Physical causes of premature ejaculation

These vary between individuals. There are a number of reasons why men develop premature ejaculation which can be divided into the following two categories:

  • Physical
  • Psychological

This section looks at the physical causes only.

Find out more about the mental aspects in our psychological causes of premature ejaculation.

Basically, the causes of premature ejaculation depend upon the nature of the problem and the person themselves. But whatever the reason there are usually physical and psychological explanations for it.

An example of this is if a man has suffered from a medical complaint which has resulted in a form of sexual dysfunction and premature ejaculation.

Two types of premature ejaculation

Premature ejaculation can be divided into these two versions:

  • Acquired
  • Lifelong

Acquired premature ejaculation is caused by both physical and psychological factors.

Lifelong premature ejaculation is almost always caused by psychological factors only.

So what are the physical causes of (acquired) premature ejaculation?

Medical conditions which cause premature ejaculation

These include:

  • Underactive thyroid
  • Diabetes
  • High blood pressure
  • Multiple sclerosis
  • Prostate disease
  • Urethritis

These conditions are responsible for this condition but add to this a couple of lifestyle factors: excess alcohol consumption and drug abuse. Certain medications such as antidepressants can also cause premature ejaculation.

Underactive thyroid

Also known as ‘hypothyroidism’ this condition is caused by a failure of the thyroid gland to produce enough hormones such as thyroxine. This produces a range of symptoms which include weight gain, depression, fatigue and sexual problems such as a drop in libido (sex drive).


This is where there is too much glucose (type of sugar) within the blood caused by a problem with insulin production. Insulin is produced by the pancreas which helps to break down glucose in the blood but if there is a problem with this or insufficient amounts then diabetes occurs. Poorly controlled blood sugar levels cause damage to the autonomic nerves which control sexual arousal and this then affects blood flow and sexual activity.

The outcome of this is premature ejaculation, retrograde ejaculation (semen passes into the bladder instead of leaving the penis) and erectile dysfunction.

High blood pressure

The medical name for this is hypertension: this very common condition is caused by pressure exerted on the artery walls as blood flows through them. This forces the heart to work harder than normal which increases the risk of a heart attack or stroke. This damage to the arteries also includes those which supply blood to the penis. It means reduced blood flow into the penis which results in problems with getting an erection – known as erectile dysfunction and/or premature ejaculation.

If you suffer from high blood pressure and are taking medication such as beta blockers or diuretics then be aware that both of these have side effects which include sexual dysfunction. But these tend to be rare.

Multiple sclerosis

This autoimmune disease occurs when the coating around the nerve fibres – called myelin - becomes damaged which stops the transmission of messages from the brain to the body.

This causes a wide range of symptoms which include muscle weakness, poor co-ordination and blurred vision and muscle spasms. It also causes sexual problems.

The symptoms of multiple sclerosis often reduce the person’s desire for sex and this applies to both sexes.

Men find that they experience fewer erections than usual and have a reduced amount of feeling in their penis. This causes difficulties with getting and sustaining an erection as well as premature ejaculation.

Prostate disease

The technical name for this is ‘benign prostatic hyperplasia’and it is characterised by an enlargement of the prostate gland. This increase in size puts pressure on the urethra (slim tube) which then restricts the flow of urine and semen down this tube and out of the body.

This causes a range of symptoms which include problems with urination and premature ejaculation.


This is the medical term for an inflammation of the urethra (slim tube). The urethra is present in both men and women and its role is to transport urine from the bladder, via this slim tube and out of the body.

The male urethra also transports semen as well as urine which are expelled from the body via the penis.

This inflammation causes painful urination, swelling around the tip of the penis, itching and pain during sex. This may interfere with ejaculation.


Excess alcohol intake is one of several known causes of erectile dysfunction so perhaps it is not surprising that it also causes premature ejaculation. Too much alcohol is responsible for a condition called ‘brewer’s droop’ which affects sexual performance and this is the same response as for premature ejaculation.

The message is that drinking excessive amounts of alcohol not only affect your ability to sustain an erection but also affects the ejaculation process and ultimately, sexual performance.

If you enjoy a few drinks then it may be a good idea to have a look at how much you are consuming in case this is causing your premature ejaculation.

Drug use

This equally applies to drug abuse: if someone is using recreational drugs or a class of drugs known as opioids then there is an increased risk of sexual problems such as this.

The opioid family are a category of drugs which were developed as painkillers and include morphine, tramadol and methadone. They are popular and highly effective drugs but they do have side effects which include sexual problems such as erectile dysfunction and premature ejaculation.

If you suffer from any of these medical conditions and have developed problems with ejaculation and/or sexual performance then speak to your GP.

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