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Premature ejaculation (Treatment)

This post is also available in: हिन्दी (Hindi)

How premature ejaculation can be treated?

The premature ejaculation can be treated by number of methods. Some methods work better in some men. You may require to try more than one method and use it for sometime. The following are the treatment options available:

• Psychological Therapy and counseling

• Behavioral Therapy and exercises

• Oral medicines

• Topical numbing agents

1. Psychological Therapy

Here a doctor or psychologist would talk to you regarding your:

• relationships and sexual issues.

• any stress or emotional conflict you are going through

• He would also talk about your sexual confidence

He would teach you ways to:

• How to manage stress and become less nervous about your sexual performance.

• How to improve your sexual confidence and may help you to understand ways to improve your partner’s satisfaction

• Take some sessions with your partner which might help you to grow intimacy between two of you.

The therapy is found to be more helpful when used with other methods usually medicines.

2. Behavioral Therapy and exercises

This method helps you build tolerance to delay ejaculation by means of exercises and maneuvers. The various techniques that can be used are:

• Pelvic floor exercises

• The Pause Squeeze Method

• The Stop-Start Method

Pelvic floor exercises

The purpose of these exercises is to strengthen the muscles that forms the floor of the pelvis (lowermost part of the abdomen). These muscles are known to play an important role in sexual function and hence are targeted to enhance sexual ability and delay ejaculation.

Researches have shown good results with Kegel exercises where about 83% people showing successful treatment of premature ejaculation.
The exercises are called Kegel exercises which are supposed to performed in following ways:

• Find the your pelvic muscles: the first step is to identify your pelvic floor muscles. This can done by following methods- by tightening the muscles that prevents you from passing gas or by stopping your urination in midstream. Identifying the muscles which act while you perform these maneuvers helps you to localize the pelvic floor muscles.

• Perform the exercise: contract your pelvic floor muscles and hold it for 3 seconds followed by relaxation for 3 seconds. Repeat the exercise ten times in a single session with at least three sessions a day. Start the exercise while lying down and when over a period of time with strengthening of your muscles try doing in similar fashion while sitting, standing or walking.

• Avoid following things: it is important to focus on contracting only your pelvic floor muscles and avoiding contracting the muscles of your abdomen, thighs or buttocks. Similarly avoid holding your breath during the exercise. You should breathe freely the entire time while performing the exercise.

The Pause Squeeze Method

In this method

• Your partner stimulates your penis until you are close to ejaculation.

• Just before ejaculation, your partner firmly squeezes the end of penis at the junction of head and shaft of the penis and maintain the squeeze for several seconds until your erection passes away.

• Repeat the technique several times before starting an intercourse. After some sessions, you might develop a feeling of knowing how to delay ejaculation without requiring the pause-squeeze technique.

The Stop-Start Method

In this method

• Similarly here also your partner stimulates your penis until you are close to ejaculation.

• Just before ejaculation, your partner would stop stimulating you to decrease the level of excitement.

• Once you regain control, your partner would start stimulating you again.

This process is repeated at least 3 times before before ejaculating. You should repeat this method 3 times a week until you have gained better control.

3. Oral medicines

There are several medicines which are basically used for other disease, but have been found effective to delay ejaculation in many people. These medicines are as follows:

• Antidepressants: the drugs called selective serotonin reuptake inhibitors (SSRIs) acts on serotonin hormone and has been found to delay ejaculation in some men. Medicines such as sertraline, paroxetine or fluoxetine are used for this purpose. Amongst them paroxetine seems to be the most effective.

These medicines may take around a weeks times to start working and 2 to 3 weeks to show its full effect.

If SSRIs doesn’t help you, your doctor might suggest an tricyclic antidepressant,clomipramine.

Side effects of these medicine may include nausea, drowsiness and decreased libido.

• Pain killers: pain medicine, tramadol may also help to delay ejaculation. Your doctor might prescribe you this when SSRIs isn’t effective. Tramadolisn’t supposed to be taken with an SSRI.
Side effects might include headache, nausea, drowsiness and dizziness.

• Phosphodiesterase-5 inhibitors: Some medications which are used for erectile dysfunction might be used for premature ejaculation especially when both the conditions occur together. These medicines include sildenafil (famous by brand name of Viagra) or tadalafil.

These medicines might be more effective when used with an SSRI.

Side effects might include headache, facial flushing, pain in abdomen and indigestion.

4. Numbing agents:

Numbing creams and gels:

Anesthetic creams and sprays, when applied can cause numbing of the penis and thus may be used to treat premature ejaculation. The agents that can be used are benzocaine, lidocaine or prilocaine. These creams or sprays are typically applied to the head of penis about 10 to 15 minutes before sex to reduce sensation and delay ejaculation.

Side effects:

• If the numbing cream/spray is applied for a longer time than suggested, you may loose your erection.

• They should not be left on the exposed penis during the vaginal sex which may lead to vaginal numbness. You should wash the cream off about 5 to 10 minutes before having sex.

Condoms

You can also use condoms to decrease penis sensitivity, which can in turn help to delay ejaculation.

Some condoms are also available in the market which contains numbing agent such as lidocaine or benzocaine or are made of thicker latex which may help in delaying the ejaculation. These are available by names such as “Climax control” condoms.

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