Author
Bowtie Team
Updated on
2025-08-26
Disclaimer: This article is translated with the assistance of AI.
As a fellow guy, Dr. Cheung Ngo gets those awkward ‘hidden worries’ we all face—premature ejaculation (aka ejaculatory dysfunction, or PE) is a common one. My recent LIHKG post on it sparked tons of questions, leaving me replying non-stop!
So, this time on the Bowtie Health Information Platform, I’ve compiled the “Brothers'” questions , along with my own YouTube content , to share with everyone.
What is Premature Ejaculation? Quick Diagnosis Questionnaire
According to the definition from the ISSM , this international organization, men must meet these 3 key criteria for premature ejaculation:
- Unable to delay ejaculation
- Ejaculation time causes negative feelings
- Ejaculates within 1 minute or 3 minutes
As for why the time varies, it’s mainly because premature ejaculation is divided into Lifelong PE and Acquired PE. Lifelong PE patients start having issues from their first sexual encounter with a partner and ejaculate within 1 minute; Acquired PE patients may not have problems initially, but it worsens over time, with the diagnostic threshold being ejaculation within 3 minutes.
One thing to note: the time is counted from vaginal penetration until ejaculation. Other forms of sexual activity are considered separately.
If you want to gauge your own risk of premature ejaculation , you can answer this questionnaire developed by researchers in 2007 called the Premature Ejaculation Diagnostic Tool (PEDT) :
| Score | |||||
| Question | 0 | 1 | 2 | 3 | 4 |
| 1. How difficult is it for you to delay ejaculation? | Not difficult at all | Somewhat difficult | Moderately difficult | Very difficult | Extremely difficult |
| 2. Do you ejaculate before you want to? | Almost never or never | Less than half the time | About half the time | More than half the time | Almost always or always |
| 3. Do you ejaculate with very little stimulation? | Almost never or never | Less than half the time | About half the time | More than half the time | Almost always or always |
| 4. Do you feel frustrated because of ejaculating before you want to? | Not at all | Slightly | Moderately | Very | Extremely |
| 5. How concerned are you that your time to ejaculation leaves your partner unfulfilled? | Not at all | Slightly | Moderately | Very | Extremely |
If your score is 11 or higher, it suggests a good chance you have a premature ejaculation issue—consider seeing a doctor for a more accurate diagnosis. And don’t worry if you think the questionnaire, designed by foreigners, might not apply— it was tested on a Chinese population in 2014, and 11 turned out to be the same cutoff point!
Premature Ejaculation Causes Aren’t Always Physical
As a doctor, I’ve heard many men mistakenly believe premature ejaculation is a congenital issue, but that’s not the case—it’s treatable. The main causes fall into three categories:
1. Lack of Serotonin
Vitamin B is one component in producing serotonin, so a deficiency can naturally lower serotonin levels.
2. Overstimulation of Ejaculation-Controlling Nerves
High androgens, hyperthyroidism, prostatitis, and diabetes can all stimulate ejaculation-related nerves, speeding up the process.
3. Erectile Dysfunction
Beyond physical factors, anxiety is a key psychological cause of premature ejaculation. Interestingly, depression and some psychiatric medications can lead to another issue—erectile dysfunction.
Those with erectile dysfunction need more stimulation than usual to achieve an erection, which can hasten ejaculation. Plus, some folks pressure themselves to “finish the job” during sex, adding invisible stress that turns into anxiety and speeds things up.
Which Doctor to See for Suspected Premature Ejaculation?
One forum user shared his experience at a clinic specializing in sexual dysfunction: he filled out a questionnaire, got his glans sensitivity tested with a machine, and the doctor said everything was normal, suggesting more exercise and less tension during sex.
However, the ISSM’s 2014 guidelines don’t mention this “machine test” for glans sensitivity. I recommend seeing a specialist to uncover the real cause.
If you suspect an issue, start with a urologist—most are male (some worry about awkwardness with female doctors). To save money, try queuing at a public hospital.
I revealed on the forum that I’m interpreting these issues as a public hospital psychiatrist, and some users wondered: What does psychiatry have to do with premature ejaculation?
The answer ties back to the previous section—anxiety can be a cause of premature ejaculation. A private psychiatrist can professionally assess if your sexual troubles stem from psychological factors.
Common Questions on Premature Ejaculation
1. Is Taking Too Long to Ejaculate a Problem?
The opposite of “premature ejaculation” is delayed ejaculation, which isn’t common, and those affected might not even see it as an issue. Notably, antidepressants can sometimes cause this.
2. Does Smoking or Drinking Cause Premature Ejaculation?
Smoking and drinking aren’t directly linked to premature ejaculation, but they do make men more prone to “erectile dysfunction” (commonly known as impotence). As a doctor, I always recommend quitting both for overall health.
3. Does Not Being Circumcised Increase Glans Sensitivity and Cause Premature Ejaculation?
Based on two large surveys, I don’t see a significant difference in ejaculation time between circumcised and uncircumcised men.
Finally, Dr. Cheung Ngo wants to say that as long as most of your ejaculation times aren’t clocking in at 3 minutes, you should treat yourself as totally normal—just like how marathon runs can be speedy one day and slower the next. And here’s my advice: don’t overdiagnose yourself, or you’ll just ramp up the pressure, creating a vicious cycle where nothing turns into something.
If you’re still keen on extending your ejaculation time to savor longer intimate moments, check out this other article about medications and self-training for treating premature ejaculation . Wishing everyone a delightful sex life!
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