Does low testosterone cause premature ejaculation?

A quick look at the causes of premature ejaculation and why low testosterone isn’t one of them

Causes of premature ejaculation

Doctors define premature ejaculation as a male orgasm that involuntarily occurs within the first minute of sexual intercourse. In plain terms this means that if you frequently can’t help coming right after you’d just started sex you are suffering from premature ejaculation. This is not a health problems and won’t stop you from producing offspring, but many men find it psychologically distressing, in particular as they are afraid of leaving their partners sexually unsatisfied.   

For reference, normal sexual intercourse on average lasts about 5 minutes. So, if you are wondering why you can’t last 20 minutes, this article isn’t relevant to you. Premature ejaculation strictly refers to orgasms that happen in under 1-2 minutes, and involuntarily so. It’s a common problem that affects up to 30 percent of men — mostly men younger than 40, but it can be a lifelong condition for some. 

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Science still owes us an answer to what precisely causes premature ejaculation. In young men, who are new to sex, it can be a combination of high sexual sensitivity and performance anxiety (often fueled by unrealistic expectations they got from watching porn). The condition often goes away by itself as the men get more mature. 

In older men and if it’s a chronic lifelong conditions, premature ejaculation often correlates with abnormally low serotonin levels. Serotonin is a neurotransmitter, i.e., it delivers information between brain cells. As such, this serotonin messaging impacts your emotional mood and mental health. People whose serotonin levels are too low, suffer from depression, anxiety and other psychological problems. If they are men, they also are more likely to experience premature ejaculation. 

There also is some evidence that increased thyroid hormone production (hyperthyroidism) can trigger or worsen premature ejaculation. Male patients with hyperthyroidism that were successfully treated showed an improvement in ejaculation control. Ask your doctor whether it would be sensible to have your thyroid hormone levels tested.

Another school of thought though holds that premature ejaculation may just be a natural condition for a big share of the male population, as it neither impacts a man’s physical health nor his procreation abilities. It’s not a genetic deficit or illness in the eyes of evolution. This view is supported by the fact how widespread premature ejaculation is and that it appears to be a genetically inheritable condition. However, more research is required to substantiate this view.      


Does low testosterone cause premature ejaculation?

In short, no. To the contrary, studies show that men with premature ejaculation issues tend to have higher testosterone levels than control groups. By the same token, men with lower testosterone levels are more likely to suffer from erectile dysfunction (especially when they are older than 40 years of age). 

If you experience premature ejaculation and are looking for treatment, there are many options, ranging from simple exercises to prescription drugs such as sertraline. Your doctor will help you to identify the underlying causes and choose suitable treatment options. 



  1. El-Hamd, Mohammed Abu, et al. “Premature Ejaculation: An Update on Definition and Pathophysiology.” Asian Journal of Andrology, vol. 21, no. 5, 2019, pp. 425–432,, Accessed 8 Jan. 2020.
  2. Corona, Giovanni, et al. “Different Testosterone Levels Are Associated with Ejaculatory Dysfunction.” The Journal of Sexual Medicine, vol. 5, no. 8, Aug. 2008, pp. 1991–1998, Accessed 8 Jan. 2020.
  3. Alizadeh, Farshid, et al. “Serum Testosterone and Gonadotropins Levels in Patients with Premature Ejaculation: A Comparison with Normal Men.” Advanced Biomedical Research, vol. 3, no. 1, 2014, p. 6,, Accessed 8 Jan. 2020.

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