How to Prevent and Treat Premature Ejaculation

Stop premature ejaculation by learning about these top treatments for premature ejaculation

a man sitting on the side of the bed upset by his premature ejaculation

Premature ejaculation (PE) is one of the most common types of sexual dysfunction in men. In fact, approximately 30% of men will deal with some form of premature ejaculation in their life!

an illustration that shows that one in three men has premature ejaculation
About 30% of men face the problem of premature ejaculation

Luckily, premature ejaculation is also one of the most treatable sexual conditions.

In this article, we will talk about treatments you can use to fix premature ejaculation. We will also guide you through the advantages and disadvantages of some of the more common premature ejaculation treatment options.

*If you are not sure whether or not you have PE, try our online premature ejaculation diagnostic tool. You can also read about the four types of premature ejaculation.

Premature Ejaculation Treatments

Let’s look at some possible treatments for men struggling with PE.

  1. Squeeze Technique and Stop-Start Method

    The squeeze technique and stop-start method are special masturbation or full penetration exercises. These exercises are designed to help men overcome premature ejaculation. During the exercises, you will practice identifying your ‘point of no return,’ as well as prolonging the time until ejaculation.

    A graph that shows the ejaculation process while practicing the stop-start and squeeze technique exercises for premature ejaculation
    Process of ejaculation during the exercises

    To use the squeeze technique and stop start method:

    1. You or your partner will stimulate your penis until your arousal level are almost at the point of climax.
    2. Stop stimulation, so your arousal levels subside.
    3. Once you’re relaxed, restart stimulation.
    4. You will need to repeat this process several times. With practice, the time until ejaculation will increase, and your control will improve.

    With enough practice you should be able to last longer even without using these techniques.

    During the exercise session, one of two techniques are used to stop stimulation:

    The Squeeze Technique – Here you stop the stimulation and firmly squeeze the glans (head) of your penis to help stop ejaculation.

    The Stop-Start Method – As the name suggests, this method requires you to stop the stimulation before ejaculation. Once your arousal levels decrease, you can restart stimulation again.

    The full treatment protocol includes a number of steps and contains different stimulation techniques and/or positions. Each step provides a higher stimulation level than the one before. The pace at which you progress between the exercises varies from person to person, but it usually takes between 4 and 12 weeks.

    A graph that shows the ejaculation process of men with premature ejaculation
    Process of ejaculation of men with premature ejaculation

    At the end of the treatment you should be able to last longer and to control your ejaculation simply by changing the strength and speed of the stimulation, just like a man without PE does.

    A graph that shows the process of ejaculation of men without premature ejaculation
    Process of ejaculation of men without PE

    Squeeze technique and stop-start method advantages:

    • Long-term solution – The main advantage of the stop-start and the squeeze techniques is that they provide a long-term solution. By training yourself, you acquire the ability to control your own ejaculation. Many men find this incredibly empowering.
    • Natural solution – Other solutions mask the symptoms of premature ejaculation through the use of medications and desensitizing materials. In contrast, the squeeze and stop start exercises are a completely natural treatment.
    • Effective – The squeeze technique and stop start method have been in use by sex therapists as a primary treatment option for PE for over 5 decades. Numerous studies have shown their efficacy. This recent 2006 study shows an 8.5-fold increase in the duration of intercourse for PE patients.
    • Spontaneous sex life – You will not be dependent on any medications or other materials. This allows you to enjoy a stress-free and spontaneous sex life.

    Squeeze technique and stop start method disadvantages:

    • Results take time and effort – It usually takes between 4 and 12 weeks to see results. During this time you will be required to commit to the process. Not all men are motivated enough to put in this effort. But the power of a satisfactory sex life should never be underestimated. If premature ejaculation is something that you seriously want to overcome, we believe you will find it worthwhile to give this a go.
    • Not easy without guidance – It is very important to know when to move between the exercises for the treatment to properly work. A personalized treatment plan, created and supervised by a sex therapy professional, is the best way to get results.

    Where can I get treatment based on the squeeze technique and stop-start method?

    There are a few ways to get treatment. You can seek out a professional by scheduling a session with a certified sex therapist. He or she will educate you about these exercises and create a personal exercise plan. You will return to the sex therapist to follow-up so he or she can adjust your personal plan based on your progress.

    Another option is the PE Program. This is a smart online system that includes exercises for self-treatment of premature ejaculation. You can learn more about it here.

    The PE Program, an exercise program for premature ejaculation
    Overcome Premature Ejaculation with the PE Program
  2. Pelvic floor exercises (Kegels)

    Pelvic floor exercises for premature ejaculation is a commonly suggested treatment in the online world. Still, the effectiveness of pelvic floor exercises as a treatment for premature ejaculation remains a controversial topic among sex therapy experts.

    Pelvic floor exercises were originally developed for help with bladder control.

    For this reason, we cannot recommend these exercises to treat premature ejaculation and have decided not to include pelvic floor exercises in the PE Program.

    If you’d still like to try kegels, you can follow this list of steps:

    1. Sit or lay down
    2. Relax your abdominal and leg muscles – these muscles should never be active when you do kegels.
    3. Squeeze your pelvic floor muscles. Think of these as the muscles you would squeeze if you wanted to stop urinating or prevent yourself from passing gas. You may feel a pulling sensation in your anus, or your penis may move slightly.
    4. Squeeze your muscles for about 5 seconds, then relax for another 5 seconds. As you improve, you can squeeze the muscles for up to 10 seconds. A squeeze-relax cycle is one repetition; try to do 30 repetitions at least twice a day.
    5. Remember to breathe normally as you do these exercises.
    6. As you get used to the exercises, you can do them standing up, or even as you do your daily activities. No one should be able to see that you are doing kegels.
  3. Oral Medications

    a bottle of pills for premature ejaculation
    Prescription Anti-depressants may be effective but have side-effects

    Some common anti-depressants from the SSRI group such as Prozac and Seroxat may have the side effect of delaying ejaculation. Certain analgesics (pain killers) also have this side effect.

    Some doctors prescribe these medicines ‘off-label’ to men struggling with premature ejaculation. ‘Off-label’ means taking a medicine, which was designed for one problem, for another problem because its side effects help to treat the second problem.

    A big downside to taking oral medications for PE is that they can decrease sexual desire and cause other types of erectile dysfunction.

    Here is a list of common oral medications used to treat premature ejaculation:

    • Antidepressant medications— typically selective serotonin reuptake inhibitors (SSRIs) are the most common medicines used to delay ejaculation. Common prescriptions are Paxil, Prozac, Zoloft, Lexapro and Celexa. Some studies suggest Paxil may be the best option as it can delay ejaculation for an average of nine minutes. It’s taken once a day and you can slowly increase the dose every 3 or 4 weeks. Men may not notice full results for several weeks and will need to keep taking the medicine indefinitely to continue to see results. Common side effects of SSRIs include sleepiness or insomnia, a decreased sex drive and nausea.
    • Anafranil (clomipramine) is a second option if SSRIs medicines don’t work for you— or you notice too many negative side effects when you take them. It’s also taken once a day. Some side effects include dizziness, sleepiness, dry mouth and changes in sex drive.
    • Ultram (tramadol) is a pain medicine that can also help with premature ejaculation. It’s only used if the other two medicine don’t work because as an opioid medicine it comes with a real risk of addiction. It also has common side effects like constipation, nausea, dizziness, and headaches.

    Be aware: Phosphodiesterase 5 inhibitors (Viagra, Cialis, Levitra) are not used to treat men with premature ejaculation only. They are sometimes given to men who have both erectile dysfunction and premature ejaculation— about 30% of men with PE. If that’s not the case for you, they may not help to delay ejaculation. If you’d like to learn more about these medications, read this article.

    Dapoxetine (Priligy)

    Recently, a new prescription SSRI drug called Dapoxetine (marketed as Priligy) has hit European markets (it still awaits clinical drug trails in the USA). Like the off-labeling of anti-depressants it is supposed to have an outcome of delayed ejaculation. However, recent studies [1][2][3] show that approximately 90% of men discontinued using the drug after 12 months. Why? The main reasons mentioned were that the effect of the drug did not meet their expectations or did not work at all. Other reasons included the drug’s costs, side effects and a resultant loss of interest in sex. Unlike other SSRIs, Dapoxetine has to be taken “on demand” before sexual intercourse, meaning a certain loss of spontaneity to sex.

    A pie chart that shows the reasons men discontinued using Dapoxetine
    90% of men discontinued using the drug after 12 months

    Advantages of oral medications for premature ejaculation

    • Easy – The most obvious advantage is the minimal effort required. After your trip to your doctor’s office, all you have to do is take the drug as instructed.
    • Effective – For some men the drugs can be highly effective. If this is the case for you – and you don’t experience any side effects – this could be an excellent solution.

    Disadvantages of oral medications for premature ejaculation

    • Can cause side effects – These drugs can cause various side effects such as headaches, dizziness, nausea, dry mouth, drowsiness, and reduced libido.
    • Loss of spontaneity – The cost of taking certain drugs is a loss of spontaneity in the bedroom. Anafranil (Clomipramine), for example, is only effective six hours after administration. This means you either have to take them daily or six hours before every sexual encounter.
    • High costs – The costs can become significant over time.
    • Temporary solution – The most important disadvantage, in our opinion, is that the drugs treat the symptoms without actually addressing the underlying problem. In other words, once you stop taking the pills, your PE is likely to return.

    Where can I get oral medications for premature ejaculation?

    Since all of these drugs require a prescription, you will have to schedule an appointment with a licensed doctor or a sex therapist. You can find a list of sex therapists near you on the AASECT website. Be aware that not all sex therapist will be able to prescribe medicines.

  4. Topical creams and sprays

    Applying a numbing agent to the penis can prevent premature ejaculation by reducing sensation during intercourse. These numbing agents usually come in the form of anesthetic creams or sprays. You should apply the cream or spray 5-20 minutes before sex on the flaccid penis.

    a picture of Promescent, a numbing spray for premature ejaculation
    Numbing materials usually come in the form of a spray or cream which you apply to the penis

    Most of these desensitizing creams and sprays contain benzocaine, lidocaine or prilocaine as the numbing agent.

    Some of the leading brands include EMLA cream (which requires a prescription), stud100 and Promescent.

    *We may receive a portion of revenues if you purchase a desensitizer using a link on this page.

    Advantages of topical creams and sprays for premature ejaculation

    • Effective – Topical creams and sprays have been shown to be effective. They have been marketed for over 25 years. Some studies have shown that topical creams and sprays can help men last up to 6.3 times longer.
    • Quick results – This is a quick and easy solution; and unlike the drugs we mentioned before, most don’t require a prescription.

    Disadvantages of topical creams and sprays for premature ejaculation

    • Decreased enjoyment – Since the cream or spray numbs the penis, your own sexual satisfaction could decrease. Still, some men put their partner’s needs before their own and feel that this is a small price to pay.
    • Loss of spontaneity – The cream or spray should be applied to the penis while flaccid, 20 minutes before penetration, leading to a loss of spontaneity.
    • Risk of numbing your partner – There is a risk that the cream or spray could pass on to your partner, causing your partner to also get numb. It is crucial to make sure the desensitizing cream or spray is completely absorbed or wiped off before penetration or oral sex.
    • Not easy to use – Finding the right dosage is a delicate process. Not applying enough will be ineffective, while applying too much will greatly decrease your sexual enjoyment and may actually render you unable to achieve an erection.
    • A temporary solution – The most significant disadvantage, in our opinion, is the fact that this is only a temporary solution. Your PE will likely return once you stop using the desensitizers.

    Where can I purchase topical creams or sprays for premature ejaculation?

    You can purchase desensitizing sprays or creams in many pharmacies without a prescription. They are also available in many online stores.

  5. Condoms

    delay condoms for premature ejaculation

    Today, there are also condoms which have the numbing material inside them. In our experience, condoms are not practical, because the desensitizing material takes about 5-20 minutes to be absorbed. Still, some men claim they find them effective.

    Some of the leading delay condoms include Trojan Extended Control condoms and Durex Prolong condoms.

    and Durex Prolong condoms.

    *We may receive a portion of revenues if you purchase condoms using a link on this page.

  6. Counselling

    a sex therapist helping a couple with premature ejaculation and relationship issues

    Premature ejaculation is intimately linked to stress and performance anxiety. In fact, performance anxiety may be a cause of premature ejaculation in a large number of men. Many men with high levels of stress or performance anxiety may benefit from seeking out a licensed therapist to help manage and overcome these issues.

    Premature ejaculation and other forms of erectile dysfunction can lead to relationship problems. Often men may feel embarrassed about the condition and find it difficult to speak openly with their partners. Seeking out a therapist, especially if your partner is willing to go with you, can really help to deal with PE. Also, sharing this experience with your partner can help to improve any relationship problems that can come up.

    Many men choose to combine counseling with oral medications or the squeeze technique or stop-start method. In fact, combining different treatments are more effective than choosing only one.

    In our Plus and Premium packages for the PE program, we offer a combination of treatments to help overcome premature ejaculation. You can choose from relationship consultation with sex therapy experts and personal exercise plans to achieve your goals.

    To learn more about premature ejaculation and performance anxiety, read this article.

  7. Alternative Treatments

    There are a few home remedies and alternative treatments that are commonly recommended online for treating premature ejaculation. These include yoga, acupuncture, zinc supplements, herbal medicine etc.

    a bottle of supplements for premature ejaculation

    Unfortunately, there is not sufficient evidence to support the use of these alternative treatments and we suggest that men stick to the treatment methods mentioned above.

    Dietary changes, and certain foods are thought to affect premature ejaculation. We do recommend maintaining a healthy diet and physical activity routine. But again, there isn’t concrete evidence that a specific diet or exercise can prevent premature ejaculation.

  8. Masturbate before sex

    masturbate before sex to last longer in bed

    Masturbating before sex or having more than one orgasm during sex is a common tip for men to last longer. And while it is true that some men are able to last longer the second time round, this does not solve the underlying problem; especially as the older you get, the longer it will take you to get an erection after ejaculation.

    Some of our clients are older men who used to rely on the second time and decided to treat their problem when they could no longer get a second erection quickly enough. Also, another thing to take into account is that many women may not want to have sex a second time. All this means that treating the problem is a far better solution than relying on everything going smoothly the second time round.

When to see a doctor

Rarely, premature ejaculation is caused by an underlying medical condition. This most commonly occurs in men who notice a rapid onset of premature ejaculation, associated with other symptoms, like painful ejaculation or changes in sensation. Some medical causes of PE include abnormal levels of certain hormones or brain chemicals (neurotransmitters) or a prostate or urine infection. Also, remember that PE commonly occurs alongside erectile dysfunction, a condition that is associated with many medical problems.

Many men may feel embarrassed or apprehensive about talking about premature ejaculation. Don’t let this keep you from talking to your doctor— he or she will be able to reassure you that it’s a common condition and help you find the best treatments that will work for you.

To Sum Things Up

Premature ejaculation is a very common sexual dysfunction, and it is nothing to be ashamed of. Luckily, it is also one of the most treatable sexual conditions. The squeeze technique and the stop-start exercises are two powerful solutions that can help you overcome PE. The PE Program or a trained sexual therapist can teach you to use these methods effectively.

There are several other options to treat PE symptoms, such as numbing creams or sprays and anti-depressants, but these only work as long as you take them. Combining treatments might be even more effective.

Don’t let PE discourage you! Take action sooner rather than later, and this could all be behind you.

Click here to learn more about the PE Program.

About The Between Us Clinic

Sex Therapy Online Programs

The Between Us Clinic is an online sex therapy clinic that aims to help both men and women overcome a variety of sexual disorders by bringing the proven and trusted methods used in traditional, in-person sex therapy to a wide audience via the Internet.