How to treat premature ejaculation?

By Dr. Praveen Tripathi - January 20, 2019

The treatment of premature ejaculation involves two broad categories:
A. Medical treatment
B. Behavioural treatment

Lets discuss both of them in details:

A. Medical treatment: Multiple drugs have been used for the treatment of premature ejaculation . These include:

1. SSRIs (selective serotonin reuptake inhibitors): These are primarily used for treatment of de-pression and anxiety. However, they were also found to delay the ejaculation, and are increas-ingly being used in patients with premature ejaculation. It must be remembered that the same drug can have role in treatment of different disorders, like in this case SSRIs are used for their effect of delaying the ejaculation and not for their antidepressant effect. These medications should be only be used after taking the recommendation from a doctor

2. Tramadol: Drugs like tramadol can also delay the ejaculation and have been used in patients with premature ejaculation. Tramadol should only be taken if recommended by a medical professional

3. TCAs (tricyclic antidepressants): TCAs are also antidepressants which can delay the ejacula-tion. These medications should be only be used after taking the recommendation from a doctor

4. Anaesthetic sprays or creams: Creams or sprays made of anaesthetic agents can decrease the sensitivity of penis and delay the ejaculation, however they sometimes can lead to loss of erec-tion too and may cause vaginal numbing.

5. Nutraceuticals: Many medicinal plants have been found to have ingredients that delay the pro-cess of ejaculation and are increasingly being used in the treatment of premature ejaculation. Many of these are available over the counter and do not need prescription. However, because of the possibility of interactions between nutraceuticals and other drugs, and possible adverse effects, these should also be preferably used after consulting a medical professional.

B. Behavioural treatment: Few techniques have been developed which can help a patient delay the ejaculation. These include:

1. Stop and start technique: In this technique, while having sex, the moment the patient feels that the process of ejaculation is about to start, the sexual intercourse is halted for around 30 seconds. This allows the body to recover and ‘ejaculation wave’ to pass off, after 30 seconds the intercourse is again resumed. In this technique, the timing is extremely important as if the halt get delayed, its impossible to stop the ejaculation

2. Squeeze technique: In this technique, while having sex, the moment the patient feels that the process of ejaculation is about to start, the patients partner squeezes the penis at the base of the head of penis. Squeeze should not be too strong as it can injure the penis. Squeeze again helps in abortion of ejaculation process and allows sex to be continued.

3. Kegels exercise: Here, the pelvic muscles are strengthened by repeated contractions and relaxations. When pelvic muscles get strengthened, the control over ejaculation improves.

The treatment of premature ejaculation should be started as soon as possible, as delay may worsen the illness and make the treatment less effective