Premature ejaculation (PE) may be embarrassing, but it can be treated. Learn about behavioral, psychological, and pharmacological treatment methods
Premature ejaculation (PE) is a medical condition in which a man ejaculates too quickly, often before or very shortly after he has penetrated his partner.
In many cases, premature ejaculation resolves on its own over time and treatment may not be needed. For some men, the following methods may help:
- Practicing relaxation techniques
- Using distraction methods
- Stopping or limiting the use of:
Diagnosis can be made through medical history and physical examination.
3 treatment methods for premature ejaculation
Treatment of PE is classified into behavioral, psychological, and pharmacological.
1. Behavioral treatment
- Condom types: If you have a particularly sensitive penis, thicker condoms or condoms with local anesthesia can help to reduce sensitivity.
- Deep breaths: Taking a deep breath if you feel you are about to ejaculate can temporarily halt the progression of your climax.
- Pause during sex: Pausing briefly can help clear your head and think of something completely different to help put off ejaculation.
- Masturbation: Masturbating before sexual intercourse makes use of the body’s natural latency between two consecutive ejaculations.
- Exercises: Pelvic floor exercises may improve both erection quality and ejaculation control.
2. Psychological treatment
- Squeeze technique: This involves having your partner masturbating you to the point of ejaculation then squeezing on the head of the penis for about 10 to 20 seconds, releasing for half a minute and then squeezing again. The process is repeated until the couple is ready for ejaculation.
- Stop-start technique: This uses the same principles as the squeeze technique, but your partner doesn't squeeze on the penis. Instead, your partner stimulates you until you are ready to ejaculate but stops exactly at the time of ejaculation. The process is repeated until the couple is ready for ejaculation.
3. Pharmacological treatment
- Medication: Local anesthesia may help in some cases. You can buy low strength numbing cream from the pharmacy, but you are likely to need a full-strength version of lidocaine to work properly.
- Oral selective serotonin reuptake inhibitor (SSRI) medication: Considered the go-to drug for PE, tablets are either taken every day or 1-2 hours before sex (“on-demand” therapy). A tricyclic antidepressant (clomipramine) is another type of antidepressant medicine that can help treat premature ejaculation.
- Phosphodiesterase-5 Inhibitors (PDE5s): Viagra (sildenafil) and Cialis (tadalafil) are typically prescribed for erectile disorder (ED). The use of PDE5 medications has been shown to be moderately effective for PE in some cases.
Since most men with PE also suffer from performance anxiety, the combination of an SSRI with Viagra-like medication is often the treatment of choice.
What are types of premature ejaculation (PE)?
Type I
- Common in young adults who were delayed in having their first sexual experience.
- This is a very mild and manageable form of premature ejaculation, typically rooted in anxiety and insufficient sexual education.
Type II
- More common in adults approaching middle age, and symptoms may appear with no warning.
- Stress is usually the underlying cause, particularly as a result of a new job, family demands, or other significant life changes.
- Once the triggering cause is discovered, treatment is usually very effective.
Type III
- Less common and more serious, typically occurring when type II PE is left untreated.
- Triggers may be more significant, such as severe depression.
- Successful treatment is still achievable, but the road to recovery is longer and may require more effort from both the doctor and the patient.
Type IV
- Most serious type because it can lead to significant health problems, including debilitating sexual dysfunction and depression.
- This type often includes an erectile dysfunction component that also requires treatment.
- PE this severe is typically approached with more in-depth treatment consisting of behavioral modalities as well as medication.
How serious is PE?
Premature ejaculation affects up to 30% of men and can happen at any age. It is the most common sexual disorder in men aged under 40. Although PE may be difficult to talk about, it can be treated by professionals with expertise in sexual health.
When choosing treatment, consideration should be given to your expectations of how long you should last, as well as other factors, such as the state of the relationship. PE can lead to anger, shame, and distance between partners. Sometimes communication between the couple and simple adjustment of the couple’s sexual technique is enough to help resolve the issue.