Lifestyle Changes to Improve Sexual Stamina

Your health care provider asks about your sex life and your health history. Your provider might also do a physical exam. If you have both early ejaculation and trouble getting or keeping an erection, your provider might order blood tests. The tests may check your hormone levels. In some cases, your care provider might suggest that you go to a urologist or a mental health provider who specializes in sexual problems. Common treatment options for premature ejaculation include behavioral techniques, medications and counseling. It might take time to find the treatment or combination of treatments that work for you. Behavioral treatment plus drug therapy might be the most effective. In some cases, therapy for premature ejaculation involves simple steps.

Other Therapy

Wait for your erection to subside a little, before carrying on. Again, the idea is to repeat three times before having an orgasm. You need practice to recognise the moment just before an orgasm in order to be able to stop in time. Psychological treatment options are sometimes used in treating premature ejaculation but no one is sure just how effective they are. Studies have shown these techniques can be effective but results are very variable.

Medications for premature ejaculation

You may prefer to try a cream or a tablet, as discussed below. If you have acquired premature ejaculation (because of another health problem, as above) the first goal is to treat that health problem. If you have had lifelong PE the current guidelines suggest that medication should be the basis of your treatment. The options are tablets and local anaesthetic spray. Behavioural and psychosexual therapy is also used but there is only weak and inconsistent evidence that this helps.

Biological causes

Sometimes psychotherapy and medication are used together. Dapoxetine is a new SSRI tablet which has specially been developed for the treatment of premature ejaculation. It starts to work very quickly, so it can be taken just when you are going to have sex, rather than every day. You have to take it 1-3 hours before you have sex. If you don't want to take tablets, local anaesthetic creams and sprays are available which help to reduce the sensitivity of the penis. They may include masturbating an hour or two before intercourse.

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This may allow you to delay ejaculation when you have sex with your partner. Your care provider might recommend avoiding intercourse for a period of time. Focusing on other types of sexual play may remove the pressure you might feel during sexual intercourse. The male pelvic floor muscles support the bladder and bowel and affect sexual function. Kegel exercises can help strengthen these muscles. Weak pelvic floor muscles might make it harder to delay ejaculation.

Treatment Options for Premature or Rapid Ejaculation at UCLA

Dr Colin Tidy is an NHS Doctor, based in Oxfordshire. The information on this page is written and peer reviewed by qualified clinicians. 2 May 2013 Originally publishedAuthored by:Dr Laurence Knott Browse discussions, ask questions, and share experiences across hundreds of health topics. Your weekly dose of clear, trustworthy health advice - written to help you feel informed, confident and in control. Premature ejaculation isn’t cause for concern if it doesn’t happen often.

Sildenafil (Viagra®) for PE

Many people feel that they have symptoms of premature ejaculation, but the symptoms don’t meet the criteria for a diagnosis. It’s typical to experience early ejaculation at times. It’s common to feel embarrassed about discussing sexual health concerns. But don’t let that keep you from talking to your provider. For example, it might be reassuring to hear that it’s typical to experience premature ejaculation from time to time.

Neuromuscular electrical stimulation

The exact cause of premature ejaculation isn’t known. It’s common for premature ejaculation and anxiety to occur together. This may be true if you’ve had sexual relationships with other partners in which premature ejaculation didn’t happen often. This may happen whether you’re aware of it or not. This may happen if ejaculation doesn’t occur in the vagina. Pelvic floor exercises (Kegel exercises) can help strengthen these muscles. To find your pelvic floor muscles, stop urinating in midstream. Or tighten the muscles that keep you from passing gas. Both actions use your pelvic floor muscles. Once you've identified your pelvic floor muscles, you can exercise them in any position. However, you might find it easier to do them lying down at first. Tighten your pelvic floor muscles, hold for three seconds and then relax for three seconds.

• Explore prescription medications like Dapoxetine.
• Practice gradual exposure therapy techniques.
• Engage in cognitive-behavioral therapy to reduce anxiety.
• Use herbal supplements with caution and medical approval.
• Implement lifestyle changes to improve overall health.
• Avoid illicit drugs that impair sexual function.
• Incorporate regular exercise into your routine.
• Prioritize stress relief activities daily.
• Use timed masturbation to increase control.
• Restrict or delay alcohol consumption before sex.
• Focus on emotional intimacy, not just performance.
• Maintain patience and realistic expectations.

Try it a few times in a row. When your muscles get stronger, try doing Kegel exercises while sitting, standing or walking.

Therapy Type	Focus Area	Frequency of Sessions	Expected Outcomes
Individual Counseling	Addressing anxiety, trauma	Weekly or bi-weekly	Increased control
Couple's Sex Therapy	Improving communication and techniques	Weekly	Better intimacy, control
Group Therapy Sessions	Sharing experiences, peer support	Monthly	Reduced stigma

For best results, focus on tightening only your pelvic floor muscles. Be careful not to flex the muscles in your abdomen, thighs or buttocks. Aim to do at least three sets of 10 repetitions a day. Your health care provider might instruct you and your partner to use the pause-squeeze technique. Begin sexual activity, including stimulating the penis, until you feel almost ready to ejaculate. Then you or your partner can squeeze the end of your penis where the head joins the shaft. Keep squeezing for several seconds until the urge to ejaculate passes.

Premature Ejaculation Types

Once you’ve identified your pelvic floor muscles, you can exercise them in any position. Specially designed “climax control” condoms are available without a prescription. They’re applied to the penis 10 to 15 minutes before sex to reduce sensation and help delay ejaculation. These drugs aren’t approved by the Food and Drug Administration to treat premature ejaculation, but some are used for this purpose. It’s not currently available in the United States.

Sertraline (Zoloft®) for PE

If SSRIs don’t improve the timing of your ejaculation, your health care provider might prescribe the tricyclic antidepressant clomipramine (Anafranil). Tramadol might be prescribed when SSRIs haven’t been effective. Tramadol can’t women libido pills be used in combination with an SSRI. Counseling is most likely to help when it’s used in combination with drug therapy. Several alternative medicine treatments have been studied, including yoga, meditation and acupuncture. By repeating as many times as needed, you can reach the point of entering your partner without ejaculating. After some practice, delaying ejaculation might become a habit that no longer requires the pause-squeeze technique. If the pause-squeeze technique causes pain or discomfort, you can try the stop-start technique. It involves stopping sexual stimulation just before ejaculation. Then waiting until the level of arousal has diminished and starting again. Condoms might make the penis less sensitive, which can help delay ejaculation.

How RedBox Rx can help

The medicines are called lidocaine or prilocaine and some options may be bought over the counter and some are available on prescription. Other selective serotonin reuptake inhibitor (SSRI) antidepressants such as paroxetine, citalopram, escitalopram, fluoxetine and sertraline have also been offered in the past, but this is an unlicensed use of the tablet. You need to take these daily for at least one or two weeks to get the full effect and you may find they start to wear off after 6-12 months. They may also give you some unpleasant side-effects such as sickness and dizziness. Surgery has occasionally been helpful in men who have a short frenulum.

Lifelong premature ejaculation

This is the bridge of skin joining the head of the penis to the shaft. It is not a common treatment for premature ejaculation. Urethritis means inflammation of the urethra (the tube inside your penis which carries urine out of your bladder). Urethritis is usually caused by a sexually transmitted infection (STI) but not always. It can occur within a stable relationship.

Behavioral methods

Balanitis is a condition that causes the head of the penis to become inflamed, causing redness, soreness, or irritation under the foreskin. It’s more common in uncircumcised men and is usually treatable. Premature ejaculation: Dapoxetine; NICE advice, May 2014 Coskuner ER, Ozkan B; Premature Ejaculation and Endocrine Disorders: A Literature Review. Sexual and Reproductive Health Guideline; Disorders of ejaculation chapter. Dr Laurence Knott qualified in 1973 and has had extensive experience as a General Practitioner. Specially designed "climax control" condoms are available without a prescription. These condoms contain numbing agents such as benzocaine or lidocaine to delay ejaculation. They might also be made of thicker latex. Examples include Trojan Extended Pleasure and Durex Prolong. Creams, gels and sprays that contain a numbing agent — such as benzocaine, lidocaine or prilocaine — are sometimes used to treat premature ejaculation. They're applied to the penis 10 to 15 minutes before sex to reduce sensation and help delay ejaculation. However, a cream containing both lidocaine and prilocaine (EMLA) is available by prescription. Although topical numbing agents are effective and well tolerated, they have potential side effects. They may cause decreased feeling and sexual pleasure in both partners.

• Regularly practice pelvic floor strengthening exercises.
• Use delay sprays or gels containing numbing agents.
• Implement the pause technique during intimacy.
• Engage in longer foreplay to reduce pressure.
• Avoid excessive masturbation to improve control.
• Maintain a daily routine of physical activity.
• Discuss treatment options with a urologist.
• Keep a journal of symptoms and progress.
• Try mental distraction techniques to delay climax.
• Use guided imagery or visualization methods.
• Establish a pre-sex routine to increase confidence.
• Be patient and consistent with treatment efforts.

These drugs aren't approved by the Food and Drug Administration to treat premature ejaculation, but some are used for this purpose. They include antidepressants, pain relievers and drugs for erectile dysfunction. These medications might be prescribed for either on-demand or daily use. Also, they may be prescribed alone or with other treatments. A side effect of certain antidepressants is delayed orgasm. For this reason, selective serotonin reuptake inhibitors (SSRIs) are used to treat premature ejaculation.

Product	Onset of Action	Duration of Effect	Side Effects
Lidocaine Cream	10-15 minutes	30-60 minutes	Numbness, temporary loss of sensation
Benzocaine Gel	10-20 minutes	30-45 minutes	Allergic reactions in some
Spray (Lidocaine-based)	5-10 minutes	20-30 minutes	Tingling, temporary numbness

The SSRI dapoxetine is often used as the first treatment for premature ejaculation in some countries.

Learn more about premature ejaculation

It’s typical to feel embarrassed when talking about sexual problems. And it’s one that can be treated. Write down any other medical conditions with which you’ve been diagnosed, including mental health conditions. Don’t hesitate to ask more questions during your appointment. Is there a generic alternative to the medicine you’re prescribing? It's not currently available in the United States. Of the drugs approved for use in the United States, paroxetine seems to be the most effective.