Introduction

Photo of a couple sitting outdoors (PantherMedia / StockbrokerXtra by Monkeybusiness) There are many myths and exaggerated expectations when it comes to sexuality. That’s also true for the question of how long it takes men to reach orgasm during sex. That depends on many factors and can vary from time to time.

Measured on a stopwatch, it takes an average of 5 to 7 minutes for a man to reach orgasm and ejaculate. But the overall range is wide, from less than one minute to over half an hour.

There are also many differences in whether and how much a relatively early orgasm affects a man, his relationship and sexual satisfaction. In studies, men tend to overestimate the time it takes until ejaculation by a quarter to one half of the actual time. So it isn't a good idea to go by what others claim.

About 4% of men have almost no control over when they ejaculate. They then always (or nearly always) "come" very early – that is, before or directly after penetration. If these early orgasms become distressful, the problem is medically diagnosed as premature ejaculation. Various treatments are possible, sometimes including medication. Sex therapy is sometimes an option as well.

Causes

There is hardly any research on the causes of premature ejaculation. So far, there are only hunches: Some experts believe it’s due to biological factors, such as an oversensitive penis or changes in how the hormones and nerves interact.

Others think the cause is to be found in emotional factors like relationship problems or fear of failure. Biological and psychological factors may both be responsible and could influence each other.

Some men have had trouble with premature ejaculation since they started having sex. Others only develop it later on in life. This can be referred to as “acquired” premature ejaculation.

Prevalence

The feeling of reaching orgasm too early is very subjective. Also, this feeling can sometimes be intensified by public campaigns on the topic of premature ejaculation. These are often financed by pharmaceutical companies, and claim to be “breaking down taboos.”

But it’s typical of such campaigns to exaggerate how common the problem is. It’s often claimed that 20 to 30% of all men have premature ejaculation. This is based solely on how long it takes to ejaculate, though. When scientifically recognized criteria for diagnosis are used, estimates turns out to be 4% at most. That is because they take into account how often premature ejaculation occurs and whether the man sees it as a problem.

Diagnosis

If you think you may have premature ejaculation, you can see a urologist or a family doctor. They will ask you about how long it takes on average to ejaculate and also about how often it happens too early, how much it bothers you and whether ejaculation can be delayed. Further testing only makes sense if the doctor thinks there's a medical problem.

It is diagnosed as premature ejaculation if

  • the ejaculation almost always occurs unintentionally within one minute of penetration,
  • this has been occurring for more than six months,
  • the premature ejaculations are very distressing, and
  • no other medical problem is identified as a cause.

Medically speaking, it is not considered to be premature ejaculation if

  • it only happens occasionally.
  • you haven't had sex for quite a long time when it happens. Then it's normal to become aroused more quickly at first and reach orgasm faster.
  • the time that it takes to achieve ejaculation is in the normal range, but it feels like it’s too short.

Other things that could affect the time until ejaculation will also be investigated during the doctor's appointment. A prostate inflammation, for instance, is a possible risk factor. If the prostate is inflamed, the cause should be treated first. Signs of that include frequent and painful urination.

Premature ejaculation is sometimes related to erection problems – for instance, if a man is hurrying up because he is worrying about losing an erection. Then the erection problem is the main issue, not the premature ejaculation.

Treatment

Decisions about whether or how to treat premature ejaculation are a very personal matter. There are various treatment options:

  • Specific techniques aim to help make it easier to control ejaculation by intentionally delaying it. One way of doing this is to repeatedly stimulate the penis until right before orgasm, and then to stop.
  • Medications can somewhat increase the time it takes to have an ejaculation. They include medicine that is swallowed and numbing medications that are applied to the tip of the penis. Both may have side effects.
  • Sex therapy treatments aim to give men and couples more confidence and to overcome fears of sexual “inadequacy.” Another goal is to focus less on ejaculation and to experience sexuality in a more differentiated way. Relationship problems may also be discussed if they play a role.

Selective serotonin re-uptake inhibitors (SSRIs) are typically used as medication. The only SSRI that is currently approved in Europe (dapoxetine) increases the time to ejaculation by only 1 to 1.5 minutes, though. Other SSRIs are much less expensive and more effective. Doctors can prescribe them as “off-label” treatment.

In Germany, the costs of medication for treating premature ejaculation aren't covered by statutory health insurers, regardless of whether they have been approved or not. This is because they are legally considered to be “lifestyle” drugs, which insurers don't have to pay for.

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Everyday life

Sexuality can greatly affect your self-esteem. And when it comes to sex, there are quite a few clichés and a lot of big talk. But there’s no need to feel intimidated: People who have premature ejaculation are no less “manly” than anyone else.

It becomes a problem when it starts to distress you and affect your sex life. Not being able to control the time it takes to reach orgasm is usually very frustrating.

Some men worry about failing to “perform” in bed and not being able to satisfy their partner. But sex and the time it takes to ejaculate don’t have to be the focus of your love life. There are many other ways to experience sexuality, have orgasms and be intimate. Many people find that their overall satisfaction with their love life and relationship is more important than how long the sex lasts.

Shifting the focus away from sexual intercourse can help. Kissing, petting and showing your affection and passion in other ways can also be satisfying and help to take the focus off the time it takes until ejaculation.

Some men try to ignore the issue rather than discuss it openly, but that tends to make the problems worse. Talking honestly about your feelings and anxieties is probably a better approach in order to solve the problem together.

Further information

When people are ill or need medical advice, they usually go to see their family doctor first. Read about how to find the right doctor, how to prepare for the appointment and what to remember.