Last updated: December 11, 2018 By Ethan Green
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 the self-help and over the counter treatments I’ve tried.
I’ll first cover some background information about premature ejaculation that I think is helpful to understand. Then I’ll run through some of the different methods I’ve tried over the years, with my current recommendations for what seems to work well.
- How many men have premature ejaculation?
- Definition and types of premature ejaculation
- What causes it?
- The different types of treatment
- What’s the best treatment?
Since most men never talk to their doctor about premature ejaculation, nobody really knows exactly how many suffer from it.
Researchers suggest that in most studies, it ranges from 4% to 39% of men. That’s a wide range, but whatever the figure is, it’s clearly a common issue.
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.
The Mayo Clinic states that the exact cause isn’t known. However, where once it was thought to be psychological, doctors now believe it “involves a complex interaction of psychological and biological factors.”
Some of those factors 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 rushed sex.
- Anxiety about lasting long enough.
- Anxiety about erectile dysfunction leading to rushed sex.
- Sex that’s too stimulating.
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 – includes the start-stop, kegels and squeeze technique.
- 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, prescription medication or treatment for an underlying cause.
- 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.
There’s isn’t a single treatment which works perfectly for all men. But some 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.
I’d also suggest that if you can handle the potential embarrassment, speaking to your doctor could be a great way to identify the cause and get any necessary treatment.
Delay sprays, referred to as topical anesthetics by the medical community, are an immediate and easy way to tackle premature ejaculation in my experience.
They aren’t a cure and need to be used every time you have sex, but for many men they work well.
The main advantages
- Available without a prescription.
- Used on demand when you have sex.
- Can take effect in as little as 5 to 10 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.
- 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.
The spray I’ve personally found to be most effective is Promescent, which you can find at Promescent.com.
There’s a surprisingly wide range of self-help techniques to stop premature ejaculation. Some simply involve changing the way you have sex, such as:
- 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.
- Usually safe as long as you practice the techniques correctly.
- 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.
- It might not work if there is a physical cause.
- It can take time and dedication to see the best results.
You can find information about these techniques widely online, including this site (see the useful articles below).
I personally bought a downloadable book, which had detailed instructions explaining the techniques.
I’ll admit that it’s a bit of a chore to read an entire book on the topic, and some of them are over the top in their sales pitch. Nevertheless, I found it helpful to learn different techniques and had good results from following a guide.
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.
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 medication in some countries.
- Tramadol. This is a strong painkiller, which seems to work well for premature ejaculation. But there are serious concerns regarding side effects and dependency.
- Erectile dysfunction drugs – for some men, drugs like sildenafil (Viagra), tadalafil (Cialis) and vardenafil (Levitra) can help with ejaculation control.
- Herbal and other remedies – often based on the traditional medicine of different cultures around the world. Sometimes the ingredients crop up in products sold online. But you can also ask a Chinese or Ayurvedic medicine practitioner for their recommendation.
Advantages of oral medication
- Some are 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.
- No techniques to practice – it’s an instant fix.
- 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.
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 of testing some of them.
I’ve covered many of the main treatment choices above, but there are a couple of other options worth considering in addition to those.
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 benzocaine 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.
You can find Durex Performax and Trojan extended climax control in many pharmacies, stores and online.
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.
Master the art of oral sex
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 happy.
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.