Premature Ejaculation (PE) affects 20%-30% of men globally, yet most suffer in silence due to stigma. This medically-reviewed guide reveals science-backed solutions targeting root causes - not myths.

I. 6 Clinical Causes of PE

1. Psychological Factors (40% Cases)

   • Performance anxiety, relationship conflicts, or childhood trauma
   • Vicious cycle: First failure → Anxiety → Repeated PE

2. Penile Hypersensitivity

   • Oversensitive glans/nerve endings accelerate sensory signals
   • Diagnostic test: Biothesiometer readings >3.0mV

3. Hormonal Imbalances

   • Low serotonin (5-HT), hypothyroidism, testosterone deficiency
   • Lab confirmation required

4. Chronic Prostatitis Link
   30% PE patients show prostate inflammation (Int. J Urol 2018)

   • Symptoms: Pelvic pain + Urinary urgency

5. Neural Control Dysfunction

   • Abnormally low ejaculation threshold in CNS

6. Behavioral Conditioning

   • "Quick-finish" masturbation patterns training early climax

II. Targeted Treatment Protocols

▎ Psychological PE

• Stop-Start Technique: Stimulate → Pause at 7/10 arousal → Repeat
• Squeeze Method: Compress glans frenulum to reduce tumescence
• CBT Sessions: 12-week program with certified sex therapist

▎ Penile Sensitivity

• Topical Anesthetics:
  • 5% Lidocaine spray (Apply 10min pre-intercourse)
  • Clinical efficacy: 3-8x latency increase (J Sex Med 2020)
• Desensitizing Condoms: Benzocaine-infused variants (e.g., Durex Performax)

▎ Hormonal Correction

• First-line Drug: Dapoxetine 30-60mg (On-demand SSRI)
  • Onset: 1-2 hours | Duration: 3-4 hours
• Testosterone Therapy: Only if serum T <300 ng/dL

▎ Prostatitis Management

• Antibiotics: 4-week fluoroquinolone course (if bacterial)
• Physiotherapy:
  • Daily sitz baths (40°C, 15min)
  • Prostate massage (2x/week)

▎ Neural Retraining

• Tramadol: 25mg PRN (Off-label CNS modulator)
• Biofeedback Devices: Perineum sensors + app-guided training

▎ Behavioral Reset

• 15min minimum foreplay before penetration
• Regular intercourse (2-3x/week ideal frequency)

IV. Lifestyle Optimization

• ✗ Tobacco/Alcohol: Vasoconstrictors worsen PE
• ✓ Kegels Protocol:
  1. Locate pelvic muscles (stop urination midstream)
  2. Contract 5 sec → Relax 5 sec 3. 3 sets of 15 reps daily
• Partner-inclusive therapy: Shared exercises reduce pressure

⚠️ Critical Reminder

Consult urologist if:

• PE persists >3 months
• Accompanied by pain/erection issues
• Diagnostic tools:
  • IIEF-5 questionnaire
  • Genital sensory testing
  • Hormonal panel

90% achieve significant improvement with non-surgical protocols!