Premature ejaculation is one of the most common sexual problems reported by men. In fact, about one-third of men aged 18-59 report that they often climax before they would like to with their sexual partners [1]. Of course, finishing quickly is not inherently problematic, but when it causes distress for the individual or makes it difficult to have a mutually satisfying sexual relationship, it becomes clinically significant and is worth addressing. Fortunately, premature ejaculation is one of the easier sexual difficulties to resolve and it does necessarily even require a visit to a doctor or a sex therapist.

The earliest treatments developed for male premature ejaculation were behavioral in nature and did not require any kind of medical intervention. The most common behavioral treatment to this day remains the stop-start technique (a therapy originally developed, appropriately enough, by a urologist named Dr. Semans). Both partners participate in this technique, which involves continuing sexual activity to brink of orgasm, then stopping everything until that feeling goes away. Once the feelings subside, stimulation resumes, but stops again the next time the feeling arises. Going through this cycle of repeatedly stopping and starting ultimately produces better ejaculatory control for a lot of men by teaching them to be more in tune with their body's level of sexual excitement. A related behavioral therapy is the squeeze technique, which is exactly what it sounds like. The partners continue sex until the point of an impending orgasm, at which point one of them squeezes the head or base of the penis to prevent ejaculation. Again, once that sensation goes away, stimulation resumes until another squeeze is necessary.

After a few weeks of practicing one of these behavioral therapies, many guys find that they are able to last longer than they were before. However, if these techniques do not produce the desired results, there are other options. One relatively new treatment possibility involves applying a desensitizing agent to the penis as a means of delaying ejaculation. There are many products on the market claiming to do this, but some of them definitely work better than others. One of the best options in this product line-up is a new lidocaine-based spray called Promescent. This product is sprayed directly onto the penis and rubbed in about 10 minutes prior to sexual activity. When used as directed, the result is a slight reduction in penile sensitivity designed to produce more stamina. Many men find Promescent to be a desirable option because it does not require a prescription, it does not have to be used in conjunction with a condom, and the product is designed not to transfer to one’s partner (and that’s a very good thing!).

Promescent is just one of many so-called "delay sprays" on the market, though. There are dozens of others available for sale on Amazon, which also sells condoms lined with desensitizing agents.

If none of the above work, one other possibility would be to consult with a physician about the possibility of taking a selective serotonin-reuptake inhibitor (SSRI). SSRIs are typically used to treat clinical depression by keeping the neurotransmitter serotonin in the brain longer; however, serotonin has a depressant effect on sexual response, which means one common side effect of SSRIs is delayed orgasm. Some studies have found that taking an SSRI results in significantly greater ejaculatory control among men who had a history of climaxing prematurely [2]. Of course, the downside of SSRI treatment is that it is available by prescription only and may be accompanied by undesired side effects. Also, fast-acting SSRIs that can be taken on an as-needed basis are not currently available in the U.S., which means that the only option for some men may be taking a daily SSRI, which is not nearly as desirable.

As you can see, there are many potential options available for the treatment of premature ejaculation. If this is something that affects you, it is highly likely that at least one of these methods can help, but be aware that you may need to experiment with different treatments until you find the right one.

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[1] Laumann, E.O., Paik, A., & Rosen, R.C. (1999). Sexual dysfunction in the United States. The Journal of the American Medical Association, 281, 537-544. doi:10.1001/jama.281.6.537

[2] Kaufman, J., Rosen, R., Mudumbi, R., & Tesfaye, F. (2009). Treatment benefit of dapoxetine for premature ejaculation: Results from a placebo-controlled phase III trial. British Journal of Urology International, 103, 651-658. doi:10.1111/j.1464-410X.2008.08165.x

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