Dealing with premature ejaculation? You're not alone. Approximately 20 to 30 percent of men experience premature ejaculation, according to a study published in July 2016 in Drug Discovery Today. And this often embarrassing sexual issue can affect men of any age.

“Premature ejaculation is more common than most people think,” says Andrew C. Kramer, MD, a urologist and associate professor of surgery at the University of Maryland School of Medicine in Baltimore. “It can cause distress and emotional and psychological issues as well as self-esteem problems.”

As hard as it might be to address the problem with your partner or even your doctor, talking about premature ejaculation is the key to overcoming it. Read on to learn exactly what premature ejactulation is, and how you can treat it.

What Is Premature Ejaculation?

In the simplest terms, premature ejaculation occurs when a man does not have control over ejaculation, and as a result, he and his partner are not sexually satisfied, says Dr. Kramer. Premature ejaculation can happen in as little as 30 seconds to a minute, and may even occur before penetration. Contrary to the unrealistic depictions seen in pornographic films, the average time it takes before a man ejaculates during intercourse is about four to five minutes, says Kramer.

Premature ejaculation may occur alongside erectile dysfunction (ED), but not always. “ED can happen to men of all ages, but in younger men, the issue is usually premature ejaculation,” says Kramer. “For men in their sixties and seventies, there is usually some degree of ED. Sometimes the [penis] just ejaculates when it’s flaccid.”

What Causes Premature Ejaculation?

The exact cause of premature ejaculation is unknown, but it's often rooted in physical, psychological, or emotional issues. “A lot of it is psychological,” explains Kramer. “When working with a patient, I may ask, ‘Are you comfortable with your partner? Or do you feel anxious around your partner?’”

Anxiety, as well as other emotional and psychological factors such as stress or depression, can also contribute to premature ejaculation.

How Can Premature Ejaculation Be Treated?

Doctors often recommend counseling to treat premature ejaculation. That may include psychotherapy, as well as learning ways to communicate with your partner about sexual dysfunction.

Another effective strategy is to work with your partner or through masturbation to train your body to delay ejaculation, says Kramer. “You get to the point where you are going to ejaculate and then stop and think about sports or something else to cool down,” he explains. “This will help you train your body to master that response when you are with your partner.”

Other treatment options for premature ejaculation include medications used to treat depression, such as Paxil (paroxetine), Zoloft (sertraline), and Prozac (fluoxetine), notes Kramer. Another option is to use numbing creams such as lidocaine or Emla (lidocaine and prilocaine) directly on the genitals to help control premature ejaculation.

These therapies may be used together in different combinations to treat premature ejaculation, and in turn improve your self-esteem and sex life.