PE can be caused by some psychological factors such as stress, depression, relationship issues or performance-related anxiety. It may also be due to physical causes, such as diabetes, high blood pressure, thyroid problems or prostate disease. Most common treatment options for PE include behavioral techniques, topical anesthetics, medications, and counseling. Keep in mind that it might take time to find the treatment or combination of treatments that will work for you. Behavioral treatment plus drug therapy might be the most effective course.