Ejaculation (coming) involves emission (release of semen), ejection (squirt from the penis) and orgasm. A potpourri of hormones and chemicals trigger ejaculation including norepinephrine, serotonin, oxytocin, GABA and nitric oxide. Premature ejaculation (PE) occurs in people of all ages, races and educational levels— but not to the same degree. So, culture and psychological factors influence who develops this sexual problem.
PE is most prevalent in men aged 18 to 40. It’s less of a problem for 40-something-year-old men, but increases again in men aged 50 to 59. The problem is more serious in men who were divorced, separated or widowed than in men who were married or who never married. Lack of education is a strong risk factor for PE. Hispanics are less likely to have the problem than whites, blacks or Asians. Factors increasing the risk of premature ejaculation include past history of sexually transmitted diseases or urinary tract infections, poor health, emotional stress, loss of income, past history of same-sex activity, history of sexual harassment and childhood abuse. Factors decreasing the risk include daily alcohol consumption, circumcision and greater sexual experience. Men with strict religious backgrounds who viewed sex as a sin or lacked attraction for their partner also have an increased risk of PE. Physical factors can play a role. These include abnormalities in the pelvic floor muscles, hypersensitivity of the head of the penis, overstimulation of the genitals from the brain, side effects from drug use (amphetamine, cocaine), urological diseases and neurological diseases (multiple sclerosis, peripheral nerve disease). Treatment for PE is difficult because of the complexity of the problem. (Journal Sexual Medicine, 3 (Suppl 4): 303-308, 2006)