One of the great mysteries concerning the functioning of the penis is the issue of premature ejaculation. Myths and fallacies regarding this have been circulating for thousands of years, but one fact with which most doctors agree is that the cause is often psychological. Stress and emotional upheaval notwithstanding, there can be physical factors that contribute to this condition, such as excessive alcohol consumption and inflammation of the prostate gland (prostatitis).
Both erectile dysfunction and premature ejaculation are conditions which can occur simultaneously and ED can lead to the development of premature ejaculations. According to Cleveland Clinic, which states “When a man knows his ability to sustain an erection is poor, he develops the habit of ejaculating soon after erection before he loses his erection.”
This is backed up by Ro which confirms, “Sexual performance anxiety happens when you fear you’re not “good enough” to please your partner. Common causes of performance anxiety include self-esteem, body image, and insecurity about sexual experience. Performance anxiety can cause premature ejaculation, erectile dysfunction, or an avoidance of sex altogether. Several effective therapies for performance anxiety include cognitive-behavioral therapy (CBT), which involves changing negative thoughts about sex.”
As far as how premature ejaculation is defined, the Cleveland Clinic offers, “The definition of premature ejaculation varies. The American Urological Association defines ejaculation as “premature” if it occurs sooner than desired, either before or shortly after penetration, causing distress to either one or both partners. The American Psychiatric Association defines three levels of severity (mild, moderate, severe), based on time to ejaculation, with mild being under one minute. If pressed for a time frame, many doctors would define prematurity as ejaculation within a minute of beginning intercourse. Despite professional opinions, your feelings as to what is premature are also considered.”
A UK site https://onlinedoctor.lloydspharmacy.com/uk/mens-health-advice/ asks the question: Can ED cause premature ejaculation?
“If you, like many men, have experienced erectile loss during sex, you may have found yourself in a vicious circle whereby you try to focus on your sexual excitement to avoid this loss. Unfortunately, this increase in sexual excitement can speed up ejaculation. In order to avoid ejaculating too soon, you find yourself focusing on reducing your sexual excitement, which leads to the loss of your erection. All the while this process is going on in your head, you become a spectator to your experience during sex and suffer from performance anxiety. So you are not very present in the moment, neither enjoying your partner’s body, nor focusing on the pleasurable sensations of being touched by your partner.
The dilemma that unfolds basically offers two unsatisfactory choices during sex: ejaculate too soon or lose your erection. It is no surprise then that sex can become something to avoid; for fear that it will lead to disappointment, frustration and embarrassment.”
The site goes on to say
"Anxiety can make ED and PE worse, and many individuals or couples facing this double whammy may not know which issue to address first.
Typically, addressing ED first means your confidence in maintaining erections increases. This means that anxiety tends to reduce, which helps prevent premature ejaculation.”
