Premature Ejaculation with Erectile Dysfunction – Everything You Need to Know

What causes PE and ED? Is it possible to have ED and PE at the same time? Read on to find out!

Man with PE and ED

Premature ejaculation and erectile dysfunction are the two most common sexual dysfunctions in men. Not surprisingly, many men suffer from both ED and PE simultaneously.

In this article, we’ll explore the link between premature ejaculation and erectile dysfunction, discuss possible causes, and suggest ways to address both PE and ED.

What’s the link between premature ejaculation and erectile dysfunction?

Premature ejaculation and erectile dysfunction appear to be interconnected. Studies indicate that men who suffer from premature ejaculation are much more likely to experience erectile dysfunction.

In fact, men with PE are four times more likely to experience ED. One study reported that 76% of men with PE also experienced ED.

The connection also seems to work the other way around – 30% – 50% of patients who complain about erectile dysfunction also suffer from PE.

So, for many men, premature ejaculation and erectile dysfunction can occur simultaneously.

What could cause both erectile dysfunction and premature ejaculation?

It seems that when ED is associated with PE, it’s less linked to health issues like diabetes mellitus, high blood pressure, high cholesterol, and smoking, even though these health issues are connected to both PE and ED

For men who suffer from both PE and ED, psychological causes such as anxiety and depression are more likely to be at play.

Does erectile dysfunction cause premature ejaculation?

Erectile dysfunction can lead to premature ejaculation in a number of ways.

First, some men with ED need higher levels of stimulation to get an erection, but the fact that they have ED, doesn’t mean that the higher levels of stimulation or arousal affect them any less. In fact, the high arousal makes them more likely to ejaculate early.

Men who suffer from erectile dysfunction often rush to penetrate as soon as they get a good enough erection. The sense of urgency causes them to lose touch with their sexual response and often leads them to ejaculate prematurely.

Some men with premature ejaculation can even ejaculate early without a full erection.

Secondly, men with erectile dysfunction often “rush” to penetrate right after they achieve an erection. Rushing sex leads them to lose touch with their sexual response and ejaculate early by mistake.

When this happens over and over again, premature ejaculation can become a learned habit. Men become triggered to ejaculate as soon as they penetrate.

Does premature ejaculation cause erectile dysfunction?

Yes, premature ejaculation can cause erectile dysfunction. In this case as well, there could be a number of factors at play.

If you suffer from premature ejaculation and try to lower your level of excitement to avoid ejaculating too quickly, you might accidentally go too far and cause yourself to lose your erection.

Experiencing incidents of both PE and ED can make men lose their self-confidence and lead to performance anxiety. Performance anxiety, in turn, can be the sole cause of both premature ejaculation and erectile dysfunction.

This vicious cycle of PE, ED, and performance anxiety can worsen both of these sexual issues, leaving men extremely frustrated.

Luckily, as we’ll see later on in this article, both premature ejaculation and erectile dysfunction can be treated or at least significantly improved.

How to treat erectile dysfunction and premature ejaculation?

When we’re talking about treating premature ejaculation and erectile dysfunction that happens at the same time, it is usually recommended first to treat ED, and only once it has improved, treat PE.

In many cases, treating ED alone will also resolve PE. If not, premature ejaculation can be treated much more easily once the erectile dysfunction has been successfully treated.

Men who suffer from both PE and ED together, are more likely to have a root cause, which is psychological, not physical, but still, it’s important to rule out any underlying medical issue.

Explore medical issues that could cause both erectile dysfunction and premature ejaculation

There are a few comorbidities, such as diabetes mellitus, high blood pressure, high cholesterol, and smoking, that are linked to both issues. But, it could also be that you suffer from two medical issues, one causing ED, and the other one causing PE.

In the case of ED, if you typically experience morning erections and/or can achieve an erection while masturbating, it is very likely that the issue is psychological.

Treat ED first

If the cause of ED is psychological, it is usually best to address the underlying psychological issue itself.

1. Psychological ED

The leading psychological causes of erectile dysfunction are stress, performance anxiety, and depression.

What these have in common is their ability to block sexual arousal, thereby preventing an erection.

A very prominent therapeutic tool is mindfulness meditation-based therapy, which can assist men in addressing both performance anxiety, stress, and depression related to erectile dysfunction:

Performance anxiety – Mindfulness meditation can help you cultivate a non-judgmental awareness of your thoughts and feelings during sex. By practicing mindfulness, you’ll learn to develop a healthier relationship with performance-related thoughts, reducing anxiety and creating a more relaxed mental state during sex. This prevents performance anxiety from affecting your erection.

Stress – Mindfulness meditation is known for its stress-reducing benefits. Stress is a common factor contributing to erectile dysfunction, as it can lead to increased levels of cortisol and adrenaline, affecting blood flow and sexual function. Through mindfulness practices, you learn to manage stress by focusing on the present moment, which can positively impact physiological responses and reduce overall stress levels.

Depression – Depression and other mood disorders can contribute to erectile dysfunction. Mindfulness meditation emphasizes observing emotions without judgment. This can help individuals identify and regulate negative emotions, fostering a more balanced mental state. Improved emotional well-being may positively influence sexual function.

If the underlying causes for erectile dysfunction are more complex, sometimes it is best to consult with a certified therapist.

A sex therapist can offer a safe environment for open discussions, tailor treatment plans, address communication challenges, offer education, and incorporate behavioral techniques.

Sex therapists address both individual and relational aspects, promoting understanding, empathy, and improved sexual satisfaction. If needed, they can also refer you for medical evaluation.

2. Physiological ED

The most common physiological cause of ED is limited or restricted blood flow to the penis. While it’s always important to get a medical evaluation to explore possible causes, ED medications like Viagra, Cialis, and Levitra, which improve blood flow, could help.

Another factor to consider is the medications you’re taking. Certain medications, such as antidepressants and anti-anxiety medications, have a side effect of erectile dysfunction.

Unfortunately, anxiety and depression can both be causes of ED, making it a bit tricky to manage.  

If you’re taking medications and also experiencing erectile dysfunction, it’s important to consult your doctor. Sometimes, simply switching medications can resolve the issue.

To learn more about treatment options for physiological ED read this article: Erectile Dysfunction – Causes, Preventions and Treatments

Then treat PE

If, after treating ED, you’re still experiencing PE, there are a few treatments to consider.

The leading underlying cause for premature ejaculation is an insufficient awareness of the sexual signs and signals your body is sending you during sex. This could be caused by several reasons, but the result is the same.

If you’re not aware enough of how sexual arousal affects you during sex, you can’t pace yourself, bringing arousal levels down when you’re getting too excited.

It might feel like you’re getting too sexually excited too fast, and come to realize you’re very excited only when there’s nothing you can do about it.

1. Premature Ejaculation Exercises

Behavioral sex therapy exercises, such as the stop-start method, and the squeeze technique, can help you develop the needed awareness in a controlled environment, get to know the signs that lead to orgasm, learn how to lower your excitement levels, and develop your sexual stamina.

These exercises work as follows: You practice masturbation, and when you feel you’re approaching climax, you stop all sexual stimulation and pause until the urge to ejaculate diminishes. You can also use the squeeze technique and squeeze the penis glans firmly for about 30 seconds to reduce arousal.

During the exercises, you should pay special attention to the signals your body is sending you, and rate your arousal levels while orgasm is approaching.

These exercises help you become more aware of your arousal levels and allows you to gain control over the timing of ejaculation. By practicing stopping and starting, you can gradually build your stamina.

While this seems straightforward, for this method to yield results, you have to follow a structured treatment plan, with exercises with increasing levels of arousal.

That’s why we created the Between Us Clinic’s Premature Ejaculation Program – an online web app that trains you step-by-step to overcome premature ejaculation.

These exercises, which are included in the program, have been used by sex therapists for decades, and have been shown to be very effective in a number of studies.

2. Desensitizing Products

Another way to approach this problem is by using desensitizing products that you apply to your penis during sex. Instead of learning to control and withstand sexual arousal through exercises like the stop-start and squeeze techniques, you reduce stimulation by desensitizing your penis.

There are several products in this category, including sprays, gels, creams, wipes, and condoms. All work on the same idea; they include materials like lidocaine or prilocaine, which temporarily numb the penis.

While all of these products can be effective, the downside is that you’re not truly overcoming premature ejaculation. They also affect spontaneity since you have to apply them 10-20 minutes before sex to a non-erect penis, and they decrease your enjoyment of sex.

3. PE Medications

Medications from the SSRI group, designed to alleviate symptoms of depression, also come with a side effect of delaying ejaculation. Some doctors prescribe these to men with premature ejaculation to help them last longer in bed.

However, it’s important to note that these medications could also lead to erectile dysfunction. Therefore, for men experiencing both premature ejaculation and erectile dysfunction, finding the right medication and dosage can be complex.

In Europe, there is a specific medication created exclusively for premature ejaculation called Priligy, which has lower rates of sexual side effects. However, research suggests that approximately 90% of men stop using Priligy within 12 months for various reasons, indicating dissatisfaction with their experience.”


In conclusion, understanding the interplay between premature ejaculation and erectile dysfunction sheds light on the complexities men may face in their sexual health.

As we’ve explored the link between these two common dysfunctions, delved into potential causes, and discussed various treatment options, it’s clear that a holistic approach is crucial.

Remember, seeking professional guidance and understanding the unique aspects of your situation are key steps toward overcoming the challenges posed by PE and ED. By doing so, men can reclaim not only their sexual satisfaction but also their overall well-being.

About The Between Us Clinic

Sex Therapy Online Programs

The Between Us Clinic is an online sex therapy clinic that aims to help both men and women overcome a variety of sexual disorders by bringing the proven and trusted methods used in traditional, in-person sex therapy to a wide audience via the Internet.