Premature ejaculation is the most common sexual concern in men, affecting a large share at some point in life — yet it’s also one of the most treatable, and one of the most under-discussed. Many men suffer in silence, assuming nothing can be done, when in fact a range of effective options exists. The first step is simply recognizing that it’s a legitimate medical issue, not a personal failing, and that real solutions are available.
Dr. Justin Houman is a board-certified urologist, Fellow of the American College of Surgeons, and Assistant Professor of Urology at Cedars-Sinai Medical Center, fellowship-trained in male reproductive and sexual medicine at UCLA. A member of the Sexual Medicine Society of North America, he treats ejaculatory concerns with the same rigor as any other medical condition — pinpointing the cause and tailoring a combination of proven approaches. His expertise in men’s sexual health has been featured in national media including Men’s Health and the New York Post.
I recommend Dr. Houman for any urology need whatsoever. No question he will handle and take care of you and will make you feel comfortable throughout the entire process. He and his staff are reachable and answer all of your questions and concerns. If you are looking for someone like that, look no further.
What Is Premature Ejaculation?
Premature ejaculation occurs when ejaculation happens sooner than a man or his partner would like, consistently enough to cause distress. An occasional episode is normal and not a concern; it becomes a diagnosable condition when it happens nearly all the time. It generally takes one of two forms: lifelong premature ejaculation, present from a man’s earliest sexual experiences, and acquired premature ejaculation, which develops after a period of normal function. Distinguishing between the two helps guide treatment.
What Causes Premature Ejaculation?
The exact cause isn’t fully understood, but it usually reflects a mix of psychological and biological factors:
- Psychological Factors: Performance anxiety, stress, and early sexual experiences can all contribute.
- Serotonin Levels: Brain serotonin influences ejaculatory timing, and lower levels are associated with quicker ejaculation.
- Heightened Sensitivity: Some men simply have greater penile sensitivity that shortens time to ejaculation.
- Related Conditions: Prostate inflammation, thyroid problems, or co-occurring erectile dysfunction can play a role.
Premature Ejaculation Treatment Options
Because the causes vary, the most effective plans often combine more than one approach:
Behavioral Techniques
The stop-start and squeeze methods help build control over time and often form the foundation of treatment.
Topical Anesthetics
Lidocaine or prilocaine sprays and creams reduce sensitivity to help delay ejaculation.
Oral Medications
Certain antidepressants (SSRIs) are commonly used off-label in the U.S. to delay ejaculation, as is tramadol in select cases.
Treating Co-Occurring ED
When erectile dysfunction is also present, addressing it with
Counseling and Sex Therapy
When anxiety or relationship factors contribute, professional support is highly effective.
Pelvic Floor Exercises
Strengthening these muscles can improve ejaculatory control for some men.
What to Expect: Evaluation
Effective treatment starts with understanding the cause. Dr. Houman conducts a thorough evaluation — a medical and sexual history, a physical exam, and, when appropriate, hormone testing or other studies to rule out contributing conditions. Because premature ejaculation often has more than one cause, this careful workup is what makes a genuinely tailored, effective plan possible rather than a one-size-fits-all fix.
Frequently Asked Questions About Premature Ejaculation
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It’s the most common male sexual concern, affecting a significant portion of men at some point — far more common than most men realize.
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It’s generally defined as consistently ejaculating sooner than desired, often within about a minute or two of penetration, in a way that causes distress.
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Usually both — psychological factors like anxiety and biological factors like serotonin levels and sensitivity often work together, which is why treatment is frequently multi-pronged.
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For many men, a combination of behavioral techniques and medication works best, tailored to the underlying cause.
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In the U.S., the antidepressants used to delay ejaculation are prescribed off-label, which Dr. Houman explains as part of your treatment discussion.
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Yes — the large majority of men see meaningful improvement and gain better control once the underlying cause is identified and addressed.
Why Choose Dr. Houman for Premature Ejaculation Treatment in Los Angeles
- Root-Cause Evaluation: Treatment guided by the actual cause, not guesswork.
- Full Range of Options: Behavioral, medical, and combination approaches tailored to you.
- Discreet, Judgment-Free Care: A comfortable space for a sensitive and common concern.
- Sexual Medicine Expertise: Fellowship-trained care focused on men’s sexual health.
Meet Dr. Houman
Expert in Men’s Health with Tower Urology and Cedars Sinai
Dr. Justin Houman, MD, FACS is a board-certified urologist and fellowship-trained microsurgeon at Tower Urology, Cedars-Sinai Medical Center in Los Angeles. His subspecialty training in male reproductive medicine and microsurgery is held by fewer than 2% of practicing urologists in the United States.
His clinical focus is narrow by design. Varicoceles, chronic testicular pain, male infertility, vasectomy, testosterone optimization, erectile dysfunction, penile implant surgery, and Peyronie’s disease are not add-on services here. They are the practice. Patients travel from across the country and internationally for procedures, particularly microsurgical varicocelectomy, spermatic cord denervation, and inflatable penile implant surgery, that require a level of subspecialty training and surgical volume most urology practices do not have.
Premature Ejaculation Treatment in Los Angeles
Premature ejaculation can chip away at confidence and intimacy, but it’s common, treatable, and nothing to be embarrassed about. Dr. Houman offers discreet, effective, individualized care for men across Los Angeles and Southern California, focused on lasting improvement rather than quick fixes. Contact the Los Angeles office to schedule a private consultation and take the first step toward better control.
