Most cases of premature ejaculation (PE) have no single clear medical cause. Some, especially when PE starts later in life, are linked to a medical condition that a doctor can check for. This page is general information. It is not a medical assessment, and it cannot tell you what is causing your own symptoms.
01
Why acquired PE needs a medical check
Lifelong PE has been present since your first sexual experiences. Acquired PE develops after a period of normal ejaculation. The European Association of Urology (EAU) guidelines advise looking for and treating an underlying cause first in acquired PE. For that reason, a sudden change is worth discussing with a doctor and not only with a counsellor or practitioner. See the types of PE.
02
Prostate and urinary conditions
Inflammation of the prostate (prostatitis) and chronic pelvic pain have been linked to early ejaculation. The guidelines report that between about 26% and 77% of men with these conditions have early ejaculation, a wide range that reflects differences between studies. Burning when passing urine, pelvic or groin pain, or a frequent need to urinate are reasons to see a doctor.
03
Thyroid and hormonal factors
An overactive thyroid has been linked to acquired PE in some studies, but not to lifelong PE. Its role is not fully settled. If a doctor suspects a thyroid problem, a blood test can check it. We do not suggest that hormones are a common cause, and you should not take hormone treatment for PE without a doctor’s advice.
04
Medicines and substances
Some prescription medicines, alcohol and recreational drugs can affect sexual function, including ejaculation. Stopping or withdrawing from some substances can also play a part. Do not change or stop a prescribed medicine on your own. Tell your doctor about everything you take, including over-the-counter and herbal products, so that they can consider whether any of it matters.
05
Erectile dysfunction as a driver
Erectile dysfunction (ED) is associated with acquired PE and is considered unlikely to be associated with lifelong PE. Some men ejaculate quickly because they are worried that they will lose their erection, and the worry can drive a cycle. Because the two often go together, both should be assessed. Read more about PE and erectile dysfunction.
06
What tests are used
Many men need no tests. A doctor will usually start with a conversation about your history, the pattern of PE, your general health and your medicines, and may do a physical examination. Depending on what you describe, they may arrange urine or blood tests, for example to check thyroid function or look for infection, but this is up to the doctor. A questionnaire may be used to describe the problem. Clinicians do not usually need a stopwatch.
07
Who to see in South Africa
A general practitioner (GP) is a sensible first step. They can assess you, check for medical causes and refer you to a urologist if needed. Urologists are specialists in the male reproductive and urinary systems. Medicines for PE and the investigation of medical causes are matters for a doctor, not for a naturopath. Our practitioner, a naturopath, can offer education and non-medical support, and will refer you on when a medical check is needed. See when to see a doctor and the overview of causes.