The cause of PE is not known as the condition is often self-defined by the individual affected. One cause can be low levels of the chemical serotonin in the brain. For men affected, stress, anxiety and depression can make the condition worse which is often the case then experiencing this condition. Men often experience lack of confidence, relationship problems and negative feelings about sex further aggravating the condition. Other causes include abnormal hormone levels, conditions of the prostate, bladder, infections and conditions of the penis such as Erectile dysfunction.