Premature Ejaculation, Your Treatment Options

Premature ejaculation is common, affecting up to one in three men, yet, unlike erectile dysfunction, it is not a topic you see or hear much about in the media. As such, many men who experience this sexual challenge typically don’t talk about it with anyone, including their doctors, and they don’t know how to treat it.

In fact, premature ejaculation can be treated using medications, counseling, and sexual techniques designed to delay ejaculation. Sometimes a combination of these approaches provide the best results.

Premature ejaculation developments

Some people are talking about premature ejaculation, however, and it’s important for men who are experiencing it to hear what they have to say. Among those discussing the topic are experts at the Committee for Medicinal Products for Human Use of the European Medicines Agency (EMA), which recently recommended a new treatment for premature ejaculation.

Although it is currently not available in the United States, the treatment, called Senstend (Plethora Pharma Solutions Ltd) has been shown to improve “ejaculatory control and sexual satisfaction and a reduction in distress related to ejaculation,” according to the EMA.

Senstend is a spray solution that contains lidocaine and prilocaine, two common anesthetics. The medications stop the transmission of nerve impulses in the glans of the penis, which in turn reduces stimulation and helps delay ejaculation.

Use of this drug combination can cause partial loss of sensation of the penis as well as erectile dysfunction.

Another treatment for premature ejaculation under investigation is transcutaneous electrical stimulation (TES). It involves use of a neuromuscular electrical stimulation device that applies stimulation to the perineum.

In a recent study, 23 men with lifelong premature ejaculation used either TES or sham treatment. The men were allowed to masturbate in private and a stop watch was used to measure their time to ejaculation.

Of the 20 men who completed the study, 17 (85%) experienced a prolonged time to ejaculation (3.5-fold longer) when using TES compared with the sham treatment. According to the authors of the study, this approach “may have the potential to become an on-demand treatment option” for premature ejaculation.

Other treatment options for premature ejaculation

While Senstend is not yet available, there are other treatment options men can use for premature ejaculation.

  • Other topical treatments. Various other sprays and anesthetic creams also contain lidocaine, benzocaine, or prilocaine. These products are applied to the penis 10 to 15 minutes before sex. Like Senstend, these items can cause temporary loss of sensitivity and lower sexual effects.
  • Kegel exercises. Also known as pelvic floor muscle exercises, Kegels are not just for women. Regular (daily) practice of Kegels can improve a man’s ability to delay ejaculation. Identify your pelvic floor muscles by tightening the muscles that prevent you from passing gas. Tighten those muscles, hold for three seconds, then relax for three seconds. Repeat this several times. Once you are comfortable doing the exercise, do at least three sets of 10 repetitions three times a day.
  • Behavioral techniques. Some sex therapists recommend men masturbate an hour or two before intercourse to help delay ejaculation during sex. Another recommendation is to avoid sexual intercourse for some time and instead focus on foreplay and other forms of sexual pleasure to help reduce the stress associated with premature ejaculation.
  • Certain types of condoms contain numbing substances that can help delay ejaculation. Typically they contain lidocaine or benzocaine or they are made of thicker latex. These are available over-the-counter.
  • One of the side effects of some antidepressants is delayed orgasm. Therefore, some doctors may recommend selective serotonin reuptake inhibitors (SSRIs), which you may know as Lexapro (escitalopram), Zoloft (paroxetine), or Prozac (fluoxetine). It can take up to two weeks or longer before you will notice the full impact from these medications on premature ejaculation.
  • Phosphodiesterase-5 inhibitors. Known as drugs that treat erectile dysfunction, these drugs (e.g., sildenafil [Viagra], tadalafil [Cialis], or vardenfil [Levitra] might also help premature ejaculation. They seem to work better when combined with SSRIs.
  • Talking with a counselor who is familiar with the challenges of premature ejaculation can be helpful, especially if the man’s partner attends the sessions as well. Sex therapists and relationship counselors are usually the most qualified. Typically, working with a counselor and adopting one or more of the other treatment options works the best.
  • Although there are limited studies of the impact of yoga on premature ejaculation, results have been promising. To experience results, it takes about one hour daily of yoga practice, which requires a great deal of discipline. The yoga poses should be taught and monitored by an experienced yoga teacher, and men should be cleared by their doctor before engaging in this practice, since it can be quite rigorous.

Bottom line

Many men who suffer with premature ejaculation don’t talk about their condition or seek treatment. Yet there are a variety of treatment options available and a few more in the pipeline. If you have premature ejaculation, seek help through one or more of the therapeutic avenues available.


European Medicines Agency. Senstend 2019 Sep 19

Joshi AM et al. Role of yoga in the management of premature ejaculation. World Journal of Men’s Health 2019; 37:e54

Mayo Clinic. Premature ejaculation

Naftulin J. I can only last 20 seconds in bed before I ejaculate and I fear it’s ruining my sex life. Is there any permanent fix to this problem? Insider 2019 Sep 17

Shechter A et al. Transcutaneous functional electrical stimulation—a novel therapy for premature ejaculation: results of a proof of concept study. International Journal of Impotence Research 2019 Sep 30