable ejaculation, stimulation is stopped until the urge subsides. The process is repeated several times and, over time this helps the man recognise control the arousal threshold.
  • Squeeze technique – there are multiple different techniques that one can use, including Kegel exercises, mindfulness, breathing control, and cognitive behaviour therapy

Addressing contributing factors, such as stress or hormonal imbalance, can be useful.

At Contour Clinics, we offer medical, non-surgical premature ejaculation treatment. It typically focuses on reducing penile nerve sensitivity. By putting pressure on these nerves, it can make them function less efficiently, and therefore reduce sensation that leads to early ejaculation. There are many studies that support this treatment. 

Any discussion of premature ejaculation treatment at Contour Clinics happens privately in consultation with a doctor experienced in men’s sexual health management. This allows suitability, risks, limitations and realistic expectations to be assessed properly before any plan is made. It also empowers you to make a medically informed decision based on a personalised anatomical assessment, rather than relying on marketing or online forums. 

These procedures are performed only after a comprehensive medical assessment to determine suitability. Specific treatment details cannot be advertised publicly under Therapeutic Goods Administration (TGA) regulations and are discussed privately during medical consultation.

Penile augmnentation Sydney with Dr Gav Scriven at Contour Clinics

Why Doctor-Led Assessment Matters

Concerns about ejaculation control can sometimes overlap with other medical or sexual health issues, including erectile dysfunction, medication effects, hormonal changes or broader wellbeing concerns. A doctor-led consultation helps ensure these possibilities are considered rather than overlooked.

Premature ejaculation treatment is a doctor-led procedure that requires medical expertise with sharing of clear, evidence-based information. 

As with all men’s health procedures, AHPRA and TGA guidelines require that medical assessments are carried out by qualified, insured doctors in accredited facilities.

Management of realistic expectations is quintessential so you can both be clear on your goals, concerns and what’s possible for your unique circumstances. 

Men’s sexual health decisions should always be explored with a private consultation with a qualified doctor experienced in premature ejaculation treatment who can help determine whether the treatment is appropriate for you.

Doctors performing male intimate area treatments must hold appropriate qualifications, be insured for intimate-area procedures and operate within accredited medical facilities. Patients are encouraged to confirm these details before proceeding with treatment. 

It is essential that you know your doctor is insured for this procedure to ensure that, in case of any complication, you are fully covered. Complications are rare but do occur and it’s important to know that you are safe. 

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The Role of Education and Support

Open, non-judgemental, confidential communication with medical practitioners is fundamental. Feeling informed and comfortable are crucial to creating a collaborative treatment plan leading to positive outcomes. 

Given that there is a strong psychological component to premature ejaculation, addressing some of those factors can be essential in addition to medical management. 

“Managing expectations is really important, along with tracking progress,” explains Dr Gav. At Contour Clinics, we encourage patients to keep a diary that allows us to track changes after treatments.

When to Seek Professional Help 

If you are experiencing distress related to premature ejaculation, it may be time to seek professional help, noting that the clinical definition for premature ejaculation must include:

  •  Distress
  •  Bother
  •  Frustration
  •  Negative personal consequences
  •  Avoidance of sexual intimacy

If any of these things apply to you, it’s worthwhile seeking medical advice. 

This advice is general in nature and is not a substitute for in person medical advice from a qualified medical practitioner. No guarantees are made as to the safety efficacy or results of this treatment.

Dr Gavin Scriven

About Dr Gavin Scriven

Dr Gavin Scriven, known to patients as Dr Gav, heads our Crows Nest clinic. He graduated from the University of Notre Dame Sydney in 2011 with a Bachelor of Medicine and Surgery, and has been practising cosmetic medicine for over a decade alongside his ongoing work as a GP. A Fellow of the Australasian College of Aesthetic Medicine (ACAM), Dr Gav maintains an ongoing commitment to professional development and takes an evidence-informed approach, tailored to each patient's individual circumstances and goals. He consults across a range of areas including anti-ageing consultations, laser rejuvenation consultations, and thread lifting consultations, and sees both men and women seeking to discuss lifestyle and aesthetic options that support their confidence and wellbeing. Dr Gav also works as a clinical trainer in aesthetic procedures and threads for educational institutions and industry suppliers.

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