The main symptom of premature ejaculation is the inability to delay ejaculation for more than one minute after penetration. However, the problem might occur in all sexual situations, even during masturbation.

Premature ejaculation can be classified as:

• Lifelong (primary). Lifelong premature ejaculation occurs all or nearly all of the time beginning with your first sexual encounters.
• Acquired (secondary). Acquired premature ejaculation develops after you've had previous sexual experiences without ejaculatory problems.

Many men feel that they have symptoms of premature ejaculation, but the symptoms don't meet the diagnostic criteria for premature ejaculation. Instead these men might have natural variable premature ejaculation, which includes periods of rapid ejaculation as well as periods of normal ejaculation.

The exact cause of premature ejaculation isn't known. While it was once thought to be only psychological, doctors now know premature ejaculation involves a complex interaction of psychological and biological factors.

Psychological causes

Psychological factors that might play a role include:

• Early sexual experiences
• Sexual abuse
• Poor body image
• Depression
• Worrying about premature ejaculation
• Guilty feelings that increase your tendency to rush through sexual encounters

Other factors that can play a role include:

• Erectile dysfunction. Men who are anxious about obtaining or maintaining an erection during sexual intercourse might form a pattern of rushing to ejaculate, which can be difficult to change.
• Anxiety. Many men with premature ejaculation also have problems with anxiety — either specifically about sexual performance or related to other issues.
• Relationship problems. If you have had satisfying sexual relationships with other partners in which premature ejaculation happened infrequently or not at all, it's possible that interpersonal issues between you and your current partner are contributing to the problem.

Biological causes

A number of biological factors might contribute to premature ejaculation, including:

• Abnormal hormone levels
• Abnormal levels of brain chemicals called neurotransmitters
• Inflammation and infection of the prostate or urethra
• Inherited traits

Various factors can increase your risk of premature ejaculation, including:

• Erectile dysfunction. You might be at increased risk of premature ejaculation if you occasionally or consistently have trouble getting or maintaining an erection. Fear of losing your erection might cause you to consciously or unconsciously hurry through sexual encounters.
• Stress. Emotional or mental strain in any area of your life can play a role in premature ejaculation, limiting your ability to relax and focus during sexual encounters.

Premature ejaculation can cause problems in your personal life, including:

• Stress and relationship problems. A common complication of premature ejaculation is relationship stress.
• Fertility problems. Premature ejaculation can occasionally make fertilization difficult for couples who are trying to have a baby if ejaculation doesn't occur intravaginally.