It’s estimated that as many as 10 to 30 percent of men will experience some degree of premature ejaculation at some point in their lives — this often embarrassing and troubling sexual problem can affect men of any age.

“Premature ejaculation is exceedingly common, more common than we think,” says Andrew C. Kramer, MD, assistant professor of surgery and an urologist at the University of Maryland Medical Center in Baltimore. “Premature ejaculation can cause distress and emotional and psychological issues as well as self-esteem problems.”

As hard as it might be to talk about it with your partner and even your doctor, addressing this sexual dysfunction will help you overcome it.

What Is Premature Ejaculation?

In the simplest terms, premature ejaculation occurs when a man does not have control over ejaculation, and he and his partner are not sexually satisfied, says Dr. Kramer. Premature ejaculation can happen in as little as 30 seconds to a minute and may occur even before penetration. Contrary to the unrealistic depictions men may see featured in pornographic films, the average time it takes before a man ejaculates during intercourse is about four to five minutes, says Kramer.

Premature ejaculation can also co-exist with erectile dysfunction (ED) and may sometimes need to be distinguished from that sexual problem. “It can happen to men of all ages, but in younger men it’s usually premature ejaculation,” says Kramer. “In older men in their sixties and seventies, there is usually some degree of ED. Sometimes the [penis] just ejaculates when it’s flaccid.”

Pinpointing the Causes of Premature Ejaculation

There are many theories about the cause of premature ejaculation, but the exact cause is unknown. Premature ejaculation can be rooted in physical, psychological, or emotional issues. “A lot of it is psychological,” says Kramer. Doctors, he adds, may try to explore both physical and psychological/emotional causes in patients with premature ejaculation. “We may ask, ‘Are you comfortable with your partner? Are you very anxious around them?’”

Anxiety in general, as well as other emotional and psychological factors such as stress or depression, can also contribute to premature ejaculation.

Treatment Options for Premature Ejaculation

Doctors often try counseling to treat premature ejaculation. That may include psychotherapy as well learning ways to communicate with a partner about sexual dysfunction.

Another effective method of treating premature ejaculation is to have patients work with their partner or through masturbation to train the body — just as you might for a marathon — to hold off ejaculation, says Kramer. “Get to the point when you are going to ejaculate and then stop and think about sports or something else to cool down,” says Kramer. “Train your body to master that response when you are with your partner.”

Other treatment options for premature ejaculation include well-known medications used to treat depression such as Paxil (Paroxetine), Zoloft (Sertraline), and Prozac (Fluoxetine), says Kramer. Another pharmacological option might be using numbing creams such as lidocaine and Emla directly on the penis.

These therapies may be used together in different combinations to treat premature ejaculation, help patients achieve greater satisfaction in their sex life, and improve their overall sense of self-esteem.