Premature ejaculation (PE) is one of the most common sexual concerns for men, but, understandably, blokes are pretty crap at talking about it. It can feel embarrassing, frustrating and sometimes a bit isolating. The good news is that it is manageable, treatable and often improves with a mix of simple, practical strategies rather than relying on a single quick fix.
Why so many young men struggle with PE
Premature ejaculation often has nothing to do with physical damage or “bad performance”. In younger men it is commonly linked to:
- Stress
- Anxiety
- Overthinking during sex
- High sensitivity due to infrequent sex
- Guilt or shame around intimacy
- Relationship tension
- Past experiences that conditioned a quick finish
Research supports this; a 2022 study by Sajdlova and Fiala found that stress has a measurable association with premature ejaculation, and a chart review by Rajkumar and Kumaran showed that anxiety is closely linked to several subtypes of the condition. So if you have ever felt like your brain is racing at full throttle during sex while you try to “hold it together”, you are definitely not on your own.
What most blokes get wrong
A lot of men think PE is a “penis problem”. It's actually an interplay between your nervous system, stress levels, pelvic floor and relationship dynamics which all play a significant role.
Common mistakes include:
Trying to “push through it” without learning any control strategies
Drinking alcohol to relax, only to make any control worse
Using numbing creams without guidance
Watching too much porn and losing touch with real-life sensations
Avoiding talking to your partner and hoping it resolves by itself
Most men improve once they use a mix of physical strategies, mental techniques and open communication.
Step 1: Build better pelvic floor control
Your pelvic floor muscles help control ejaculation. If they are weak or switch on too early under stress, you lose control.
Kegels are genuinely helpful when done properly.
Australian physiotherapist Michelle Kenway has excellent, safe pelvic floor guidance for men. Good technique matters. Poor technique, or “squeezing everything tight”, can make things worse. So if you have too much tension down there to start with, the wrong exercises can actually make things (that tension) worse. But that is the exception not the rule. Increasing the neural “traffic” and coordination between brain and pelvis will almost definitely help.
Kegel Basics
Gently squeeze the muscles you’d use to stop yourself letting a massive fart rip. Or to stop peeing. Or if you imagine shortening your penis (crazy, I know).
Hold for 3 to 5 seconds
Repeat 10 times
Do this two or three times a day
Avoid holding your breath or clenching your abs
Most men see improvement within a few weeks.
Just like guys can go from barely being able to do a push up, to benching their body weight, the pelvic floor can go from a few seconds squeeze while sitting, to clenched for a minute while running (but you probably don't need that). The point is, it's a journey and while there's evidence that a few weeks or months can help, it's a process and you may need to be consistent and patient.
PS don't do Kegels if you have a (foley) catheter.
Step 2: Learn the stress and anxiety triggers
Your body treats sex like a performance event. If you are stressed, sleep-deprived, worried about work, or arguing with your partner, your sympathetic nervous system fires up and everything becomes more sensitive.
Try these strategies:
Slow breathing before and during sex
Avoid rushing intimacy
Focus on sensations rather than “don’t finish don’t finish”
Do a quick check in with yourself about how tense your body feels
Reduce stimulants like caffeine (do as I say, not as I do ☕☕☕🤩🤩🤩)
Managing anxiety often makes the biggest difference for younger men.
Step 3: Relationship communication
You do not need a TED Talk level heart to heart. Just a simple chat.
Examples:
“Hey, this sometimes happens when I’m stressed, but I’m working on it.”
“Can we slow things down a bit at the start?”
“Let’s take pressure off trying to make everything perfect.”
Partners almost always appreciate honesty. It also reduces pressure, which reduces anxiety, which improves control.
Step 4: Know the role and risks of medications
Dapoxetine is the most common prescription medication for premature ejaculation. It is taken before sex and can lengthen the time before ejaculation for many men. It is actually the same class of medications that are anti-depressant, anti-anxiety (SSRIs) which we've talked about previously, including the role of serotonin in PE (see here and here).
Pros
Works "quickly" (1 to 3 hours before good-foot-bad-thing)
Useful for situational or persistent PE
Good evidence base
Cons and risks
Can cause nausea, dizziness or feeling a bit “off”
Not suitable for men on certain antidepressants or heart medications
Can interact with alcohol
Not necessarily a cure by itself
Not always needed for younger men who respond well to non-drug strategies
A 2025 meta-analysis in The Journal of Sexual Medicine found dapoxetine is effective but works best when combined with behavioural strategies rather than used alone.
If you are considering medication, it is worth getting proper medical advice rather than buying it online (without personalised medical advice).
Step 5: Healthy habits make a real difference
Simple things improve control:
Regular exercise
Better sleep
Less alcohol
Cutting back on vaping or smoking
Reducing porn consumption
Strengthening emotional connection
Think of it like training: better physical and mental conditioning gives you better control.
Most younger men improve with
- A few weeks of good pelvic floor technique
- Managing stress
- Some practice with mindfulness and sensation focus
- Being honest with their partner
- Using medication only if needed
If this is something you’re dealing with, you’re definitely not on your own and it is absolutely something that can improve. I’m putting out heaps of practical men’s health content across my socials, so feel free to follow along, ask questions and learn at your own pace. Just keep in mind that everything I share is general information only and not personal medical advice. If you have concerns about your sexual health or anything else, have a proper chat with a qualified health professional who can assess your specific situation.
⚠️ Disclaimer
This article is general information only and is not personalised medical advice. Always speak with your GP for assessment, diagnosis and recommendations tailored to you.
#MensHealth #PrematureEjaculation #AussieMen #PelvicFloor #MichelleKenway #SexualHealth #StressManagement #DrJamesAU #GPAdvice #Wellbeing
References
Nieves Martín M, Marín Novoa P, Avendaño-Coy J. Dapoxetine combined with non-pharmacological approaches for lifelong premature ejaculation. A systematic review and meta-analysis. J Sex Med. 2025 Nov 2;22(11):1948-1957. doi: 10.1093/jsxmed/qdaf238. PMID: 41020367. https://pubmed.ncbi.nlm.nih.gov/41020367/
Rajkumar RP, Kumaran AK. The association of anxiety with the subtypes of premature ejaculation: a chart review. Prim Care Companion CNS Disord. 2014 Jul 31;16(4):10.4088/PCC.14m01630. doi: 10.4088/PCC.14m01630. PMID: 25664211; PMCID: PMC4318671. https://pmc.ncbi.nlm.nih.gov/articles/PMC4318671/
Sajdlova R, Fiala L. Premature ejaculation and stress. Eur Psychiatry. 2022 Sep 1;65(Suppl 1):S282. doi: 10.1192/j.eurpsy.2022.723. PMCID: PMC9564967. https://pmc.ncbi.nlm.nih.gov/articles/PMC9564967/
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