Behavioral therapy is one possible approach for treating premature ejaculation. Most commonly, the "squeeze technique" is used. If a man senses that he is about to experience premature orgasm, he interrupts sexual relations. Then the man or his partner squeezes the shaft of his penis between a thumb and two fingers. The man or his partner applies light pressure just below the head of the penis for about 20 seconds, lets go, and then sexual relations can be resumed. The technique can be repeated as often as necessary. When this technique is successful, it enables the man to learn to delay ejaculation with the squeeze, and eventually, to gain control over ejaculation without the squeeze. Behavioral therapy helps 60% to 90% of men with premature ejaculation. However, it requires the cooperation of both partners. Also, premature ejaculation often returns, and additional behavioral therapy may be needed.
Another possible treatment is prescription medication that helps to delay ejaculation. Delayed orgasm is a common side effect of certain drugs, particularly those used to treat depression. This is true even for men who are not depressed. When this type of medication is given to men who experience premature ejaculation, it can help to postpone orgasm for up to several minutes. Drugs used for this type of treatment include selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac), paroxetine (Paxil) or sertraline (Zoloft); and tricyclic antidepressants, such as clomipramine (Anafranil).
Some men with premature ejaculation may benefit from drugs called phosphodiesterase inhibitors, such as sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis). A phosphodiesterase inhibitor can be used alone or in combination with an SSRI. One drug should be started at a time, preferably at a low dose.
Some men with premature ejaculation also benefit from reducing the stimulation they experience during sex. A number of creams are available that can partially anesthetize (numb) the penis and reduce the stimulation that leads to orgasm. Another option is to use one or more condoms. However, these techniques may interfere with the pleasure experienced during sex.
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