What is it:

Premature ejaculation occurs when men reach orgasm within the first few seconds of penetration, or even before penetrating. This can lead to unsatisfactory sexual relations for both sexual partners.

This type of sexual dysfunction is more common in teens, due to hormonal fluctuations that can cause greater excitation. However, it can also occur in adults as a result of psychological impairments, like stress, anxiety or fear.

Premature ejaculation can be managed with some techniques and exercises, although some cases may require medication and psychotherapy to treat. It is best to consult a urologist to identify the underlying cause of premature ejaculation and to start treatment as needed.

Treatment for premature ejaculation

The main ways to treat premature ejaculation are:

1. The "start-stop" technique

This technique is very used and helps men to tolerate longer times before ejaculating. This technique should be done in gradual steps, which include:

On the first day, the man should masturbate with a dry hand, performing 3 strokes followed by a 2-3 second pause. This should be repeated 10 times. If ejaculation occurs before the 10 times, you should repeat this exercise in the following days, until you can complete 10 cycles of this "start-pause" pattern.
After achieving the previous exercise, repeat these same 10 cycles, except performing 5 strokes followed by a 2-3 second pause.
After achieving the 10 cycles with 5 strokes, repeat this same exercise, but perform 7 strokes followed by a 2-3 second pause.
After achieving 10 cycles with 7 strokes, repeat this same exercise but with a moist hand, starting again with 3 strokes for each pause.
Gradually work your way up to 10 cycles of 7 strokes with pauses again, and then repeat it, but have a partner perform the stroking.

This technique should be performed over several days, so that the stimulus and urge to ejaculate remain similar.

Ideally, this technique helps men to identify and manage the sensations that are felt before ejaculating. To obtain best results, men should still seek assessment with a urologist.

2. Compression technique

With this technique, men learn to distinguish the feelings that emerge prior to ejaculation so that they can be managed. The advantage of this technique is that it can be perform my men alone, without the help of a partner.

Start by stimulating the penis through masturbation or sex, and when you feel the urge to ejaculate, apply pressure on the head of the penis by placing your thumb beneath the head (over the foreskin) and the index and middle fingers on top of the head, closing off the urethra.

Maintain pressure for 3 to 4 seconds. It should be slightly uncomfortable and not painful. This technique should be repeated up to 5 consecutive times.

Another option is to tighten the base of the penis. This can be done during penetration, however the partner should be instructed not to move to reduce stimulation at the moment of compression.

3. Desensitization technique

This is a very simple technique, but it may not be effect for all men. It consists of masturbating 1 to 2 hours prior to sex, which helps to reduce penile sensitivity.

Men can also be advised to use condoms, which can also decrease sensation and can help to manage orgasms.

4. Kegel exercises

Kegel exercises help to strengthen the pelvic floor muscles, which are a group of muscles in the pelvic area and around the urethra. When these muscles are stronger, men are able to better manage premature ejaculation.

These exercises should be done every day, 10 times with 10 reps.

5. Topical anesthetics

There are some ointments or sprays that contain anesthetic substances like lidocaine and benzocaine that can be used to decrease penile sensitivity. This can help to increase sexual duration without premature ejaculation. These products should be prescribed by a doctor and applied 10 to 15 minutes prior to sex.

There are also condoms that contain anesthetic within them to help decrease sensitivity. Although anesthetics have a great effect and can delay ejaculation, they can cause secondary effects like decreased pleasure during sex due to a loss of sensation.

6. Medication use

Medications are usually prescribed when other techniques are not effective, and can include antidepressants like sertraline, fluoxetine or trazodone. These mainly treat anxiety, which is common in these cases.

Which doctor should I see?

The best doctor to consult regarding premature ejaculation is a urologist, who will help to identify the underlying cause and initiate treatment as necessary.

In some cases, men may benefit from seeing a psychologist, particularly when premature ejaculation is associated with emotional factors like fear or anxiety.

Is premature ejaculation curable?

A cure for premature ejaculation can be achieved using simple auto-control techniques. When these are not sufficient, men can opt to decrease penile sensitivity or take prescription medication. A great strategy to manage premature ejaculation is to perform kegel exercises 300 times per day, every day.