For some time now I have been convinced that a major cause of pe is pelvic floor imbalance.
This causes involantary kegel type spasms, leading to orgasm/ejaculation.
Guys with natural good pelvic floor balance talk, of sexual endurance as a decision, an act of will. Whereas guys with pe, describe a runaway train .
If the pelvic floor is in tune, the sex process happens in a controlled way, leading to the ability to have sexual relations for the desired length of time. In pe, an imbalance causes uncontrolled contractions ,which rush ejaculation.
I have long thought there is also a link to Delayed ejaculation (de). It has struck me ,that in this case, the contraction acts in a different way. Instead of a series of short contractions, a long contraction is produced, this contraction prevents ejaculation/orgasm. This long contraction ,is similar to the hold used during mmo ,except that as it has been held before orgasm is approached, it prevents orgasm as well as ejaculation.
If I am correct, then this is a big step forward, not only in understanding but also in treatment.
Reverse kegels seem to rebalance the pelvic floor in the case of pe, I believe they will also be very helpfull in many cases of de.
I am well aware there are many factors in both pe and de; mental and physical. However this appears to be a major physical factor, overcoming it is big step forward.