The exact cause of premature ejaculation is not always known, but it is likely a combination of physical and psychological factors. Some possible causes include:Psychological factors such as anxiety, depression, stress, relationship problems, guilt, performance anxiety, and unrealistic expectations about sex can all contribute to PE.Biological factors such as Certain medical conditions, such as hormonal imbalances, thyroid problems, and nerve problems, can also play a role.Lifestyle factors such as alcohol use, smoking and drug use can all increase the risk of PE.