There is no universally accepted definition of premature ejaculation, yet its known to be one of the commonest of all sexual problems. Good treatments are available, but a careful history is required for the correct diagnosis. In many men there is a significant psycho-sexual component, and treatment may involve behavioural sex therapy, as well as the use of drugs, either topical applications or oral medication. Problems with ejaculating occur quite commonly and these include premature (early), delayed or absent ejaculation. Other problems include unusual discharge, pain upon climax, or a dry ejaculation.

Most men experience some form of erection or ejaculation problem during their lifetime. For example, around 3 out of 10 men have had a problem with premature ejaculation. Such problems often cause anxiety and self-doubt which can make the problem worse. Fears and worries can also lead to abstinence or a decrease in frequency of intercourse or masturbation; again aggravating the problem.

Many ejaculation problems can be resolved with simple self-help techniques, but you should see a doctor if you feel it is severe or ongoing. It is important to remember that these problems happen to a lot of men occasionally.

There are no precise rules about how soon ejaculation should take place after intercourse starts or masturbation begins. Instead, the general principle is that ejaculation is premature if it happens more swiftly than the individual or the couple would prefer. It may occur a few seconds into intercourse, or even prior to penetration, and it may not provide satisfaction for the man, or for his partner.

In most cases a man initially becomes aware that there is a problem through observation of his own behaviour, or in discussion with his partner or others.

Depending on the nature of your problem, the doctor may be ask questions about:

• family medical history
• conditions such as diabetes, heart disease, and high blood pressure
• your sexual and emotional health
• injury or surgery to the pelvic area
• check what medications you are taking
• aspects of your lifestyle such as alcohol intake.

A rectal examination may be done to check for an enlarged prostate gland, check the nerves of the penis for any damage and perhaps blood and urine samples taken to test for hormone and cholesterol levels. He may also carry out a visual examination of the pelvic area to check for injury.

It may be a mild case of premature ejaculation, for instance if you can last five minutes but would like to last ten, and this is may not be classed as a problem. In more severe problems its best to seek consultation with a doctor for treatment. There are several drugs available, for example antidepressant drugs, or topical applications, but these may have undesirable side-effects. An awareness of the effects of conditions such as diabetes will enable the man to control his performance more, and prevent him from worrying that he is at fault. This may relax him and enable him to enjoy the experience and thus overcome the difficulties naturally.

Varying the duration or type of foreplay, or using different sexual positions can also be helpful. Other techniques to delay ejaculation can be used while masturbating or sex with a partner. There are many new anti-PE devices and techniques available but these are best used as part of a regular programme and you should see a doctor for advice.