Premature Ejaculation Overview & Treatment Options

Last updated: September 19, 2018 By Ethan Green

photo of some of the premature ejaculation treatments I've personally tried
Do you find it difficult to control when you ejaculate during sex? Do you regularly reach orgasm before your partner does?

Premature ejaculation is a frustrating problem that can have a profound effect on your self-confidence in bed. And sooner or later, it can also cause relationship difficulties.

Having experienced it myself, one of my main goals with this site is to provide useful information about all the different treatment options.

On this page, you’ll find a discussion of the pros and cons of different methods for tackling premature ejaculation. Hopefully, you’ll find a solution that works well and gives you better control during sex.

Contents

Background information

  1. How many men have premature ejaculation?
  2. Definition and types of premature ejaculation
  3. What causes it?
  4. The different types of treatment
  5. What’s the best treatment?

Treatment options

  1. Delay sprays
  2. Natural behavioral techniques
  3. Medication
  4. Other options

Background information


Below are some key points about premature ejaculation that you might find useful before looking at specific treatment options.

1. How many men have premature ejaculation?

Since most men never talk to their doctor about premature ejaculation, nobody really knows exactly how many suffer from it.

A recent piece of research suggests that in most surveys it ranges from 4% to 30% of men. That’s a wide range, but whatever the figure is, it’s clearly a common issue.

2. Definition and types of premature ejaculation

The definition of premature ejaculation varies from one source to the next, but most experts refer to three main types:

  • Lifelong PE – when it’s a problem from the very first sexual encounter. Usually the man ejaculates in under a minute of penetrative sex.
  • Acquired PE – when it becomes a problem after months or years of normal sex. The man usually ejaculates in under 3 minutes.
  • Normal variable PE – this is the case for many men: sometimes they ejaculate quickly, but other times last much longer.

In addition, there are some who argue that it’s a subjective problem. Even if a man lasts longer than 3 minutes, it could still be considered premature if he and/or his partner feel it is.

3. What causes it?

It’s thought that there are various possible causes, and sometimes a combination of more than one. But in many cases, there simply isn’t a clear cause to be found.

Some scientists argue that it’s a purely biological problem, while others feel it’s more psychological. Possible causes include:

  • Abnormal hormonal or brain chemical levels.
  • Inflammation or infection of the prostate or urethra.
  • Early sexual experience, such as rushed masturbation.
  • Sexual abuse.
  • Poor body image.
  • Guilt leading to rushing sex.
  • Anxiety about lasting long enough.
  • Stress.
  • Sex that’s too stimulating.

4. Which type of treatment?

Before discussing specific treatment options, it’s useful to look at the main categories. If you’re interested in self-help, your main options are:

  • Topical anesthetics – delay sprays, creams and condoms.
  • Behavioral techniques – found online and in guidebooks.
  • Medications – available over the counter or online.

If you want to seek professional help, you have 2 main choices:

  • Speak to your doctor – who might also recommend self-help. Additionally, they might offer counseling and/or medical treatments.
  • Speak to a counselor or therapist – if you feel that there’s a psychological cause, or it’s causing you personal distress and relationship problems.

5. What’s the best treatment?

There’s isn’t a single treatment which works perfectly for all men. But research studies suggest that medical treatments, like anti-depressants and delay sprays, are usually the most effective.

There’s also growing evidence that self-help behavioral techniques can help. And my personal experience has definitely been positive with these methods.

So even if you do choose the easier option of a delay spray or oral medication to start with, I recommend working on your control naturally too.

So what’s the best option?

My personal opinion is that it’s better to avoid strong medication unless nothing else works, or your doctor recommends it.

Try starting with a delay spray if you’re currently sexually active. And at the same time start working on the self-help behavioral techniques.


Treatment options


1. Delay sprays and creams

photo of four different delay sprays

Delay sprays, also referred to as topical anesthetics, are one of the best ways to tackle premature ejaculation.

They aren’t a cure and need to be used every time you have sex, but for many men they work very well.

The main advantages

  • Available without a prescription.
  • Used on demand when you have sex.
  • Usually work in around 10-15 minutes.
  • Can help you last several minutes longer, and sometimes much longer.
  • Some can be used with oral sex and with or without a condom.
  • Usually safe for most men.

Potential issues

  • They don’t always work for all men equally, so there’s no guarantee of success.
  • They can sometimes cause too much numbing, leading to erection loss.
  • Some can cause a tingling or burning sensation.
  • You have to use them properly to avoid transference to your partner.

I recommend

The spray I’ve personally found to be most effective is Promescent, which you can find at Promescent.com

Useful articles

The 10 best delay sprays

Promescent review

Stud 100 review

How to use delay sprays

The benefits and side effects of delay sprays


2. Natural behavioral techniques

image listing different Behavioral techniques for premature ejaculation

There’s a surprisingly wide range of self-help techniques to stop premature ejaculation. Some simply involve changing the way you have sex – little ‘lightbulb moments’ like these:

  • Masturbate an hour before sex
  • Wear a condom
  • Spend less time in the missionary position or from behind
  • Master the art of oral sex
  • Have sex more often

Others involve specific techniques you’ll have to practice for longer, like the start and stop method, sensate focusing, kegels, and arousal control.

The main advantages

  • It doesn’t involve medication.
  • There are no ongoing costs or risks of side effects.
  • There’s the chance of permanently stopping your premature ejaculation.
  • If done right, you can have sex for much longer, not just a few minutes.
  • Changing the way you have sex can be very positive for you and your partner.

Potential issues

  • It might not work for all guys, especially those with a physical cause.
  • It can take time and dedication to see the best results.

I recommend

If you’d like a complete guide to the natural techniques, the one I currently recommend is The Ejaculation Trainer. I used the techniques it describes myself and had great results from them.

Useful articles

My recommended sexual stamina guides

The Ejaculation Trainer review

Tips for lasting longer

The start and stop method

My guide to kegel exercises


3. Medication

photo of priligy and viagra

First of all, I should mention that I’m not a doctor. So my knowledge about the drug treatments is based on personal experience and research – not medical training.

From my understanding, there are a few different categories of oral medical treatment:

  • Anti-depressants like paroxetine, sertraline, fluoxetine and clomipramine. A side effect of anti-depressants is that they can cause delayed ejaculation.
  • Dapoxetine (Priligy). This was originally intended to be another anti-depressant but ended up becoming an approved oral medication for PE in some countries.
  • Tramadol. This is a strong painkiller, which seems to work well for PE, though does have concerns regarding side effects and dependency.
  • Erectile dysfunction drugs – for some men, drugs like sildenafil (Viagra), tadalafil (Cialis) and vardenafil (Levitra) seem to help with ejaculation control too.
  • Herbal and other remedies – I’ve seen and tested a range of supposed remedies for PE. Unfortunately, none of them worked for me and the ingredients usually aren’t regulated, so I don’t advise them.

Advantages of oral medication

  • Proven in clinical trials to work, often adding several minutes to the lasting time.
  • You can take them discreetly on an ongoing basis, so your partner doesn’t need to know about it.
  • You don’t have to do anything other than taking a pill.

Potential issues

  • They can cause side effects, some of which can be serious, including other types of sexual dysfunction.
  • You need to get a prescription from your doctor for some of them.
  • They won’t cure the problem, so you need to take them on an ongoing basis.

I can understand why oral medication will appeal to some men. I had some success with them personally, so I know they can help and with minimal effort.

But I also had some minor side effects when trying them. So I recommend weighing up the pros and cons carefully before taking any strong medication.

I recommend

Because I’m not a doctor, I don’t feel comfortable recommending medication. I think it’s a personal choice best discussed with a medical professional.

However, you can read about my experience testing some of them.

Useful articles

Dapoxetine review

Viagra review

Premature ejaculation pills overview


4. Other options

I’ve covered the main treatment choices above, but there are a couple of other options worth considering in addition to those.

Numbing condoms

photo of 3 different types of numbing condoms

Numbing condoms work on a similar principle to delay sprays and creams, but with even more desensitizing due to the condom itself.

Durex, Trojan and Pasante all make them, adding a little lidocaine to the inside of the condom, which will activate with body heat.

In my experience, they work well, but can cause erection loss and less pleasure due to the strong numbing effect.

I recommend

You can find Durex Performax and Trojan extended climax control in many pharmacies, stores and online.

Useful articles

Numbing condoms review

Tips for using condoms without losing your erection

Fleshlight stamina training unit

fleshlight stamina training unit

If you’re single or live alone, it’s useful to practice ejaculation control techniques with a realistic vagina.

It can also help you stay used to more intense levels of physical stimulation for when you next have sex.

I used one and found it was helpful for practicing and perfecting the techniques in a relaxed way without having to worry about a partner.

I recommend

You can use any sex toy if you know the right techniques. I recommend getting the stamina training unit from the fleshlight website as it comes with a guide book explaining the techniques.

Useful articles

Fleshlight stamina training unit review

Master the art of oral sex

oral sex image

For me personally, improving the skill of oral sex was one of the best ways to deal with premature ejaculation.

Getting better at this is as easy as learning some good techniques and then simply deciding to do it more and do it better.

Then no matter how long you last for during sex, you’ll always have a way to make your partner very happy. Trust me, it’s worth spending time on this!

Read tips for giving a woman oral sex

Summary

For me personally, the key to overcoming premature ejaculation was to be willing to engage in some trial and error.

There are lots of desensitizing products you can try, and they are available all around the world. And it’s easy to get hold of a guide to the behavioral techniques and start learning control naturally.

So really, you have the short term and the long term approach, which I think are equally important.

If you need something that will immediately improve your love life, you can use one of the temporary desensitizing options. And then start working on the problem naturally to see if you can stop it once and for all.