Premature ejaculation (PE) is a diagnosable medical condition and is far more common than you might think. Typically, PE is defined an ejaculation that always, or almost always, occurs within one minute after vaginal (or anal) penetration. It affects about 20-30% of all men, old and young alike. It can feel emasculating and shameful, and unfortunately sometimes men with PE start to avoid sex altogether.
There is a wide variety of ways to treat PE including topical creams and sprays, medication or behavioral therapies. Depending on the severity of the condition and sometimes, your genetic make-up, certain treatment options may or may not be effective.
The most commonly known behavioral treatment option for PE is the “stop-start” method during masturbation, sometimes referred to as edging. This method involves bringing yourself close to ejaculation, but not all the way. Typically, you would do this about three times before ejaculation, gradually increasing the intervals of time between each. While it sounds good in theory, it’s typically not effective and can even be counterproductive, as it forces a man to hyper focus on ejaculation rather than arousal.
A more effective treatment option is a topical agent that works by minimally desensitizing the penis to prevent overstimulation and premature ejaculation. Promescent, which is a lidocaine spray, is one of many over-the-counter products available. The benefit of a topical agent is that it’s fast acting, has little to no side effects, and typically doesn’t require a prescription.
The gold-standard for PE treatment are oral medications. The most common medications, usually in capsule or tablet form, are Serotonergic Antidepressants, or SSRIs. Some common brand names are Prozac (Fluoxetine), Celexa (Citalopram), Paxil (Paroxetine), and Zoloft (Sertraline). SSRI’s work by gradually increasing serotonin levels in the body, rather than delivering a massive efflux of serotonin during intercourse, which may result in overstimulation and early ejaculation.