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Once a month, Dr. Joe DeOrio, a urologist in Chicago, answers your questions on male sexual health. To ask him your own question, click here.

Dear Dr. Joe,

My girlfriend and I have been together for nearly two years and have been having sex for nearly a year and a half of that. When we do foreplay, I’m fine and enjoy it. However, as soon as I enter her, I ejaculate really quickly, like after 5-10 seconds. We have tried different positions and used performance condoms, but these made no difference. It is starting to ruin our relationship, and we both get down after trying to do it.

— Early Bird

Dear E. B.,

First off, let me say that I am sorry that you are suffering from this condition. Ejaculating before you want to can cause distress, dissatisfaction, and a strained relationship. But don’t feel alone. Premature ejaculation, as this condition is commonly called in the medical community, is very common. In fact, between 25-40% of men will experience it at some point in their lives. It’s also treatable, so don’t fret that you will have to live with it forever.

The American Urological Association defines premature ejaculation as such: ejaculation that occurs sooner than desired, either before or shortly after penetration, causing distress, and occurring in greater than 50% of sexual encounters. Causes for early ejaculation are varied.

For one, there are biological causes, such as abnormal hormone levels, dysfunctional reflex activity of the ejaculatory system, hypersensitivity of the pelvic floor musculature and erectile dysfunction. Many individuals with biological causes, however, suffer lifelong premature ejaculation. On the contrary, your symptoms seem consistent with acquired premature ejaculation, characterized by development of symptoms after a period of normal, satisfying sexual activity.

Acquired premature ejaculation is often indicative of psychological causes. Job stress, personal stress, anxiety about sexual performance, depression, mistrust of your sexual partner, and poor communication within your relationship are just a few of the possible causes of premature ejaculation. To make matters worse, even in the context of a healthy relationship, premature ejaculation in itself can cause feelings of dissatisfaction and emotional distress, which can then exacerbate the problem. In truth, the potential causes are numerous, so the best treatment is a proper evaluation by a doctor and possibly a counselor, with the goal of treating the underlying cause(s).

Regardless of cause, there are multiple medical treatments available. You have already tried performance condoms and varying your sexual technique, which is a great start. Another treatment is to apply a mild topical anesthetic to the penis for about 20 minutes prior to intercourse. The slight decrease in sensation often delays orgasm. Just make sure to wash off the jelly before intercourse, as your partner may not be too pleased with the lack of sensation.

Use of certain anti-depressants, such as Zoloft or Paxil, has been shown to delay ejaculation. These medications may be used on a daily basis, or as needed on days of sexual activity. The dosing regimens are different than for depression, and use for this indication is not approved by the FDA. In addition, you may experience some side effects, such as reduced libido, dry mouth, nervousness, nausea, diarrhea, headache, or drowsiness.

Finally, using Viagra or Cialis may also be helpful, possibly by improving erections and/or alleviating performance anxiety. So, remember that this condition is treatable, and often resolves completely. See a doctor as soon as you can for a full evaluation and before attempting any of the above-mentioned treatment regimens. And consider seeing a counselor or sex therapist, who may offer various other non-medical therapies. Good luck!

— Dr. Joe

Dr. Joe earned his undergraduate degree in Molecular Biology from Princeton University. After attending the Loyola University Stritch School of Medicine, he completed his residency training in urological surgery at the Los Angeles County Medical Center. He lives and works in Chicago, IL. Keep an eye out for his upcoming blog at docjoe.net.