The word “premature” has always bothered me.

Not because it’s inaccurate, exactly. But because of what it implies. Premature means before the right time. It carries a verdict. It tells someone that their body arrived before it was supposed to, that it did something wrong, that they did something wrong.

And when someone is already sitting with shame about sex — research shows that premature ejaculation affects at least 1 in 3 men — the last thing a label should do is confirm their worst fear about themselves.

So I stopped using it.

In my practice, and in all of my work at GETSOME, I use the term early ejaculation instead. This isn’t just a semantic preference. It’s a clinical one. And if you’ve ever Googled “premature ejaculation” at midnight wondering what’s wrong with you, I want to explain why this shift matters for you specifically.

“Premature” is a judgment. “Early” is a description.

Here’s the counterintuitive part: the word you use to describe a pattern can actually influence how that pattern plays out.

Shame activates the nervous system. When the nervous system is activated, the body responds. And early ejaculation, in most cases, is a nervous system pattern — not a flaw in your character, not evidence of weakness, not something irreparably broken.

Translation: the label “premature” isn’t just unhelpful. It can be part of what keeps the pattern going.

When I work with people in my practice, I watch this happen in real time. Someone comes in already braced for judgment — for a clinician to confirm the story they’ve been telling themselves for years. The moment the conversation shifts from “fixing a dysfunction” to “understanding a pattern,” something visibly changes. The nervous system softens. Curiosity replaces shame. And from curiosity, actual change becomes possible.

This is the core of the unshaming approach: you cannot address a pattern that you’re too ashamed to look at clearly.

Why “early” works better

“Early” is simply descriptive. It doesn’t assign blame or suggest a verdict about your worth as a partner or a person. It says: ejaculation happened earlier than you wanted it to. That’s the whole thing. That’s all it is.

It’s also more accurate to the nervous system framework. This isn’t about a body that failed. It’s about a nervous system that learned a particular pattern, usually in conditions of anxiety, urgency, or shame. Patterns can be understood. Patterns can shift.

“Premature” forecloses the conversation before it starts. “Early” opens it.

You didn’t choose the word you inherited. You were handed it by a medical system that, frankly, wasn’t thinking hard enough about what shame does to people or to the body. That’s not a failure on your part. It’s a gap in the field. It’s also why I wrote Coming Soon: The Unshaming Guide to Early Ejaculation and Lasting Longer — because the last go-to self-help resource in my field was published over 20 years ago.

Who benefits from this language shift

Everyone, actually. But I want to name a few groups specifically.

Partners. When the framing is “premature ejaculation,” it often creates a silent question for partners: was I not exciting enough? Was I too much? The word implies that something external caused the timing. “Early ejaculation” reframes it clearly as a nervous system pattern that belongs to no one and blames no one.

People in queer relationships. The medical language around PE was built on a very specific model of sex. It assumes heterosexuality, penetration, and a finish line. “Early ejaculation” is more flexible language for bodies and relationships that don’t fit that model.

Anyone who’s been carrying this alone. The 2am Googlers. The people who’ve avoided intimacy rather than risk the conversation. If the word you’ve been using to describe your experience carries shame in its syllables, you deserve a different word.

You’re not broken. You’re human. And your body has been doing exactly what nervous systems do under pressure.

“This is a much needed modernized book on premature ejaculation… The focus is on comfort and pleasure, not performance.”
— Barry McCarthy, PhD, professor emeritus of psychology, American University; author, Rekindling Desire

The bottom line?

Language is not just semantics. It’s the environment your nervous system lives in.

Choosing to say “early ejaculation” over “premature ejaculation” is a small act of unshaming. It won’t solve everything on its own. But it’s where the work starts: with a word that describes rather than judges, that opens rather than closes, that treats your body as something to understand rather than something to fix.

If this resonates, the book goes considerably deeper into all of it. Early ejaculation as a nervous system pattern, the role shame plays in keeping patterns in place, practical approaches that don’t require numbing yourself or outsmarting your body, and how partners can be part of the conversation instead of left outside it.

Get your copy at comingsoonbook.ca.

Michelle Fischler, MSW, RSW, RP, is an ASTO-certified sex therapist and supervisor based in Toronto. She is the founder of GETSOME INC. and the author of Coming Soon: The Unshaming Guide to Early Ejaculation and Lasting Longer.

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Frequently Asked Questions

What is the difference between premature ejaculation and early ejaculation?

They describe the same experience — ejaculation that happens sooner than a person wants it to — but the language carries different weight. “Premature” implies a verdict or a failure. “Early” is simply descriptive. Certified sex therapist Michelle Fischler uses “early ejaculation” in her clinical practice because shame-free language is part of the unshaming approach to treating this pattern.

What is the unshaming approach to premature ejaculation?

Rooted in David Bedrick’s unshaming framework, this approach is applied to early ejaculation by Michelle Fischler, ASTO-Certified Sex Therapist and founder of GETSOME. The premise is that early ejaculation is a nervous system pattern, and shame activates the nervous system. If the shame piece is not addressed first, technique-based interventions have limited lasting effect. This framework is the foundation of Coming Soon: The Unshaming Guide to Early Ejaculation and Lasting Longer.

Does changing the word you use actually help with early ejaculation?

Language shapes the environment your nervous system operates in. When shame is part of the frame — and the word “premature” carries a verdict — the body responds accordingly. Adopting language that is descriptive rather than judgmental is not a cure, but it creates the conditions in which genuine change becomes more possible. It is the first step in the unshaming approach.

Is early ejaculation a psychological or physical issue?

Most often, it is both — and the distinction matters less than how you approach it. Early ejaculation is understood in Michelle Fischler’s framework as a nervous system pattern shaped by anxiety, urgency, and frequently, shame. Addressing the emotional and physiological layers together produces more lasting results than targeting one without the other.

When should someone seek help for early ejaculation?

If early ejaculation is causing distress, affecting your relationship, or significantly impacting your quality of life, speaking with a certified sex therapist is a good starting point. For persistent or medically complex presentations, a conversation with your physician is also appropriate. You do not need to be experiencing a crisis to deserve support.

This content provides educational information and is not a substitute for professional medical or therapeutic advice. If you have concerns about your sexual health, please consult a qualified healthcare provider.