Premature ejaculation means ejaculation within few seconds of sexual intercourse, which interferes with sexual satisfaction of both partners; leading to physical, emotional and psychological problems.

Proper assessment and management of premature ejaculation requires detecting the causative factors; so we will highlight the most important causes of premature ejaculation.

1. Excessive masturbation: it's the most common cause of premature ejaculation. Doctors pointed out that addiction of masturbation (especially before marriage) contributes to acceleration of ejaculation during sexual intercourse after marriage.
2. Direct trauma to the spinal cord or spine (especially coccygeal portion responsible for mechanism of ejaculation) as well as tumors and hematomas in these regions: these injuries induce frequent sexual arousal leading to premature ejaculation.
3. Multiple sclerosis: it's a neuromuscular disease affects peripheral nerves and muscles of the extremities. With disease progression, the damage extends to spinal cord leading to disturbance in the mechanism of ejaculation as well as premature ejaculation.
4. Diabetes mellitus: premature ejaculation is one of the most common complications in diabetic patients, which occur due to peripheral neuritis.
5. Marital discords: psychological studies have been pointed out that marital problems could lead to premature ejaculation; as sexual relationship in such cases is imposed and free of pleasure, which urges the husband to finish it quickly.
6. Fear of losing erection during intercourse: this feeling drives the husband to finish quickly to avoid losing erection.
7. Drug abuse: it causes defect in the nervous excitement, which has a negative effect on the mechanism of ejaculation and causes premature ejaculation.
8. Emotional stress; whether associated with family, work or any other issue.
9. Frequent exposure to chemicals and heavy metals (lead, mercury and cadmium).