"Efficacy and safety of pharmacological treatments in patients with premature ejaculation: an umbrella review of meta-analyses of randomized controlled trials". ^ a b c d e f Crowdis, Marissa; Nazir, Saad (2022), "Premature Ejaculation", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID 31536307, retrieved 2022-07-19 ^ Hutchinson, K; Cruickshank, K; Wylie, K (May 1, 2012).
| Side Effect | Medication Type | Incidence Rate | Severity Level | Management Strategies | Notes |
|---|---|---|---|---|---|
| Nausea | SSRIs, topical anesthetics | 10-15% | Mild to Moderate | Dose adjustment, timing | Usually transient |
| Dizziness | SSRIs, topical anesthetics | 8-12% | Mild | Standing slowly, hydration | Common with beginning treatment |
| Headache | SSRIs, topical anesthetics | 5-10% | Mild | Analgesics, time to adjust | Typically diminishes over time |
| Reduced Sensation | Topical anesthetics | 10-20% | Mild | Reduced dose, application timing | Can affect partner satisfaction |
"A benefit-risk assessment of dapoxetine in the treatment of premature ejaculation".
Scheduling an Appointment
[53] Other studies report PE prevalence ranging from 3 percent to 41 percent of men over 18, but the great majority estimate a prevalence of 20 to 30 percent—making PE a very common sex problem. [5][11][52][55][23][56][57][58] There is a common misconception that younger men are more likely to develop premature ejaculation and that its frequency decreases with age. [59][60] Prevalence studies have indicated, however, that rates of PE are relatively constant across age groups. Male mammals ejaculate quickly during intercourse, prompting some biologists to speculate that rapid ejaculation had evolved into genetic makeup of human males to increase their chances of passing their genes. Ejaculatory control issues have been documented for more than 1,500 years.
How common is premature ejaculation?
The Kamasutra, the 4th century BCE Indian marriage handbook, declares that "if a male be long-timed, the female loves him the more, but if he be short timed, she is dissatisfied with him. Waldinger summarizes professional perspectives from early in the twentieth century. Sex researcher Alfred Kinsey did not consider rapid ejaculation a problem, but viewed it as a sign of "masculine vigor" that could not always be cured. [66] The belief that it should be considered a disease rather than a normal variation, has also been disputed by some modern researchers. In the 19th century, a symptom called spermatorrhoea invented by William Acton in 1857, meaning excessive or involuntary semen discharge, was developed and at the time used as a medical justification of celibacy. ^ McMahon, CG; Althof, SE, Kaufman, JM, Buvat, J, Levine, SB, Aquilina, JW, Tesfaye, F, Rothman, M, Rivas, DA, Porst, H (February 2011). "Efficacy and safety of dapoxetine for the treatment of premature ejaculation: integrated analysis of results from five phase 3 trials".
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{{cite journal}}: CS1 maint: multiple names: authors list (link) ^ Zhang, Dong; Cheng, Yue; Wu, Kerong; Ma, Qi; Jiang, Junhui; Yan, Zejun (2019-01-03). "Paroxetine in the treatment of premature ejaculation: a systematic review and meta-analysis". "The use of tramadol "on-demand" for premature ejaculation: a systematic review".
When to seek medical attention
[68][69] Spermatorrhoea was later sub-classified into other symptom clusters based partially on how it affected semen. [69] Treatment for spermatorrhoea at the time included catheterisation, cauterisation, circumcision, and sticking needles through the perineum into the prostate. [69] In the 19th and early 20th centuries, cultural stigma towards researching sexuality drove its unpopularity as a subject of study among doctors and in publications. [68] The first recognition the symptoms described in spermatorrhoea as a disorder in itself is believed to be in 1883, termed ejaculatio praecox. [69] The origin of the modern version of ejaculatio praecox, called premature ejaculation, is thought to have begun with Alfred Adler before major developments of psycohanalytic theory.
Lidocaine 2.5% and prilocaine 2.5% (EMLA)
Through the mid 20th century, Sigmund Freud published widely accepted and virtually unchallenged theories that rapid ejaculation was due to neurosis, that penetrative sex was the only right way to achieve female orgasm, and that a man's erection was essential to female orgasm. [71][72] It stated that males who ejaculate prematurely have unconscious hostility toward females, so they ejaculate rapidly, which satisfies them but frustrates their partners, who are unlikely to experience orgasm that quickly. [73] Freudians claimed that premature ejaculation could be cured using psychoanalysis. But even years of psychoanalysis accomplished little, if anything, in curing premature ejaculation. [73] In 1974, there was no evidence found to suggest that men with premature ejaculation harbor unusual hostility toward females. "Phosphodiesterase Type 5 Inhibitors for Premature Ejaculation: A Systematic Review and Meta-analysis". "Pd69-02 Double-Blind, Randomized Controlled Trial of Topical 4% Benzocaine Wipes for Management of Premature Ejaculation: Interim Analysis".
| Medication Name | Type | Typical Dosage | Onset Time | Duration of Effect | Common Side Effects | Approval Status | Available By Prescription | Estimated Cost (USD) |
|---|---|---|---|---|---|---|---|---|
| Dapoxetine | SSRI | 30 mg | 1-3 hours | 12-24 hours | Nausea, dizziness, headache | Approved | Yes | 2-5 |
| Paroxetine | SSRI | 20 mg/day | 1-2 hours | 24 hours | Fatigue, dry mouth | Approved | Yes | 1-4 |
| Sertraline | SSRI | 50 mg/day | 2-4 hours | 24 hours | Diarrhea, insomnia | Approved | Yes | 2-4 |
| Topical Anesthetics | Local anesthetic | Varies | Immediate | 30-60 minutes | Loss of sensation in area | Approved | Yes | 3-7 |
"Selective resection of dorsal nerves of penis for premature ejaculation".
| Strategy | Description | Expected Outcome | Time Frame | Additional Notes |
|---|---|---|---|---|
| Mindfulness Meditation | Practice focusing on the present moment to reduce anxiety | Reduced performance anxiety | Weeks to months | Complements other treatments |
| Sensate Focus Exercises | Partner-based touching exercises to build comfort | Increased control and intimacy | Several weeks | Requires partner cooperation |
| Cognitive Behavioral Therapy | Therapy addressing thoughts and anxiety related to sex | Better sexual confidence | Several sessions | Often part of a comprehensive plan |
"Effects of glans penis augmentation using hyaluronic acid gel for premature ejaculation". "Long-term effects of glans penis augmentation using injectable hyaluronic acid gel for premature ejaculation". "Surgery is not indicated for the treatment of premature ejaculation".
Preparing for your appointment
"A multinational population survey of intravaginal ejaculation latency time". "Proposal for a definition of lifelong premature ejaculation based on epidemiological stopwatch data". "Canadian Male Sexual Health Council Survey to Assess Prevalence and Treatment of Premature Ejaculation in Canada". Nevertheless, it is well accepted that men with IELTs below 1.5 minutes may be "happy" with their performance and do not report a lack of control, and therefore, do not suffer from PE. "Disorders of Ejaculation: An AUA/SMSNA Guideline".
Chatbots’ performance in premature ejaculation questions: a comparative analysis of reliability, readability, and understandability
conceptualized two provisional diagnoses that may be applicable in the context of men who have concerns about PE but do not meet specific criteria for either lifelong or acquired PE. Natural variable PE is defined as occasional short ELT that occurs irregularly and inconsistently and over which the man feels diminished sense of control. This condition is typically minimally or non-disruptive of overall sexual satisfaction and does not occur with a frequency that poses serious impediment for the patient. Subjective PE (SPE, also known as PE-like dysfunction) is defined as subjective concern or preoccupation about short ELT that is within population norms.24 Data on management of these provisional conditions is limited; for the time being education and/or psychosexual therapy, rather than pharmacotherapy, are favored as the treatments of choice for Natural variable PE and SPE. ^ a b c d Serefoglu E.C. "Is there a place for surgical treatment of premature ejaculation?".
About this article
This so-called coital imperative has later been argued as a medically recognised disorder that did not actually serve the satisfaction of women but rather contributed to the pressure on and pathologisation of men in obtaining a so-called optimal time to ejaculation. ; Giraldi, Annamaria; Glina, Sidney; Incrocci, Luca; Jannini, Emmanuele; McCabe, Marita; Parish, Sharon; Rowland, David; Segraves, Robert Taylor; Sharlip, Ira; Torres, Luiz Otavio (June 2014). "An evidence-based unified definition of lifelong and acquired premature ejaculation: report of the second international society for sexual medicine ad hoc committee for the definition of premature ejaculation". "Premature and delayed ejaculation: Genetic and environmental effects in a population-based sample of Finnish twins". "Premature Ejaculation: The Scope of the Problem".
How can I prevent premature ejaculation?
"Premature or Rapid Ejaculation: Heterosexual Couples' Perceptions of Men's Ejaculatory Behavior". "Premature Ejaculation Results in Female Sexual Distress: Standardization and Validation of a New Diagnostic Tool for Sexual Distress". "What Does Premature Ejaculation Mean to the Man, the Woman, and the Couple?". "Treatment of rapid ejaculation: Psychotherapy, pharmacotherapy, and combined therapy", pp. ), Principles and practice of sex therapy (4th ed.). "Urologist's Practice Patterns Including Surgical Treatment in the Management of Premature Ejaculation: A Korean Nationwide Survey".
- Dapoxetine's side effects can include nausea, headache, and dizziness.
- Topical anesthetics include lidocaine and prilocaine-based creams or sprays.
- SSRIs like fluoxetine, sertraline, may also be used off-label for PE.
- Opioid medications require careful medical oversight due to dependency potential.
- Behavioral approaches are first-line treatment for many men with PE.
- Regular exercise can improve overall sexual function and control.
- Some innovations include vibration devices to delay ejaculation temporarily.
- Medical tests may be recommended to exclude underlying causes.
- Education about sexual response stages can improve control strategies.
- Sex therapy often involves both partners to address relational issues.
- Medications may take several weeks to show maximum benefit.
- Lifestyle modifications, like reducing alcohol, can also help manage PE.
"Sexual Dysfunction in the United States: Prevalence and Predictors". "Next Men's Clinic Erectile dysfunction in the community: trends over time in incidence, prevalence, GP consultation and medication use—the Krimpen study: trends in ED".
- Topical anesthetic creams temporarily desensitize the penis to delay ejaculation.
- SSRI medications like paroxetine are prescribed off-label for premature ejaculation.
- Dapoxetine is a short-acting SSRI specifically approved for PE treatment.
- Tramadol, an opioid, can help delay ejaculation but carries dependency risks.
- Topical sprays offer quick, localized numbing effects to control ejaculation timing.
- PDE5 inhibitors like sildenafil may improve performance in men with PE and ED.
- Behavioral therapies include the stop-start and squeeze techniques to extend duration.
- Kegel exercises strengthen pelvic muscles, potentially delaying ejaculation.
- Counseling and sex therapy can address psychological causes of PE.
- Combining medication with behavioral techniques enhances treatment effectiveness.
- Herbal supplements lack robust clinical evidence but are used by some for PE.
- Consultation with a healthcare provider is essential to tailor appropriate therapy.
"Prevalence and Correlates of Premature Ejaculation in a Primary Care Setting: A Preliminary Cross-Sectional Study". "The Premature Ejaculation Prevalence and Attitudes (PEPA) Survey: Prevalence, Co-morbidities, and Professional Help-Seeking".
Guidelines for Management of Premature Ejaculation
Effects of a new functional-sexological treatment for premature ejaculation. Journal of Sex & Marital Therapy, 32(2), 97-114. "Re: Effects of a New Functional-Sexological Treatment for Premature Ejaculation". "The US Public's Use of and Interest in Sex Therapy". doi:10.1080/0092623X.2023.2264470 (inactive 1 July 2025). "Self-Reported Premature Ejaculation and Aspects of Sexual Functioning and Satisfaction".
Analgesic, Opioid
"New Insights on Premature Ejaculation: A Review of Definition, Classification Prevalence, and Treatment". EAU Guidelines on Erectile Dysfunction, Premature Ejaculation, Penile Curvature and Priapism (PDF). Archived from the original (PDF) on 16 March 2018. ^ Masters, W.; V. Johnson (1970), Human Sexual Inadequacy, Little Brown & Company Lasting Longer: The Treatment Program for Premature Ejaculation. "8 Sex Myths That Experts Wish Would Go Away".
What Are the Signs and Symptoms of Premature Ejaculation?
"Demonstration of ejaculation-induced neural activity in the male rat brain using 5-HT1A agonist 8-OH-DPAT". "International Society for Sexual Medicine's Guidelines for the Diagnosis and Treatment of Premature Ejaculation". Archived from the original (PDF) on 2021-11-06. {{cite web}}: CS1 maint: archived copy as title (link) ^ Böhlen D, Hugonnet CL, Mills RD, Weise ES, Schmid HP (2000). "Five meters of H(2)O: the pressure at the urinary bladder neck during human ejaculation".
Analysis of the Average Time to Ejaculate for Men
"Identification 10mg vardenafil online of a potential ejaculation generator in the spinal cord". ^ Kinsey, Alfred (1948), Sexual Behavior in the Human Male, Philadelphia: W. B. Saunders Co Archived from the original on 2017-07-08. {{cite web}}: CS1 maint: bot: original URL status unknown (link) ^ Waldinger MD, Quinn P, Dilleen M, Mundayat R, Schweitzer DH, Boolell M (2005). "Premature ejaculation: challenging new and the old concepts".