Premature ejaculation (PE) is a common sexual dysfunction affecting millions of men worldwide. It is described as the frequent or continuous ejaculation before, during, or soon after modest sexual excitement after penetration, causing distress or interpersonal difficulty. PE can significantly impact a man's sexual satisfaction, self-esteem, and overall quality of life. The goal of this paper is to give a brief overview of the symptoms, causes, and prevention strategies of premature ejaculation. The primary symptom of PE is the incapacity to manage ejaculation, resulting in premature or fast ejaculation during intercourse. This can occur in less than a minute after penetration, leaving both partners dissatisfied. PE can be classified into two types: lifelong (primary) and acquired (secondary) [1]. Lifelong PE is present from the first sexual experience, while acquired PE develops later in life due to psychological or physical factors. The exact cause of PE is not fully understood, but it is believed to be a combination of psychological, biological, and environmental factors. Psychological factors such as anxiety, guilt, and relationship issues can contribute to PE. Biological factors such as hormonal imbalances, genetic predisposition, and abnormal nerve reflexes may also play a role. Environmental factors such as performance pressure, stress, and certain medications can also contribute to PE [2]. Fortunately, there are several prevention strategies available for PE. One of the most effective ways to prevent PE is to practice techniques that help delay ejaculation, such as the stop-start and squeeze techniques. These involve stopping sexual activity before reaching the point of ejaculation and then resuming once the sensation has subsided. Another prevention strategy is to engage in regular pelvic floor exercises, which can help strengthen the muscles responsible for controlling ejaculation. It is also essential to address any underlying psychological or relationship issues that may be contributing to PE. Seeking therapy or counseling can help individuals and couples improve communication, reduce anxiety, and enhance sexual satisfaction. Additionally, avoiding alcohol and recreational drugs, which can affect sexual function, can also help prevent PE [3].

Premature ejaculation can have a significant impact on a man's personal and sexual relationships. It can lead to feelings of inadequacy, low self-esteem, and even depression. This condition can also cause strain and frustration in a couple's sexual relationship, as it may leave one partner feeling unsatisfied. Oftentimes, it can also lead to avoidance of sexual activity, which can further strain the relationship.

SYMPTOMS [4-5]

The primary symptom of PE is the inability to control ejaculation, which occurs before or soon after penetration. However, other symptoms may accompany this condition, including:

1. Ejaculating within one minute of penetration consistently.
2. Inability to delay ejaculation during sexual intercourse.
3. Feelings of frustration, guilt, or shame after sexual encounters.
4. Avoidance of sexual intimacy due to fear of failure.
5. Relationship problems due to unsatisfactory sexual experiences.     

Importantly, PE is relatively rare, and isolated episodes do not always signify a long-term issue. However, if the symptoms persist and cause distress, it is advisable to seek medical help.

CAUSES [5]

It's unclear exactly what causes premature ejaculation. However, several factors may contribute to this condition, including:

1. Psychological factors:

Anxiety, stress, and depression can all contribute to PE. Performance anxiety, in particular, can lead to a fear of failure and a constant worry about ejaculating too quickly, creating a self-fulfilling cycle.

2. Biological factors:

Certain medical conditions, such as diabetes, high blood pressure, and thyroid problems, can cause PE. Additionally, hormonal imbalances, abnormal levels of neurotransmitters, and genetic predispositions may also play a role.

3. Relationship issues:

Problems in a relationship, such as lack of communication, unresolved conflicts, or sexual incompatibility, can lead to PE.

4. Inexperience:

In some cases, PE may be due to a lack of sexual experience or inadequate knowledge about one's own body and sexual responses.

5. Erectile dysfunction (ED):

Men with ED may develop a habit of ejaculating quickly to avoid losing their erections, leading to PE.

6. Inflammation or infection:

Inflammation or infection of the prostate or urethra can cause PE, as these conditions can affect the nerves and muscles involved in ejaculation.

Prevention methods for PE can be divided into psychological and behavioral interventions. Psychological interventions involve addressing any underlying psychological issues, such as anxiety or relationship problems, through therapy or counseling. Behavioral interventions focus on developing techniques to delay ejaculation, such as the start-stop technique, which involves stopping sexual activity when nearing ejaculation and then resuming once the sensation has passed. Other behavioral techniques include the squeeze technique, which involves squeezing the head of the penis to delay ejaculation, and the use of condoms to reduce sensitivity.PE can be prevented or managed effectively through various treatments and lifestyle changes. These include:

1. Behavioral techniques:

Techniques such as the 'squeeze' and 'stop-start' methods involve temporarily halting sexual activity when the man feels he is about to ejaculate. This can help to delay ejaculation and increase control.

1. 1. Stop – Start:

The partner stimulates the penis until they are almost ready to ejaculate during the start-stop phase. The companion should then come to a stop and allow the male to regain control of his instincts. This procedure will be repeated twice more by the partner. He can then ejaculate on the fourth try. Experts advise doing this technique three times a week or more to improve control over ejaculation during intercourse[8]

1. 2. Squeeze:

To achieve the climax of the erection with the squeeze method, the partner stimulates the penis and then applies tight pressure until the erection begins to weaken. To gain control and delay ejaculation, this technique aids in improving the realization of the peak sense. It can take a few weeks for this approach to show results.

2. Counselling:

Seeking therapy or counseling can help address any underlying psychological issues that may be contributing to PE. It can also improve communication and intimacy within a relationship.

3. Medications:

Certain medications, such as selective serotonin reuptake inhibitors (SSRIs) and topical anesthetics, can delay ejaculation and improve control [9].

4. Lifestyle changes:

Making healthy lifestyle choices, such as exercising regularly, reducing stress levels, and avoiding alcohol and drug use, can help manage PE.

5. Communication and education:

Open communication with your partner about sexual needs and preferences can help alleviate performance anxiety and increase intimacy. Additionally, educating oneself about sexual responses and techniques can improve control and delay ejaculation.

6. Topical Anesthetics:

Over-the-counter topical anesthetics, such as lidocaine, can be applied to the penis to reduce sensitivity and delay ejaculation. However, these should be used with caution, as they may also reduce sensitivity for the partner, leading to unsatisfactory sexual experiences [10].

7. Condoms:

Using condoms can also help delay ejaculation by reducing sensation. Some condoms are specially designed with thicker latex or numbing agents that can help prolong sexual activity.

8. Pelvic Floor Exercises:

Exercises that strengthen the pelvic floor muscles, also known as Kegel exercises, can help improve control over ejaculation. These exercises involve contracting and relaxing the muscles used to control urination and can be done discreetly at any time.[11,12]