Causes

Experts are still trying to determine exactly what causes premature ejaculation. While it was once thought to be only psychological, we now know premature ejaculation is more complicated and involves a complex interaction of both psychological and biological factors.

Psychological Causes
Some doctors believe that early sexual experiences may establish a pattern that can be difficult to change later in life such as:

• Situations in which you may have hurried to reach climax in order to avoid being discovered
• Guilty feelings that increase your tendency to rush through sexual encounters
Other factors that can play a role in causing premature ejaculation include:
• Erectile dysfunction. Men who are anxious about obtaining or maintaining their erection during sexual intercourse may form a pattern of rushing to ejaculate which can be difficult to change.
• Anxiety. Many men with premature ejaculation also have problems with anxiety — either specifically about sexual performance, or caused by other issues.

Biological Causes
Experts believe a number of biological factors may contribute to premature ejaculation, including:
• Abnormal hormone levels
• Abnormal levels of brain chemicals called neurotransmitters
• Abnormal reflex activity of the ejaculatory system
• Certain thyroid problems
• Inflammation and infection of the prostate or urethra
• Inherited traits

Rarely, premature ejaculation is caused by:
• Nervous system damage resulting from surgery or trauma
• Withdrawal from narcotics or a drug called trifluoperazine (Stelazine), used to treat anxiety and other mental health problems

Although both biological and psychological factors likely play a role in most cases of premature ejaculation, experts think a primarily biological cause is more likely if it has been a lifelong problem (primary premature ejaculation).