Solutions for Premature Ejaculation

Premature ejaculation (PE) is one of men’s most common and distressing sex problems. The prevalence rates for PE vary considerably depending on the source, but it is estimated to impact between 30-70% of men at some point in their life. The good news? There are a variety of evidence-based strategies that can help. In this blog, we’ll explore practical, effective solutions to help gain ejaculatory control and feel more confident in the bedroom.

Premature Ejaculation

According to the International Society for Sexual Medicine [1], premature ejaculation (PE) is characterized by ejaculation that almost always occurs within a short period of time (usually under a minute), an inability to delay/control ejaculation, and significant personal distress. The distress part is key to the definition because if you ejaculate quickly but this isn’t a problem for you or your partner, then it wouldn’t be considered a clinical issue.

Men who experience PE often report reduced sexual satisfaction and less frequent sex (some may avoid sex because they find their rapid ejaculation to be a source of embarrassment and shame). Other research finds that men with PE report lower life satisfaction than men who don’t have it [2]. Partners of these men frequently experience similar emotional and sexual dissatisfaction, and many couples express a strong desire to find effective solutions to the problem. Fortunately, there are a variety of strategies that can help, which we highlight below.

Solutions for Premature Ejaculation

Since PE is so common, you may be wondering what the most effective strategies for managing PE are. In one study of practicing American urologists, on-demand SSRI therapy (i.e., SSRIs taken before sexual activity) was the most common strategy for navigating premature ejaculation (almost 30% of patients) [3]. Urologists also reported combining SSRI therapy with the “stop/start” technique or the “squeeze” technique with many of their patients.

Selective Serotonin Reuptake Inhibitors (SSRIs)

Selective Serotonin Reuptake Inhibitors (SSRIs) are typically used in the treatment of depression, but they are frequently prescribed off-label for premature ejaculation. Why is that? A common side effect of SSRIs is delayed ejaculation, which occurs because serotonin inhibits orgasm. These drugs may be taken daily or only when needed before sexual activity. Research has shown that SSRIs significantly increase the time to orgasm in men with PE [4]. While they work well for some, SSRIs aren’t optimal for everyone because they can also potentially cause other unwanted side effects (e.g., reduced libido, erectile issues).

Stop-Start Technique

The stop-start technique involves beginning sexual activity and then pausing when you sense that orgasm is about to happen. During these pauses, the squeeze technique can also be used, which involves gently squeezing the tip of the penis for a few seconds until the urge to orgasm subsides. During these pauses you can incorporate other forms of play with your partner (e.g., oral sex, manual stimulation, dirty talk, or really anything else that you and your partner might find enjoyable). Since many men worry that their PE might take away from their partner’s sexual satisfaction and sexual experiences, this can be a good time to pause and lean into some of their preferred types of stimulation.

Pelvic Floor Muscle Training and Kegels

Weak pelvic floor muscles can make it more difficult to control orgasm. As a result, pelvic floor exercises (or Kegels) are commonly recommended to help strengthen these muscles. A recent literature review published in the Journal of Sexual Medicine concluded that there is strong empirical support for the use of pelvic floor exercises to increase time to orgasm during partnered sex, with benefits that appear to be sustained over time. To learn more about pelvic floor exercises and how to do them correctly, listen to our podcast episode with Dr. Lance Frank where we discuss the importance of pelvic floor health and how to know if Kegels are right for you.

Popstar’s Delay Spray

If the strategies above haven’t worked for you, or if you’re looking for a more immediate, situational solution, there’s a new and innovative option available on the market: Popstar Delay Spray. This is a lidocaine-based topical spray designed to help delay orgasm. It works by temporarily relaxing nerves in the penis to help prolong climax, without transferring to your partner during sex.

One of the advantages of this approach is that you can adjust the dose as desired and tailor it to your body and to the situation. It also works very quickly: simply spray on, wait a few minutes for it to absorb, and then you’re ready to go. Popstar’s Delay Spray is a doctor-formulated product that’s backed by science: studies show that lidocaine application is one of the most effective methods of dealing with PE. [5]

Takeaways

While PE is a common and distressing problem that many men experience at some point in their lives, there are a variety of different strategies available—from behavioral techniques and medications to pelvic floor exercises and topical solutions. While different approaches may work better for different men, the solutions covered here can help those with PE to experience pleasurable sex by giving them more control over their orgasms.

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References:

[1] Serefoglu, E. C., McMahon, C. G., Waldinger, M. D., Althof, S. E., Shindel, A., Adaikan, G., Becher, E. F., Dean, J., Giuliano, F., Hellstrom, W. J. G., Giraldi, A., Glina, S., Incrocci, L., Jannini, E., McCabe, M., Parish, S., Rowland, D., Taylor Segraves, R., Sharlip, I., & Torres, L. O. (2014). An evidence‐based unified definition of lifelong and acquired premature ejaculation: Report of the second International Society for Sexual Medicine Ad Hoc Committee for the definition of premature ejaculation. Journal of Sexual Medicine, 11(6), 1423–1441. https://doi.org/10.1111/jsm.12524

[2] Brock, G. B., Gajewski, J., Carrier, S., Bernard, F., Lee, J., & Pommerville, P. (2007). 861: The prevalence and impact of premature ejaculation in Canada. The Journal of Urology, 177(4), 287–287. https://doi.org/10.1016/S0022-5347(18)31101

[3] Shindel, A. W., Nelson, C. J., Bulock, T. L., & Brandes, S. B. (2007). 860: Urologist practice patterns in the treatment of premature ejaculation: A nation-wide survey. The Journal of Urology, 177(4), 287–287. https://doi.org/10.1016/S0022-5347(18)31100-5

[4] Siroosbakht, S., Rezakhaniha, S., & Rezakhaniha, B. (2019). Which of available selective serotonin reuptake inhibitors (SSRIs) is more effective in treatment of premature ejaculation? A randomized clinical trial.  International Brazilian Journal of Urology, 45(6), 1209–1215.

[5] Martin-Tuite, P., & Shindel, A. W. (2020). Management options for premature ejaculation and delayed ejaculation in men. Sexual medicine reviews, 8(3), 473-485.

Image Credits: Deon Black via Unsplash