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How are Premature Ejaculation and Erectile Dysfunction Related?

Can Viagra Play a Role in Treating Both

Disclaimer: Your healthcare provider is the best source of health and medical information. Articles written by UPGUYS are informed by peer-reviewed studies and research, as well as governmental health authorities and agencies — but they cannot replace advice from a healthcare professional. Talk to your healthcare provider about any physical or mental health concerns you might have.

Erectile dysfunction and premature ejaculation are the two most common sexual performance issues men face. The oft-cited Massachusetts Male Aging Study found that more than half (52 percent) of men experienced some form of erectile dysfunction — be it mild, moderate or complete. With respect to premature ejaculation, the European Association of Urology asserts that between 20–30 percent of men report having issues with ejaculatory control.

Given their relatively high prevalence, it would stand to reason that some men experience both. Research has shown that common psychological conditions like anxiety and depression play an important role in ED; anxiety is also commonly hypothesized to be closely associated with PE.

So then what is the relationship between the two?

Same but different

A cursory glance at the literature regarding both conditions will draw out some obvious similarities. Both PE and ED pertain to men’s sexual health, potentially causing deleterious impacts to men’s sex lives and overall wellbeing.

A study of more than 2400 Spanish men that measured patients’ erectile function and health-related quality of life found those who experienced ED reported a lower overall quality of life. For its part, premature ejaculation has been associated with a range of negative psychological effects from anxiety and depression, to creating stress between men and their sexual partners. Suffice to say that no matter the differences between these two common conditions, their impacts are ultimately quite similar.


There are appreciable differences between the two of course. Erectile dysfunction is commonly defined as an inability to achieve and maintain an erection sufficient for sexual activity. Put simply, ED is caused by a lack of blood flow to the penis essential for getting a firm erection, and satisfactorily maintaining the erection.

A universally accepted definition of premature ejaculation can be harder to come by. Broadly, PE occurs when a man ejaculates quicker than he or his partner would like or expect. In other words, it’s not necessarily the quality of erection at issue. Rather, premature ejaculation focuses on a separate sexual complaint all together.

Same but Same

Those who might overemphasize the differences between premature ejaculation and erectile dysfunction risk missing the forest for the trees. A 2015 review and meta-analysis of 18 studies comprising 57,229 male patients looked at the interplay of ED and PE.

No matter how premature ejaculation was defined, the study found that the presence of PE was associated with a significant increase in the risk of developing ED. It also showed that subjects with both PE and ED more often reported symptoms related to anxiety and depression. But perhaps most importantly, the study’s authors, while acknowledging that ED and PE are not completely discrete, encourage health care professionals to consider both issues separately with regard to treatment.

Medical Treatment Options

Medical professionals around the world heed the recommendation of the aforementioned 2015 review and meta-analysis. Treatment for premature ejaculation is based primarily on reducing sensations that lead to climaxing. Among medical treatments promoted by the European Association of Urology are SSRI antidepressants, local anesthetics and analgesics (in the form of oral tablets, topical creams or sprays) and PDE5 inhibitors like sildenafil — better known by its brand name Viagra.

Serotonin (the second ‘S’ in SSRI) is involved in ejaculatory control and has been shown to slow ejaculatory response. While the mechanism of action is not completely understood, thanks to countless studies in both animals and humans, many scholars conclude that there is little doubt that SSRIs are effective in the treatment of PE.

Topical anesthetics containing lidocaine/prilocaine have also been shown to delay ejaculation. One review of eight clinical trials found that the use of creams and sprays that serve to desensitize the glans of the penis produced significantly better results in treating PE than placebo. They also come with fewer side-effects than SSRIs.

PDE5 inhibitors like sildenafil (Viagra), tadalafil (Cialis) and vardenafil (Levitra) are used in treating both premature ejaculation and erectile dysfunction — but to different ends. In the treatment of erectile dysfunction, these drugs create a mechanism of action whereby smooth muscles in the penis are relaxed, increasing blood flow to the penis and allowing users to achieve and maintain firmer erections.

In the treatment of PE however, sildenafil hasn’t been shown to actually decrease the time it takes to ejaculate. But what it does show — according to one eight-week, double-blind, placebo controlled study — is sildenafil increases confidence and the perception of ejaculatory control, leading to improvements in overall sexual satisfaction.

Non-medical treatment options

Given the potential of psychological conditions contributing to both PE and ED, therapy can sometimes play a role in non-medical treatment options. There are also ways for men to “practice” controlling their orgasms (known as the stop-start method) and improving erectile function by reducing external stressors. What’s more, improvements in diet, frequency of exercise, and reducing tobacco and alcohol have all been shown to support men’s sexual health.

Both medical and non-medical treatments can play a role in improving common sexual issues like premature ejactulation and erectile dysfunction. Ultimately, your doctor or pharmacist are the best resources for understanding all your options and choose those that are best for your particular needs. If getting to see a doctor or pharmacist in person is burdensome, online pharmacies can help fill the gap.

While there is certainly overlap between PE and ED, both require treatments tailored to each specific condition. What both have in common however, is the ability to be effectively treated.



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