Overcoming Premature Ejaculation: A Comprehensive Guide to Treatments

July 01, 2024

4 mins

Experiencing sexual dysfunction can be frustrating, embarrassing, and difficult to discuss, even with a doctor. Many men avoid seeking treatment for these common issues, despite the availability of discreet options, including online prescriptions. The first step towards treatment is identifying and understanding the problem.

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What is Premature Ejaculation?

Premature ejaculation (PE) occurs when a man ejaculates sooner than desired during sexual activity. This common issue affects approximately 20-30% of men, although the actual number might be higher due to underreporting. PE is often defined as ejaculating within one minute of penetration, but it can also happen before penetration begins.

What Causes Premature Ejaculation?

PE can be categorized into two types:

• Primary (lifelong) PE: This begins with the first sexual encounter and continues throughout life. Causes can include physical conditions, genetic traits, or psychological factors like upbringing, culture, or past traumatic experiences.

• Secondary (acquired) PE: This develops later in life, often due to physical conditions such as obesity, diabetes, high blood pressure, or psychological issues like stress, depression, or performanc

  e anxiety.

Some common physical and psychological factors contributing to PE include:

• Hormonal imbalances

• Depression

• Diabetes

• Prostate or urethra inflammation or infection

• Low self-esteem

• Nervous system conditions, such multiple sclerosis

• Overactive thyroid

• High penile sensitivity

• Relationship problems

• Stress/anxiety/guilt

Treatments for Premature Ejaculation

1. Selective serotonin reuptake inhibitors (SSRIs)

How they work: SSRIs, such as sertraline (Zoloft), paroxetine (Paxil), and fluoxetine (Prozac), are antidepressants t

hat increase serotonin levels, which can delay ejaculation.

Side effects: Fatigue, excessive sweating, and diarrhea. These medications are often used off-label for PE.

2. Topical anesthetics

How they work: Numbing agents like benzocaine, prilocaine, and lidocaine reduce penile sensitivity. They are applied 20-30 minutes before sex and wiped off before intercourse to avoid transferring to the partner.

Side effects: Mild burning sensation and decreased sex drive.

3. Condoms

How they work: Condoms reduce sensation. Thicker condoms or those with numbing agents can further delay ejaculation.

4. Behavioral techniques

Stop-start method: Engage in sexual activity until nearing ejaculation, then stop and focus on something non-sexual. Resume once excitement decreases.

Squeeze method: At the brink of ejaculation, squeeze the penis head until the urge subsides. Repeat as needed.

5. Therapy

Individual therapy: Address underlying psychological issues like anxiety or depression.

Couples counseling: Improve relationship dynamics and communication, enhancing intimacy and reducing performance anxiety.

6. Pelvic floor exercises

How they work: Strengthening the pelvic floor muscles, especially the pubococcygeus muscle, can help control ejaculation. Kegel exercises involve tightening these muscles for five seconds, relaxing for five seconds, and repeating multiple times daily.

7. Masturbation

How it works: Masturbate an hour or two before sex to exploit the refractory period, delaying ejaculation during intercourse. Timing is crucial to avoid disinterest or difficulty in becoming aroused.

8. Analgesics

How they work: Tramadol can delay ejaculation as a side effect. It is used when SSRIs are ineffective, but cannot be combined with them.

Side effects: Nausea, headache, sleepiness, dizziness.

9. PDE5 Inhibitors

How they work: Medications like sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra) treat erectile dysfunction and may help with PE.

Side effects: Headache, facial flu

shing, indigestion. Often combined with SSRIs for better results.

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How Rex MD Can Help

Premature ejaculation is a common issue with various treatment options, from medications and topical treatments to behavioral techniques and therapy. Consulting a doctor is crucial to identify the underlying cause and determine the best treatment plan. With proper treatment, men can regain control and improve their sexual satisfaction.

That’s why Rex MD offers men access to medications like sertraline and PDE5 inhibitors to men who may need a boost in the bedroom. 

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