Management and Treatment of Premature Ejaculation

For most men a combination of various treatments works best. It helps if they have a supportive and understanding partner who is willing to support them in their process of overcoming premature ejaculation.

  • Sex therapy
  • It is recommended that both partners take part in sex therapy. The sex therapist should first educate the couple regarding sex and the sexual act. He or she should discuss any misconceptions either party might have when it comes to sexual issues. Sex therapy will be individualized for every couple. It could be recommended that the man masturbates an hour or two before engaging in sexual activity so that he is able to “last longer” during sex.

    The man will also gain confidence by learning various other love-making techniques which do not involve sexual intercourse. When he learns that he is able to please his partner without intercourse the pressure is taken off of him to perform which would make him feel less anxious. If the woman is sexually satisfied she will also be more supportive of his premature ejaculation issue.

    Squeeze Technique

    A common technique taught to patients complaining of premature ejaculation is the “Squeeze Technique”

    A common technique taught to patients complaining of premature ejaculation is the “Squeeze Technique”. Basically, when the man feels the urge to ejaculate, the man’s partner squeezes his penis where the glans joins the shaft. She should maintain the squeeze for several seconds and when she releases they should wait 30 seconds before resuming sexual activity. If he feels the urge to ejaculate again, she again squeezes his penis. Eventually the man can learn how to control his ejaculation without the “squeeze technique” being performed.

    cryoablation

    Cryoablation device

  • CT-guided Percutaneous cryoablation
  • A study which was recently done showed successful treating of premature ejaculation with cryoablation. Extreme cold is used to “burn” the dorsal penile nerve. This procedure is still new but shows promising results. It can be done on an out-patient basis which also makes it convenient.
     
     
     
     

    Psychotherapy

    sessions of Psychotherapy can be good for a man with anxiety and stress

  • Psychotherapy
  • A few sessions of psychotherapy can be good for a man with anxiety and stress. It is also good in cases where there might be an underlying and suppressed psychological reason for premature ejaculation. During psychotherapy thoughts and emotions and their roots are explored and they can then be better understood and resolved. It is important for a patient to feel comfortable with his psychologist or the professional performing the psychotherapy. Psychotherapy is a process which takes time and patience. Overnight results should not be expected.

    sildenafil-citrate

    Medications which may also be used for premature ejaculation are Phosphodiesterase type 5 inhibitor therapy

  • Medication
  • There are currently no specific medications which are designed for premature ejaculation. There are medications which are used “off-label” for premature ejaculation. A common side-effect of some antidepressant medicines is that it prolongs the time it will take a man to ejaculate during intercourse. If used in men who don’t have premature ejaculation it may cause them to have delayed ejaculation. The antidepressants that are prescribed are part of the Selective Serotonin Reuptake Inhibitor group. They increase levels of the neurotransmitter, Serotonin. Examples of these antidepressants are Fluoxetine (Prozac), Sertraline (Zoloft) and Paroxetine (Paxil). Other medications which may also be used for premature ejaculation are Phosphodiesterase type 5 inhibitor therapy like Sildenafil. Pindolol and Tramadol have also been used as treatment.

    topical_cream

    A topical anaesthetic cream can be applied to the tip of the penis about 15 minutes before intercourse

  • Topical cream
  • A topical anaesthetic cream can be applied to the tip of the penis about 15 minutes before intercourse. The cream will make the penis less sensitive and therefor will help to treat premature ejaculation. An example of this type of cream is Emla which contains 2 different types of anaesthetics: Lidocaine and Prilocaine.
     
     
     
     
     

  • Lifestyle changes
  • exercise_yoga_sun

    Exercises, yoga, sun increase Serotonin levels

    • Exercise
    • Doing more cardiovascular and weight-lifting exercises naturally increases the body’s Serotonin levels. This will make the man feel better, decrease anxiety and improve his ability to last longer in bed.

    • Spending time in the sun
    • Spending some time in the sun produces Vitamin D which is needed for the production of Serotonin. If a man has too little Vitamin D, it might hamper his Serotonin production and play a role in causing premature ejaculation.

    • Stress less
    • Chronic stress causes anxiety and decreases Serotonin levels, so developing better stress management skills will definitely lead to a more balanced life and possibly an improvement of premature ejaculation. Sometimes lifestyle changes and adjustments need to be made to stress less, like working less overtime hours or changing jobs.

    • Sleep well
    • Sleeping well is important for general health. Serotonin is also produced during sleep. Sleeping too little or not sleeping well can result in decreased serotonin production which could contribute towards premature ejaculation.

    • Yoga and meditation
    • Yoga and meditation are alternative methods of treatment for premature ejaculation. The reasoning behind these methods is that they focus on decreasing anxiety. Because stress and anxiety are often a cause of premature ejaculation it is thought that if the man is more relaxed and more in control of his thoughts, he will also be more relaxed in the bedroom.

    condom-use

    Using a condom makes the penis a little less sensitive

  • Condom use
  • Using a condom makes the penis a little less sensitive to touch and stimulation so it might be a way for men to “last longer” during sexual intercourse. Some condoms are especially designed to make a man last longer.
     
     
     
     

  • Relationship therapy
  • Relationship conflict can cause the man to feel more stressed out which can result in premature ejaculation. Likewise, premature ejaculation can also put strain on a relationship because one partner might not be sexually satisfied. Learning good communication through relationship therapy can help to resolve conflict and improve premature ejaculation.

  • Second attempt at Coitus
  • If the man is able to achieve an erection again after he has prematurely ejaculated, coitus (sex) may be re-attempted and he should be able to last longer the second time round.

 

A healthy sex life is an important part of life and of every sexual relationship. Premature ejaculation is a common sexual problem which many men suffer from. There are many treatment and management options and a man need not feel embarrassed to discuss his sexual problems with a medical professional. His sex life and his relationship can be improved a lot with the right management and advice.