Sexual Medicine
Premature Ejaculation
Specialist assessment for ejaculation that happens sooner than wanted, with treatment considered across behavioural, psychosexual, medical and procedural options — matched to the individual, not a single default approach.
What it is
Reduced Control Over When Ejaculation Happens
Premature ejaculation refers to ejaculation that happens sooner than a man or his partner would like, often with little perceived control, and with associated distress.
Not a single timed threshold
Occasional early ejaculation is common and not automatically a medical concern. Assessment focuses on frequency, degree of control, and the distress or difficulty it causes — not on comparing against a fixed number.
Why assessment matters
Several Factors Can Contribute
Psychological / performance anxiety
Anxiety about sexual performance, whether longstanding or situational, can itself shorten time to ejaculation.
Relationship context
New relationships, infrequent sexual activity, or relationship stress can all be relevant contributing factors.
Sensitivity / response threshold
Some men have a naturally lower threshold for ejaculatory response, present from the first sexual experiences onward.
Erectile dysfunction
Anxiety about maintaining an erection can independently shorten time to ejaculation — the two are often assessed together.
Hormonal or medical factors
Less commonly, hormonal, prostate-related or neurological factors can contribute and are considered where relevant.
Previous experience
Learned patterns from earlier sexual experiences can play a role, independently of any physical cause.
Treatment approach
Matched to the Individual, Not a Fixed Sequence
Not every man needs every approach, and there is no single correct starting point — the approach depends on whether the pattern is lifelong or acquired, whether erectile dysfunction is also present, and personal and relationship factors.
Behavioural techniques
Structured techniques, such as stop-start or squeeze approaches, aimed at building awareness and control over time.
Psychosexual support
Considered where performance anxiety, relationship factors or past experience appear to be significant contributors.
Medical treatment
Oral or topical options can be considered after assessment, matched to the pattern involved and any contraindications.
Procedural options in selected cases
A small number of patients may be suitable for a procedural option, discussed individually and only after the approaches above have been considered.
Selected procedural option
Hyaluronic Acid Treatment at the Glans
In selected cases, hyaluronic acid treatment at the glans may be considered as part of a broader management strategy for premature ejaculation. This is not the first or only option, is not suitable for every patient, and is only considered after assessment has clarified the pattern involved and the approaches above have been discussed.
- Suitability is assessed individually, based on symptoms, medical history, anatomy and expectations — not offered as a routine or default option.
- Goals and realistic limitations are discussed in detail before any procedure is considered.
- It is one part of a broader management strategy, not a stand-alone guaranteed solution.
- It is only ever discussed alongside the behavioural, psychosexual and medical approaches above, matched to individual assessment findings.
Every approach — behavioural, psychosexual, medical or procedural — is considered on individual assessment, never assumed from a general description alone.
Why specialist care
Dr. Alejandro Molina
Consultant Urologist & Andrologist
Premature ejaculation is assessed within a Consultant Urologist & Andrologist’s practice, alongside related sexual and hormonal health — since erectile function, hormonal factors and psychosexual context can all be relevant to the same presentation.
FAQs