There are a number of potential causes for premature ejaculation, but before we get into that, we first need to define "premature ejaculation". While this may seem simple, there are actually four different types of PE: lifelong PE, acquired PE, subjective PE, and variable PE.

Lifelong PE: caused by a biological functional disturbance. Ejaculation occurs in less than 1 minute of penile stimulation.

Acquired PE: medical, psychological, or interpersonal causes. Ejaculation occurs in less than 3 minutes of penile stimulation.

Variable PE: normal variant of sexual functions... the occasional premature ejaculation that happens to all men.

Subjective PE: caused by cultural or abnormal psychological constructs; people who are unhappy with their stamina.

The type of premature ejaculation we care about for the purpose of this guide is Acquired Premature Ejaculation. A large percentage of men will naturally experience this in their lives for a short period of time, and it's usually brought on by an unfortunate set of biological and/or social circumstances. For example, a man may have a quick orgasm during sex at some point, and their partner may shame or humiliate them for it. The use of condoms can introduce biological factors such as sexual frustration or penile sensitization. A man's partner may have unrealistic stamina expectations, causing him severe performance anxiety. The combinations that can cause someone to acquire PE are truly numerous.

Of the many ways to acquire PE, every case of Acquired PE is caused by some combination of physical and psychological factors. Before we discuss physical and psychological factors in detail, we should first understand the role of each root cause and how they work together to cause PE. For men, their overall arousal is caused by the sum of physical and emotional arousal. Since an orgasm occurs once their overall arousal exceeds a certain threshold, then it becomes clear that manipulating one's physical or emotional arousal can alter how the time it takes for someone to achieve an orgasm.

Now that we know the underlying factors that cause an orgasm, we also know what we should focus on. If we want someone to take longer to ejaculate, then we simply try to desensitize them to physical and psychological triggers. Alternatively, if we want someone to take less time to ejaculate, then try to sensitize them to physical and psychological triggers. One question remains though: how can distress over potentially cumming too quickly cause someone to actually cum too quickly? It turns out that Pavlovian Conditioning is to blame.

When a man has an orgasm, what he's doing immediately prior to that orgasm becomes associated with the orgasm itself. If, in the moments prior to several orgasms, a man is anxious that he will cum too soon, that anxiety will become a trigger for his emotional arousal for future orgasms. In short, his concern that he can't hold back will actually become a cause of his future orgasms.

On the physical side of things, physical stimulation and fluid buildup are the main contributors for physical arousal. Things that desensitize his penis, such as condoms or numbing agents, will slowly condition him to orgasm with less and less physical stimulation. Eventually, his psychological arousal will be the main driver of his orgasms. Errant sexual thoughts can cause him to spontaneously approach orgasm. If not "drained" every other day, one of these thoughts will eventually cause him to have a sudden and unwanted ruined orgasm at some point.

Now that we know how someone can acquire premature ejaculation, we can leverage this information to create a simple regime that is guaranteed to cause stamina issues.