Very severe premature ejaculation

Dear Ask The Doctor: In what instances can premature ejaculation be physical rather than physcological as i am a long term sufferer and nothing i have tried has worked for me.

Dear Dean: Most cases of premature ejaculation are due to pyshcological causes which include unrealistic expectations from sexual intercourse, anxiety and worry over the experience, other concomitant stressors in life. Rarely depression may contribute as an organic cause of premature ejaculation. Also substance abuse induced premature ejaculation may be a secondary cause of the same. I would advice you to see your family physician for a complete physical evaluation .