Premature ejaculation

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician. Same symptoms don't mean you have the same problem.

Therapy Type	Description	Typical Duration	Success Rate	Noted Benefits	Noted Drawbacks
SSRI Medications	Selective serotonin reuptake inhibitors, delay ejaculation	4-12 weeks	70%	Long-term control	Possible side effects
Behavioral Therapy	Techniques like start-stop and squeeze method	Several sessions	60-80%	No medication needed	Requires patient commitment
Topical Anesthetics	Numbing creams or sprays applied to glans penis	As needed	65-75%	Fast onset	Reduced sensation, partner sensitivity
Pelvic Floor Exercises	Exercises to strengthen pubococcygeus muscles	6-12 weeks	50-65%	Improves control	Time-consuming

Which fast-acting medicine can be taken for premature ejaculation before sex? What are the drugs of choice for social anxiety?

Selective Serotonin Reuptake Inhibitors

If you've been experiencing the inability to control ejaculation during sex for more than six months, you should talk to your primary care physician about premature ejaculation. You can expect your doctor to ask you many detailed questions about your medical and sexual history to help diagnose premature ejaculation. Be expected to answer questions about your: Feelings of anger or frustration caused by the premature ejaculation. Your answers may tell the doctor whether a medication change or lifestyle habit could be contributing to your condition. If your doctor suspects that your condition has a medical cause, they may order lab tests to uncover the cause.

Basic questions to ask your doctor

Depending on your conversation with your doctor, they should be able to diagnose the condition and discuss personalized treatment options. While there is no cure for premature ejaculation, there are many treatment options available today that can make the condition manageable. Success rates for treatment are high, but it is common to relapse at some point. Typically, this condition gets better over time with age and experience. Lifestyle changes, counseling, different therapy methods, and medication may be useful depending on the causes of your issue.

Biological causes

Several lifestyle changes may help with premature ejaculation, including: Your doctor or a therapist can recommend several behavioral therapy techniques, such as: Start-and-stop technique pills for womens libido — This method involves engaging in sexual activity until the feeling of ejaculating begins, then stopping all sexual activity and using a distraction method. When the feeling to ejaculate dissipates, resume sexual activity. This method helps train the body to delay ejaculation naturally and is most successful when done consistently. The squeeze method — This method involves engaging in sexual activity, then grasping the head of the penis and lightly squeezing it when the feeling of ejaculation begins. This motion usually ends an erection fast. Taking medicines, but I do not feel completely good.

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I have premature ejaculation after getting circumcised.

Additional information

Once the feeling of ejaculating dissipates, you may resume sexual activity. This method also helps train the body to delay ejaculation and has a high success rate at first. After a few years if not resolved, the success rate of this method drops significantly. Individual or couples counseling can help you and your partner learn to use different techniques to delay ejaculation. A sex counselor or doctor may recommend trying different positions and communicating with your partner leading up to an orgasm to slow or stop stimulation.

American Urological Association and Sexual Medicine Society of North America

Counseling can also aid you in reducing symptoms of stress, anxiety, or depression, along with stress directly caused by premature ejaculation. These therapy methods may offer different approaches to combat the issue, including: Creating a safe environment to discuss relationship and personal issues. Empowering the person to confidently make changes for their sexual health. While there is no medication specifically designed to treat premature ejaculation, some antidepressants and other medicines can prevent or slow an orgasm, which helps combat premature ejaculation. Your doctor may prescribe one of these medications and provide guidance on how to use it: Topical anesthetics — These come in spray, cream gel, and wipe form and are applied to the tip and shaft of the penis before sexual activity.

Topical Treatments for Premature Ejaculation

These topical solutions can reduce sexual pleasure for both partners — a condom can be used to help reduce impact on a partner’s experience. SSRIs: These antidepressant medications are taken daily and delay ejaculation by affecting the serotonin transporter. Because symptoms may return if you cease medication, many men use SSRIs indefinitely. Other antidepressants and pain medications — Doctors may prescribe other medications such as tramadol, dapoxetine, clomipramine, nonselective beta-adrenergic blockers, or alpha-adrenergic blockers to help delay ejaculation. Wearing a condom can also help dull the sensation and may improve sexual function. Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician.

Further reading

Lack of confidence/poor body image — Low self-esteem and anxiety. Mental health issues — Anxiety, depression, guilt, and stress. Relationship problems — Interpersonal issues between you and your partner. Sexual repression — Negative feelings about sex, often linked with feelings of guilt or shame. Your risk of premature ejaculation may increase if you have: A medical condition that contributes to premature ejaculation.

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Since premature ejaculation is primarily a psychological condition, therapy can help prevent it. The therapy programs that have the most success preventing and treating premature ejaculation are: Behavioral therapy — Can help educate and train someone to delay ejaculation. Muscle rehabilitation therapy — Retrains the muscles to delay premature ejaculation and help extend sexual pleasure. Pharmacological therapy — Topical anesthetics, SSRIs, and other medications to help delay ejaculation. Physical therapy — Helps minimize and prevent premature ejaculation.

Vardenafil (Levitra®) for PE

Combining different therapy methods has proven successful in addressing the condition from different perspectives. Premature ejaculation is primarily indicated by uncontrolled ejaculation that happens within one to three minutes of penetration or after little sexual stimulation. Other signs that premature ejaculation is a chronic condition include: Avoiding sexual intimacy for fear of ejaculating early. Inability to delay or control ejaculation during sex most of the time. Feelings of anger, depression, frustration, guilt, or shame. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis.

• Dapoxetine's side effects can include nausea, headache, and dizziness.
• Topical anesthetics include lidocaine and prilocaine-based creams or sprays.
• SSRIs like fluoxetine, sertraline, may also be used off-label for PE.
• Opioid medications require careful medical oversight due to dependency potential.
• Behavioral approaches are first-line treatment for many men with PE.
• Regular exercise can improve overall sexual function and control.
• Some innovations include vibration devices to delay ejaculation temporarily.
• Medical tests may be recommended to exclude underlying causes.
• Education about sexual response stages can improve control strategies.
• Sex therapy often involves both partners to address relational issues.
• Medications may take several weeks to show maximum benefit.
• Lifestyle modifications, like reducing alcohol, can also help manage PE.

Do not delay or disregard seeking professional medical advice because of something you have read on this website.

Drug Name	Approval Year	Primary Use	Recommended Dosage	Prescription Needed	Monitor Required	Typical Side Effects
Dapoxetine	2009	Premature ejaculation	30 mg before sex	Yes	Yes	Nausea, dizziness
Paroxetine	Approved for other uses, off-label for PE	20 mg/day	Yes	Yes	Yes	Fatigue, sexual dysfunction
Sertraline	Approved for depression, off-label for PE	50 mg/day	Yes	Yes	Yes	Insomnia, digestive issues

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When to seek medical attention

Many factors may contribute to the inability to control ejaculation, including health conditions, substance use, and mental health conditions. Treatment is most successful when using a multimodal approach that incorporates different types of therapy. Premature ejaculation is when you ejaculate earlier than you or your partner would like, generally before or just after sexual penetration. Ejaculation earlier than planned commonly happens during sex but can become a chronic condition that needs treatment if it happens for more than six months and causes psychological distress. Premature ejaculation happens when there is limited sexual stimulation, and it often results in unsatisfactory sex for both partners.

On average, how long does a man last?

This, in turn, can lead to anxiety or negatively affect your relationship. Premature ejaculation is one of the most common types of sexual dysfunction. Most men have experienced it, and about 1 in 3 men will have problems with premature ejaculation at some point in their lives. Even though premature ejaculation is common, many men are too embarrassed or ashamed to talk about the condition with their doctors. Doctors haven't pinpointed the exact causes of premature ejaculation.

Behavioral techniques

However, feelings of anxiety, depression, guilt, or stress can make it worse. This condition is most often thought to be psychological, although it may involve a mix of psychological and medical factors. Some biological and medical factors that can contribute to premature ejaculation include: Age — Being younger and having less sexual experience can cause premature ejaculation or being older and experiencing physical changes to erections. Concern over sexual performance — Nervousness of performance or being with a new person. Interpersonal issues — Such as hostility against women, self-loathing, lack of confidence, or personal history of sexual abuse. Premature ejaculation (PE) is defined as a male sexual dysfunction characterized by ejaculation that occurs prior to or within about one minute of vaginal penetration, an inability to delay ejaculation during vaginal intercourse, and negative personal consequences such as distress or avoidance of sexual intimacy.

Side Effect	Medication Type	Incidence Rate	Severity Level	Management Strategies	Notes
Nausea	SSRIs, topical anesthetics	10-15%	Mild to Moderate	Dose adjustment, timing	Usually transient
Dizziness	SSRIs, topical anesthetics	8-12%	Mild	Standing slowly, hydration	Common with beginning treatment
Headache	SSRIs, topical anesthetics	5-10%	Mild	Analgesics, time to adjust	Typically diminishes over time
Reduced Sensation	Topical anesthetics	10-20%	Mild	Reduced dose, application timing	Can affect partner satisfaction

AI generated definition based on: The Journal of Sexual Medicine, 2008 You might find these chapters and articles relevant to this topic. 2021, The Journal of Sexual MedicineElizabeth R.

• Dapoxetine is contraindicated with certain medications and health conditions.
• Topical creams should be used sparingly to prevent partner numbness.
• SSRI treatment may cause emotional blunting or decreased libido.
• Tramadol's risk of dependency requires careful medical supervision.
• Mechanical devices can provide temporary ejaculation delay.
• Behavioral training involves specific sex exercises for control.
• Mindfulness and relaxation techniques benefit PE management.
• Proper diagnosis is essential to rule out underlying disorders.
• Incorporate partner feedback to improve treatment results.
• Avoid abrupt discontinuation of prescribed medication.
• Lifestyle modifications can include weight management.
• Ongoing research aims to develop more effective PE treatments.

Bird PhD, .. Sarah Campbell PhD Premature ejaculation is typically defined as ejaculation that occurs within one minute or no more than 3 minutes of sexual activity.80 There were 3 studies that examined the relationship between PTSD and premature ejaculation among men veterans.65,66,70 Results were largely mixed, with 2 studies demonstrating a nonsignificant relationship between DSM-IV PTSD diagnosis66 or a probable DSM-IV PTSD diagnosis65 and premature ejaculation, respectively. However, results from one study that examined PTSD cluster symptom severity using DSM-5 criteria suggested that NACM symptoms were moderately associated with premature ejaculation and this relationship.70 Additionally, those with a PTSD diagnosis who were prescribed antidepressants were moderately less likely to report problems with premature ejaculation, compared to those with PTSD who were not prescribed antidepressants.66 Overall, given the limited evidence available and mix of findings, it is difficult to glean clear conclusions about the relationship between PTSD and premature ejaculation. 2002, Encyclopedia of PsychotherapyHeather J. Meggers, Joseph LoPiccolo Premature ejaculation is defined as the persistent onset of orgasm and ejaculation with minimal stimulation, before or shortly after intromission occurs.

• Dapoxetine is taken as needed, usually 1-3 hours before sex for rapid action.
• Topical anesthetics should be used sparingly to avoid numbness of partner.
• SSRIs may cause side effects like nausea, dizziness, or decreased libido.
• Tramadol carries potential for abuse and should only be used under medical supervision.
• Daily use of certain medications may be recommended for persistent PE.
• Psychological counseling helps address performance anxiety contributing to PE.
• Pelvic floor exercises improve control and delay ejaculation naturally.
• Partner involvement in therapy can improve treatment adherence.
• Discontinuing medication abruptly may cause withdrawal symptoms or rebound.
• For some men, combining therapy with lifestyle changes yields better results.
• Over-the-counter remedies should be approached cautiously and discussed with a doctor.
• Research continues into new pharmacological and non-pharmacological treatments.