Can hypogonadism (low testosterone) cause premature ejaculation?

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Last updated: April 18, 2025 • View editorial policy

From the Research

Low testosterone is not typically a direct cause of premature ejaculation (PE), and treating it alone may not resolve the issue if other underlying causes exist. PE is more commonly associated with psychological factors (anxiety, stress, relationship issues), neurobiological factors, or hypersensitivity of the penis. While testosterone plays an important role in male sexual function, its deficiency is more strongly linked to reduced libido, erectile dysfunction, and delayed ejaculation rather than premature ejaculation, as noted in a study published in Maturitas in 2018 1. Some men with low testosterone may experience PE, but this is likely due to associated psychological stress or compensatory behaviors rather than the hormone deficiency itself.

Effective treatments for premature ejaculation include:

  • Behavioral techniques (stop-start method, squeeze technique)
  • Topical anesthetics (lidocaine sprays or creams)
  • Selective serotonin reuptake inhibitors (SSRIs) like dapoxetine (30-60mg taken 1-3 hours before intercourse), which have been shown to improve symptoms of PE in a study published in The Cochrane database of systematic reviews in 2021 2
  • Counseling

It's essential to consult with a healthcare provider for proper diagnosis, as a comprehensive approach addressing both physical and psychological factors typically yields the best results for managing premature ejaculation. Other studies have also explored the use of SSRIs in combination with other treatments, such as phosphodiesterase-5 inhibitors, for the treatment of PE, as seen in a study published in Andrologia in 2015 3. Additionally, a study published in Andrologia in 2020 compared the safety and efficacy of different SSRIs and found that sertraline (100 mg, on-demand) had a similar efficacy to daily sertraline and was more effective than sertraline (50 mg, on-demand) and dapoxetine (30 mg, on-demand) 4.

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