Editorial
Written byMen's Health Istanbul Editorial Team
Medical reviewer (awaiting sign-off)Prof. Dr. Ateş Kadıoğlu
Published
Updated
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The short answer
Several treatments have good evidence. Behavioural techniques such as the stop-start and squeeze methods help many men gain more control, especially with practice and a supportive partner. Anaesthetic sprays or creams applied to the penis reduce sensitivity and can delay ejaculation. Certain prescription medicines, taken either daily or before sex, also lengthen the time to ejaculation. Counselling helps when anxiety or relationship strain is involved, and treating erectile dysfunction helps when the two occur together. Combining approaches often works well. Most so-called natural remedies sold online have no reliable evidence.
Key takeaways
- Premature ejaculation is defined by short time to ejaculation, a lack of control and distress, not by a stopwatch alone.
- Behavioural techniques, numbing sprays or creams and certain prescription medicines all have evidence behind them.
- Counselling and involving a partner can make other treatments work better.
- If erectile problems are also present, treating them first often helps.
What counts as premature ejaculation?
Almost every man ejaculates sooner than he would like at some point. That alone is not premature ejaculation (PE). The International Society for Sexual Medicine uses a definition with three parts:
- Time. In lifelong PE, ejaculation always or nearly always happens before or within about one minute of penetration. In acquired PE, which develops after a period of normal control, there is a clear drop in time, often to about three minutes or less.
- Control. The man is unable, or nearly unable, to delay ejaculation on all or nearly all occasions.
- Consequences. It causes distress, frustration or avoidance of intimacy.
If the timing does not bother you or your partner, it is not a medical problem.
What causes premature ejaculation?
Lifelong PE is thought to be partly biological, involving the way the brain and nerves control the ejaculation reflex. Acquired PE is more often linked to something that has changed: performance anxiety, relationship difficulties, erectile problems, prostate inflammation or thyroid problems. Anxiety tends to feed itself; worrying about finishing too soon makes it more likely to happen.
Do the stop-start and squeeze techniques work?
They can, particularly with patience. In the stop-start technique, stimulation stops just before the point of no return and resumes once the urge fades. The squeeze technique adds gentle pressure below the head of the penis at that point. Practised alone and then with a partner, both help men learn to recognise and manage rising arousal.
Guidelines note that these methods take time, work well with a cooperative partner and that the benefit can fade without continued practice. They are often combined with other treatments.
Do numbing sprays and creams work?
Yes, for many men. Local anaesthetic sprays and creams reduce sensitivity of the penis and have good evidence for delaying ejaculation. They are applied shortly before sex. Possible downsides include too much numbness, which can affect erections or enjoyment, and transfer to a partner, which a condom or washing before penetration can prevent.
Are there tablets for premature ejaculation?
Yes. Medicines from the antidepressant family known as SSRIs can lengthen the time to ejaculation, a well-recognised effect of these drugs. One, dapoxetine, is approved in many countries specifically for PE and is taken before sex. Others are taken daily and used off-label. Each has side effects, such as nausea or dizziness, and none should be stopped abruptly without advice. A doctor decides which, if any, is suitable.
When PE occurs alongside erectile dysfunction, guidelines recommend treating the erectile problem first, because men who struggle to keep an erection often rush to ejaculate before they lose it.
Does counselling help?
Psychosexual counselling helps men and couples deal with anxiety, pressure and communication, which are often part of the problem. Guidelines suggest that combining counselling with medical treatment can work better than either alone, particularly for acquired PE.
What does not work?
Supplements, herbal pills and "delay" products sold online without a prescription generally have no reliable evidence behind them. Masturbating before sex or distracting yourself during it may help a little for some men but rarely solves the problem.
When to see a doctor
If PE is causing you or your partner distress, if it has started recently after years of normal control, or if you also have erection problems, it is worth seeing a urologist. It is a routine conversation for specialists. Our premature ejaculation guide explains how it is assessed.
Questions men also ask
How long should sex last?
There is no correct duration. Doctors are more interested in whether you feel you have control and whether the timing causes distress to you or your partner.
Can premature ejaculation go away on its own?
Occasional early ejaculation, for example with a new partner or after a long gap, often settles by itself. Lifelong or persistent problems are more likely to need treatment.
Do condoms help with premature ejaculation?
Some men find that a condom slightly reduces sensation, and some condoms contain a mild anaesthetic. They can be one part of a wider plan.
Sources & further reading
- Journal of Sexual Medicine An update of the International Society of Sexual Medicine's guidelines for the diagnosis and treatment of premature ejaculation (PE) (opens in a new tab) (2014) Althof SE, et al.
- European Urology European Association of Urology Guidelines on Sexual and Reproductive Health—2021 Update: Male Sexual Dysfunction (opens in a new tab) (2021) Salonia A, et al.
- EAU EAU Guidelines on Sexual and Reproductive Health (opens in a new tab) (2024) European Association of Urology
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This article is general health information. It does not replace an individual medical consultation, examination or diagnosis. Read our editorial policy and medical review policy.
