Are erectile dysfunction and premature ejaculation related?
Reviewed by our clinical team - 26.9.22
The two most common male sexual problems are premature ejaculation (PE) and erectile dysfunction (ED), but it is less widely known that these two sexual dysfunctions often come as a pair.
Can erectile dysfunction 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.
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.
Techniques to help with erectile dysfunction and premature ejaculation
Learn to relax
Lower your anxiety in general, by exercising regularly and practising ‘mindfulness techniques.’ There are many internet resources and apps to help to do these quick and simple breathing exercises daily to train you to stay focused and relaxed. Being relaxed during sex will help you to focus your attention on pleasurable sensations, rather than being preoccupied with your erection or ejaculating too soon.
Practise losing and gaining erections
A useful exercise for ED is to practise getting an erection, then letting the penis go flaccid (either with or without your partner), until you become used to the idea that with the right state of mind and stimulation, erections come, go and come back again. Also, it can be helpful to get more acquainted with your flaccid penis – it is not the enemy and can give you and your partner pleasure.
Experimenting with an erection ring
An erection ring is a round elastic plastic cylinder that is worn at the base of the penis to help maintain an erection. They can only be worn for a limited time during sex.
Pelvic floor exercises
Pelvic floor exercises may help with ejaculatory control and erections. Your pelvic floor muscles are situated between your legs from your tailbone to pubic bone. You can squeeze and relax them by imagining you are holding in wind or urine. Squeeze and relax these muscles, both as quick flicks and slowly by holding for 10 seconds and resting for four seconds a few times a day.
N.B. Make sure you are not also squeezing your buttocks, thighs or tummy muscles and don’t hold your breath whilst doing these pelvic floor exercises.
Practise the ‘stop start technique’ for PE
A useful exercise for PE is to stop and start your arousal, so that you really get to know your own arousal process and can identify the point before you are going to ejaculate. With lots of practise, you should become more confident at controlling your arousal and ejaculation.
Try stimulating your partner so their arousal is heightened, then ejaculating quickly upon penetration may not be such an issue.
Open up and talk
If you are in a relationship, try talking to your partner first. Many couples are amazed at how effective talking about sex and other relationship issues can be. If you feel you need further help, you may wish to consider seeking specialist psychosexual and relationship therapy.
Medical treatments for ED
Medical treatments for PE
Medical treatments for PE, such as Priligy (Dapoxetine) work by delaying the chemical reactions causing ejaculation by increasing serotonin, and may double or triple your current time to ejaculate.
Remember, penetration is not the be all and end all; it is only one of many sexual activities and many people take great pleasure from other kinds of stimulation.
Sexual dysfunctions can be caused by many factors. They might be physical, and/or psychological and a medical consultation may be necessary to investigate any underlying health issues.