Although there is rarely a physical cause, occasionally there exists unusual nerve sensitivity around the opening of the penile glands and frenulum which can lead to premature ejaculation. Some infections of the urethra and prostate, neglected gonorrhea and an overly tight uncircumcised foreskin have also been seen as possible causes of premature ejaculation. More commonly the man has not learned to pay attention to the sensory feedback that signals ejaculation. He has essentially taught himself to not pay attention to erotic sensation. Often men, in an effort to prolong the duration of intercourse, will distract themselves during sexual interaction. One man told me that he usually thinks of mathematics during intercourse. His belief was that if he thought about what was happening he would not "last." As we will see in the chapter on therapy, this is the exact opposite of what needs to occur. Another possible cause is conditioning. Men often train themselves to ejaculate as soon as possible for fear of being discovered. One man spoke of his adolescent masturbatory practices as follows:

I used to time myself in the bathroom when I was a kid. If I took too long people would know I was jacking off so I would limit myself to two minutes. (personal files)

The man in the above story had taught himself to ejaculate quickly. This learning did not go away simply because he no longer worried about getting caught. He had conditioned himself to not pay attention to his sensory feedback while learning how to ejaculate "as soon as possible."

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