Ejaculation problems

Treating premature ejaculation

There are a number of things you can try yourself before seeking medical help.

Measures you can try yourself

It can sometimes help to:

masturbate an hour or two before having sex
use a thick condom to help decrease sensation
take a deep breath to briefly shut down the ejaculatory reflex (an automatic reflex of the body during which ejaculation occurs)
have sex with your partner on top (to allow them to pull away when you are close to ejaculating)
take breaks during sex and think about something boring

Couples therapy

If you're in a long-term relationship, you may benefit from having couples therapy. During these sessions, the therapist will:

encourage couples to explore any relationship issues they have, and give them advice about resolving them
show the couple techniques that can help the man "unlearn" the habit of premature ejaculation (the two most popular techniques are the "squeeze" and "stop-go" techniques)

In the squeeze technique, the woman masturbates the man, but stops before the point of ejaculation and squeezes the head of his penis for between 10 to 20 seconds. She then lets go and waits for another 30 seconds before resuming masturbation. This process is carried out several times before ejaculation is allowed to occur.

The stop-go technique is similar, but the woman doesnt squeeze the penis. Once the man feels more confident about delaying ejaculation, the couple can begin to have sex, stopping and starting as required.

These techniques may sound simple, but they require lots of practice.

Antidepressants(SSRIs)

Selective serotonin reuptake inhibitors (SSRIs) are designed to treat depression, but they also delay ejaculation. SSRIs used for this purpose include:

paroxetine
sertraline
fluoxetine

Some men may experience an improvement as soon as treatment begins. However, you'll usually need to take the medication for one to two weeks before you notice the full effects.

Side effects of SSRIs are usually mild and should improve after two to three weeks. They include:

fatigue
feeling sick and being sick
diarrhoea
excessive sweating

Local NHS authorities can choose to prescribe it on the NHS.

It acts much faster than the SSRIs mentioned above and can be used "on demand". Youll usually be advised to take it between one and three hours before sex, but not more than once a day.

Your response to the treatment will then be reviewed after four weeks (or after six doses), and again every six months.

Dapoxetine isn't suitable for all men diagnosed with premature ejaculation. For example, it is not recommended for some men with heart, kidney and liver problems. It can also interact with other medications, such as other antidepressants.

Common side effects include:

headaches
dizziness
feeling sick

Topical anaesthetics and condoms

The use of topical anaesthetics such as lidocaine or prilocaine can help but may be transferred and absorbed to the vagina, causing decreased sensation. Condoms can also be used and are effective, particularly when combined with local anaesthesia.