Dealing with premature ejaculation can really bring you…um…down. Although it can be frustrating and stressful, it’s not an unusual occurrence. In fact, about one in three men will experience premature ejaculation at some point in their life, making it the most common sexual disorder in males (1;2-4).
Premature ejaculation is when a man experiences ejaculation before they wish to, with very little sexual stimulation (1;5-6). It can occur before, at the time of, or shortly after penetration. Not only does premature ejaculation put a damper on sexual satisfaction—it can also take a toll on relationships and quality of life (1;7-8).
This condition can affect a man at any age, and no one knows why it happens. For some, it’s a lifelong problem, whereas for others it may creep up later in life (1;9-10). The bottom line is that health, not age, is a key factor that affects a person’s sexuality, and premature ejaculation is one condition that can play a role (11).
Although there is no cure for premature ejaculation, there is hope. From behavioural techniques to creams, sprays, medications, acupuncture, Chinese herbal medicine, and delay devices, there are plenty of treatment options available to help. One systematic review explored the pros and cons of each (1).
What the research tells us
Overall, the findings of the review were promising! Many of the treatments showed that they have the potential to increase the time from vaginal penetration to ejaculation by 1 to 6 minutes, and improve sexual satisfaction. But, just which treatments worked for each outcome, and what side effects need to be considered?
Well, behavioural therapy was one treatment that increased both time to ejaculation and improved sexual satisfaction, without any negative side effects.
A huge number of drugs were also tested, including opioid-based painkillers (tramadol), anti-depressants (citalopram, escitalopram, fluoxetine, paroxetine, sertraline, fluvoxamine, dapoxetine, duloxetine, and clomipramine), drugs for erectile dysfunction (vardenafil, tadalafil, and sildenafil), and drugs used to treat high blood pressure (terazosin). All of these drugs were found to be effective in increasing time to ejaculation, except for fluvoxamine and sildenafil (1). Some also appeared to assist with improving sexual satisfaction—including citalopram, paroxetine, dapoxetine, tramadol, and erectile dysfunction drugs. However, despite these desired benefits, many drugs were associated with side effects like nausea, dry mouth, headache, dizziness, nose irritation, flushing, palpitations, low blood pressure, and drowsiness (1;12).
What’s more, it turns out that behavioral therapy and medication may be a ‘dynamic duo’, with reports that their combined use could provide greater benefits than using either alone.
For those looking for non-drug options outside of behavioral therapies, time to ejaculation may also be improved by anesthetic creams and sprays, delay devices (e.g., numbing band with a stop–start technique), acupuncture, and Chinese herbal medicine. But, it’s worth noting that after about 20 minutes or more of using creams and sprays, loss of sensation, irritation, and loss of erection can occur. Reports of soreness from overusing delay vices were also seen. Side effects of treatments such as acupuncture and Chinese medicine were not adequately reported in the included studies.
For those experiencing premature ejaculation, the news is good—there is an arsenal of treatment options out there that can work. Individual preferences and side effects vary, so it’s important to speak with your health care provider about which option might be optimal for you. Future research will need to explore whether these treatment options are safe and effective over the long-term and which ones work best (1).
