Recent attempts to find effective pharmacological treatments for premature ejaculation (PE) have spurred significant interest in the causes of, consequences of, and existing therapies for this common male sexual dysfunction. The recurring tendency in science and medicine, however, to dichotomise causes of such problems into either biological or psychological is not only counterproductive, it is misguided. Ejaculatory response should be viewed as a system of integrated and inseparable hardwired and softwired central and peripheral responses, some being readily modifiable, others not. Such a view argues that treatment of PE aimed at multiple levels of functioning will be self-enhancing and ultimately more effective in producing positive therapeutic outcomes than strategies relying solely on either psychological or biological approaches.