Premature Ejaculation And Anxiety: What’s The Connection?

There are a number of ways our mental health can impact our sexual performance — whether it’s stress, depression, or relationship issues. One major contributing factor can be performance anxiety. You may have heard that ‘pressure to perform’ can lead to sexual function issues such as erectile dysfunction, but anxiety can lead to other concerns like premature ejaculation (PE, or ‘early climax’), too.

Here’s how, why, and what can be done to help prevent premature ejaculation caused by anxiety.

What is performance anxiety?

First of all, what is performance anxiety? It’s important to note that this type of anxiety disorder isn’t just related to sexual activity. Performance anxiety is situation-based, or ‘situational’, meaning it may not always be present, but can occur before or during events that make you feel nervous or under pressure, such as an exam or public speaking event.

Common symptoms of situational anxiety include a strong heartbeat, feelings of dizziness and difficulty making decisions. When it comes to sexual performance, anxiety may manifest in premature ejaculation. [1] This can occur when anxiety-induced tension leads to unintentional contraction of the pelvic floor muscles, which are closely related to the ejaculation process in the body. [2]

What is premature ejaculation?

PE is defined as ejaculation that happens earlier than desired during sexual activity, usually within the first minute of penetration. [3] There are no health risks associated with PE, but it can lead to lack of confidence or further feelings of anxiety, creating an ongoing cycle of performance anxiety and premature ejaculation.

Can premature ejaculation be treated?

The good news is yes, there are treatments available for premature ejaculation caused by anxiety.

1. Therapy

If you’re experiencing trouble with your mental health, seeking the support of your doctor or a licensed therapist could be a good place to start. Cognitive behavioral therapy (CBT), in particular, can help address the physical effects of anxiety and stress. [4] If relationship issues with your sexual partner are contributing to premature ejaculation, couples therapy may also be helpful. 

2. Medication

It’s possible to treat both PE and anxiety with certain antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs). One example is sertraline [5], which is sometimes prescribed specifically for PE as it can help men delay climax by as much as 7x as long. [6] To find out if sertraline is right for you, take a quick consultation here.

3. Physical methods

Some manual practices to delay ejaculation include the squeeze technique, which involves squeezing the head of the penis for around 10-20 seconds [7] and the ‘stop-start’ method, which is done by stopping sexual activity just before climax, then resuming and repeating for the desired duration of time. [8]

Want to know more about treatment options for premature ejaculation, and other sexual performance concerns like erectile dysfunction?

Head to ZipHealth today.

References

1. NHS. Anxiety - Every Mind Matters [Internet]. nhs.uk. 2021. Available from: https://www.nhs.uk/every-mind-matters/mental-health-issues/anxiety/#signs-of-anxiety
2. Cohen D, Gonzalez J, Goldstein I. The Role of Pelvic Floor Muscles in Male Sexual Dysfunction and Pelvic Pain. Sexual Medicine Reviews. 2016 Jan;4(1):53–62.
3. Crowdis M, Nazir S. Premature Ejaculation [Internet]. PubMed. Treasure Island (FL): StatPearls Publishing; 2021. Available from: https://www.ncbi.nlm.nih.gov/books/NBK546701/
4. Yang Q, Cai H, Wan Z, Chen M, Yang B, Xie Y, et al. Impact of cognitive behavioral therapy on premature ejaculation patients: A prospective, randomized controlled trial protocol. PloS one. 2023 Dec 27;18(12):e0295663–3.
5. Singh HK, Saadabadi A. Sertraline [Internet]. PubMed. Treasure Island (FL): StatPearls Publishing; 2023. Available from: https://www.ncbi.nlm.nih.gov/books/NBK547689/
6. McMahon CG. Treatment of premature ejaculation with sertraline hydrochloride. International journal of impotence research [Internet]. 1998;10(3):181–4; discussion 185. Available from: https://www.ncbi.nlm.nih.gov/pubmed/9788108
7. NHS Choices. Ejaculation problems [Internet]. 2024 [cited 2024 Sep 17]. Available from: https://www.nhs.uk/conditions/ejaculation-problems/#:~:text=In%20the%20squeeze%20technique%2C%20you
8. Mohee A, Eardley I. Medical therapy for premature ejaculation. Therapeutic Advances in Urology [Internet]. 2011 Oct 1;3(5):211–22. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3199591/