Treatment for premature ejaculation can include behavioral therapy (including learning specific sexual techniques), certain medications and counseling or psychotherapy. Often, a combination approach works best. 80-90% of people experiencing premature ejaculation are able to learn better control through treatment.
In some cases, behavioral therapy may involve simple steps such as masturbating an hour or two before intercourse to help you delay ejaculation during sex or stimulating your partner to a state of high arousal before you have your genitals touched, so that your orgasms can be achieved closer to the same time.
Another approach that may help is to avoid intercourse for a period of time and instead focus on other types of sexual play so that pressure is removed from your sexual encounters. Connecting in this way can help you re-establish a satisfying physical bond with your partner(s).
Behavioral Methods
In addition to the approaches above, there are two specific behavioral methods which can help you develop ejaculatory control:
- The stop and start method helps you learn to recognize when climax is imminent and to slow down or reduce stimulation in order to extend the time until ejaculation. If you find yourself nearing climax, withdraw your penis from your partner or otherwise reduce stimulation and allow yourself to relax enough to prevent ejaculation. By starting and stopping sexual stimulation and learning to notice when climax is imminent, you can learn to prolong the sex act.
- A second method known as the squeeze technique also helps you gain control over the timing of your ejaculation. To use the squeeze technique, you begin sexual activity as usual, including stimulation of the penis, until you feel almost ready to ejaculate. Have your partner squeeze the end of your penis, at the point where the head joins the shaft, and maintain the squeeze for several seconds, until the urge to ejaculate passes. After the squeeze is released, wait for about 30 seconds, then go back to sex play. (You may notice that squeezing the penis causes it to become less erect, but when sexual stimulation is resumed, the full erection returns.) If you again feel you're about to ejaculate, have your partner repeat the squeeze process. By repeating this as many times as necessary, you can reach the point of entering your partner without ejaculating. You can also use this technique without a partner by masturbating and then applying the squeeze yourself as described above. After a few practice sessions, the feeling of knowing how to delay ejaculation may become a habit that no longer requires the squeeze technique.
Medication
Medication is another option for treatment and generally most effective when used in combination with behavioral methods. Certain antidepressants and topical anesthetics can be used to treat premature ejaculation. You may need to try different medications or doses before you and your doctor find a treatment that works for you.
A side effect of certain antidepressants is delayed orgasm. Doctors sometimes suggest people who are experiencing premature ejaculation can take antidepressants to benefit from this specific side effect. You may not need to take these medications every day to prevent premature ejaculation. Taking a low dose several hours before you plan to have sexual intercourse may be enough to improve your symptoms. Other side effects of these antidepressants can include nausea, dry mouth, drowsiness and decreased libido.
Desensitizing Lubricants
Desensitizing lubricants can also be used to treat premature ejaculation. They contain a mild anesthetic (7.5 percent benzocaine) that causes a temporary numbing sensation after being applied to the skin. The purpose of this desensitization is to help men to keep their erections and to postpone ejaculation. Since the penis has less sensation, sexual pleasure could be reduced. Wearing a condom when you use these products can help so that the lube can't rub off onto your partner's body, diminishing sensation and pleasure for them as well. Desensitizing lubes are water-soluble, not oil-based, and so they can be used with latex condoms. They are available over the counter. Durex Play Longer is one of the most commonly available desensitizing lubes.
Mental Health Professional
If you suspect that the main cause of your premature ejaculation is anxiety, meeting with a mental health professional to address this issue can be an essential step in treating the problem. If you are a Brown student, you can make an appointment with Counseling and Psychological Services by calling 401.863-3476.