andrology · rapid ejaculation · ejaculation control · Gdańsk
Premature ejaculation is a problem with controlling the moment of ejaculation, causing discomfort, tension in a relationship or avoidance of intercourse. It may be present from the beginning of sexual life or appear only later. The cause may be stress, fear of failure, hypersensitivity, erectile dysfunction, inflammation of the prostate or urethra, hormonal problems, chronic diseases or partner-related factors. At Wyspa Medycyny Przyjaznej, patients with this problem are consulted by Jakub Krukowski, MD, PhD — urologist and andrologist.
This section is educational and directs patients toward diagnostics. Detailed information about prices and procedures, including P-SHOT, should remain in the andrology price list and on service pages.
The most important answer
Premature ejaculation is diagnosed not only by the time to ejaculation, but also by lack of control and discomfort experienced by the patient or couple. In some men, ejaculation occurs very quickly from the beginning of sexual activity; in others, the problem appears only after some time and may be related to stress, erectile dysfunction, prostatitis, a change in the relationship, anxiety, hypersensitivity or coexisting diseases. Treatment is selected according to the cause and may include education, behavioural techniques, work with tension, treatment of erectile dysfunction, treatment of inflammation, pharmacotherapy prescribed by a doctor or selected procedures, such as P-SHOT — but only after qualification.
What is premature ejaculation?
Premature ejaculation is a situation in which ejaculation occurs earlier than the patient would like, and the man feels he has little control over the timing of ejaculation. The problem is clinically significant especially when it causes stress, frustration, avoidance of intercourse, tension in a relationship or reduced sexual satisfaction.
Not every “faster ejaculation” is a disorder. The duration of intercourse varies and depends on arousal, stress, frequency of sexual activity, relationship, erection quality, experience, medications and general health. Therefore, more important than the stopwatch itself are the answers to the questions: does the patient have control, is the problem recurring and does it cause distress?
Types of premature ejaculation
Distinguishing the type of problem helps select treatment. A patient who has had very rapid ejaculation “from the beginning” is managed differently from a man in whom the problem appeared suddenly after years of satisfying intercourse.
Primary premature ejaculation
It occurs from the beginning of sexual life or almost from the beginning. It is often associated with low ejaculation control in most sexual contacts. It may be related to individual sensitivity, patterns of sexual response, anxiety, tension or biological factors.
Acquired premature ejaculation
It appears after a period during which the patient previously had satisfactory ejaculation control. It requires special diagnostics because it may be associated with erectile dysfunction, prostatitis, infection, stress, thyroid disease, medication changes, relationship problems or other health factors.
Situational premature ejaculation
It occurs only in selected situations: with a specific partner, under high stress, after a longer sexual break, with fear of being judged, in new relationships or when there is concern about maintaining an erection. It often requires a different approach than a persistent problem.
Symptoms most commonly described by patients
- ejaculation occurs before penetration or very shortly after it begins,
- the patient feels a lack of control over the timing of ejaculation,
- intercourse ends sooner than the patient and partner would like,
- tension, shame, frustration or avoidance of intimacy appears,
- the patient focuses on “lasting longer”, which increases anxiety,
- the problem coexists with erectile dysfunction,
- lowered self-esteem or conflict in the relationship appears,
- the problem occurs almost always or has been worsening recently.
Possible causes of premature ejaculation
Premature ejaculation usually does not have one simple cause. Biological, psychological, relationship-related and urological factors often overlap.
Psychosexual factors
- fear of failure,
- stress and tension,
- rushing patterns established in previous sexual experiences,
- high focus on “performance”,
- relationship difficulties, pressure from a partner,
- shame, low self-esteem, fear of being judged.
Urological and health-related factors
- erectile dysfunction — the patient may rush intercourse out of fear of losing erection,
- prostatitis, urethritis or urinary tract symptoms,
- glans hypersensitivity, short frenulum or pain during intercourse,
- thyroid diseases, especially hyperthyroidism,
- some medications or withdrawal of some medications,
- chronic stress, insomnia, fatigue,
- metabolic diseases and general health condition.
Important: if premature ejaculation appeared suddenly after years of good control, it is worth looking for the cause. An acquired problem may be related to erection, prostate, infection, stress, hormones or medications.
When should you see an andrologist?
A consultation is indicated when the problem is recurring, causes stress, affects the relationship or the patient begins to avoid intercourse. It is also worth seeking help if the problem appeared suddenly or coexists with erectile dysfunction, pain, burning during urination, prostate symptoms or a change in libido.
Seek help sooner if:
- the problem appeared suddenly and was not present before,
- erectile dysfunction coexists,
- you have pain in the perineum, testicles, penis or lower abdomen,
- there is burning during urination, frequent urination or urinary urgency,
- urethral discharge has appeared,
- there is pain during ejaculation,
- blood appears in semen or urine,
- the problem causes strong anxiety, avoidance of sex or conflict in the relationship.
What does diagnostics involve?
Diagnostics usually begins with a conversation. The doctor asks when the problem began, whether it is constant or situational, whether it concerns every sexual activity, whether the patient has control over ejaculation, and whether erectile dysfunction, pain, urinary symptoms, stress, medications or chronic diseases are present.
Depending on the situation, the doctor may recommend a urological examination, prostate assessment, urine test, hormone tests, thyroid assessment, infection diagnostics, assessment of erectile dysfunction or psychosexual consultation. Not every patient requires all tests.
How can premature ejaculation be treated?
Treatment depends on the cause. The goal is not only to “extend time”, but to improve control, reduce stress and improve sexual satisfaction. In many patients, combined treatment gives the best results.
Education and behavioural techniques
The doctor may discuss techniques that help recognise increasing arousal and better control the timing of ejaculation. In some patients, breathing exercises, work with tension, pelvic floor muscle training, stop-start or squeeze techniques and modification of intercourse rhythm may be helpful.
Treatment of erectile dysfunction
If the patient also has erectile dysfunction, it should be assessed and treated. Fear of losing erection may intensify rushing and reinforce rapid ejaculation.
Treatment of inflammation and coexisting diseases
If there are symptoms of prostatitis, urethritis, infection, pain during ejaculation, urinary problems or hormonal diseases, treatment should address the cause, not only the symptom.
Topical and oral medications
In selected patients, the doctor may consider topical medications that reduce sensitivity or oral medications affecting ejaculation control. They should not be used independently, because treatment selection depends on health condition, other medications, adverse effects and the cause of the problem.
Psychosexual or couples therapy
If the problem is strongly related to anxiety, pressure, relationship issues, shame or avoidance of closeness, psychosexual therapy may be helpful. This does not mean that the problem “is only in the head” — sexuality connects the body, emotions and relationship.
P-SHOT after qualification
At Wyspa Medycyny Przyjaznej, the andrology price list includes the item “treatment of premature ejaculation (P-SHOT)”. This is a method that may be discussed during a consultation, but it should not be treated as a universal solution for every patient. First, the cause must be assessed, factors requiring different treatment must be ruled out, and possible effects and limitations must be discussed realistically.
What should you avoid in premature ejaculation?
- do not buy medications for premature ejaculation online without consultation,
- do not use random anaesthetic products on the penis without medical advice,
- do not increase alcohol intake before intercourse as a method of “delaying”,
- do not assume that the problem is always psychological,
- do not ignore erectile dysfunction, pain, burning during urination or prostate symptoms,
- do not assess treatment effectiveness after one attempt,
- do not hide medications, supplements, stimulants or erection problems from the doctor.
How should you prepare for the consultation?
- think about when the problem started,
- determine whether the problem has always been present or appeared recently,
- note whether it occurs in every situation or only sometimes,
- tell the doctor whether you have erectile dysfunction, pain, urinary symptoms or decreased libido,
- prepare a list of medications, supplements and chronic diseases,
- inform the doctor about stress, relationship changes and fertility problems, if present,
- do not be ashamed to describe the problem directly — for an andrologist, this is a typical medical topic.
Patient pathway: from symptom to treatment
This section is not a P-SHOT procedure page. Its purpose is to help the patient understand the problem and direct them to appropriate diagnostics.
Ejaculation occurs sooner than the patient wants and causes stress or relationship problems.
Dr Jakub Krukowski assesses whether the problem is primary, acquired, situational, related to erection, prostate, stress or another cause.
If needed, the doctor orders tests and assesses erection, infections, prostate, hormones or medications.
Options include behavioural techniques, pharmacotherapy, treatment of the cause, psychosexual therapy or P-SHOT after qualification.
Andrologist consulting premature ejaculation at Wyspa Medycyny Przyjaznej
urologist, andrologist, aesthetic urology
He consults patients with andrological problems, sexual dysfunction, ejaculation problems, erectile dysfunction and qualification for treatment, including P-SHOT.
Doctor’s profile →Do you have a problem with premature ejaculation?
Book an andrology consultation. The doctor will assess the cause of the problem and discuss possible treatment — from behavioural techniques and treatment of the cause to pharmacotherapy or P-SHOT, if justified.
FAQ – premature ejaculation
Is premature ejaculation a disease?
It is a sexual disorder when ejaculation occurs too early, the patient has little control over ejaculation and the problem causes discomfort or relationship tension. Not every short intercourse means a disease.
Can premature ejaculation appear suddenly?
Yes. Acquired premature ejaculation may appear after a period of good control. In that case, it is worth looking for the cause, such as erectile dysfunction, prostatitis, stress, infection, medications or hormonal diseases.
Can premature ejaculation be treated?
Yes. Treatment may include education, behavioural techniques, treatment of erectile dysfunction, treatment of inflammation, pharmacotherapy, psychosexual therapy or selected procedures after qualification. The method is selected by the doctor.
Does P-SHOT help with premature ejaculation?
P-SHOT is one of the methods that may be discussed during consultation, but it is not a universal treatment for every patient. First, the cause of the problem, expectations, contraindications and other available methods must be assessed.
Can erectile dysfunction cause rapid ejaculation?
Yes. A man who is afraid of losing erection may rush intercourse and ejaculate faster. Therefore, in premature ejaculation, it is also worth assessing erection quality.
Should the partner participate in treatment?
Not always, but in many cases, talking with the partner, reducing pressure and working together on techniques may improve treatment results.
Who consults premature ejaculation at Wyspa Medycyny Przyjaznej?
Patients with premature ejaculation are consulted by Jakub Krukowski, MD, PhD — urologist and andrologist.
Related pages
This section explains the problem of premature ejaculation and directs patients to the appropriate services. Details of procedures and prices should remain on service pages and in the price list.
Book an andrology consultation
If ejaculation that is too fast causes stress, avoidance of intercourse or relationship problems, book a consultation. Dr Jakub Krukowski will assess the cause and choose the appropriate treatment pathway.
The information on this page is educational and does not replace a medical consultation. The diagnosis of premature ejaculation, diagnostics, pharmacological treatment, psychosexual treatment, treatment of coexisting diseases or qualification for P-SHOT is decided by the doctor after examination and medical history. Medical review is required before publication.