Psychological therapy, behavioral therapy, and drugs are the main treatments for PE. You can talk with your health care provider to decide what will help. More than one type of treatment may be used at the same time.
Therapy is a way to address the negative feelings and emotions that lead to problems with sexual relationships. Psychological therapy can be used as the only treatment, or it may be used along with medical or behavioral therapy. The goal of therapy is to learn the source of problems and find solutions that may end PE. It can also help couples learn to grow closer. Psychological therapy can help you become less nervous about sexual performance. It can also give you greater sexual confidence and understanding to improve your partner's satisfaction.
Behavioral therapy uses exercises to help build tolerance to delay ejaculation. The goal is to help you train your body away from Premature ejaculation. Examples include the squeeze method and the stop-start method. Exercises work well, but they may not be a lasting answer. They depend upon your partner's help, which is not always possible.
The Squeeze Method
With this method, your partner stimulates your penis until you are close to ejaculation. When you are close, your partner firmly squeezes your penis so your erection partly goes away. The goal is for you to become aware of the sensations leading to climax. Then you can better control and delay climax on your own.
The Stop-Start Method
In this method your partner stimulates your penis until just before ejaculation. Your partner then stops until the urge to climax lets up. As you regain control, you ask your partner to start stimulating your penis again. This process is repeated 3 times. You ejaculate on the fourth time. You repeat this method 3 times a week with your partner until you have gained more control.
No drugs have been approved in the United States to treat PE. Still, there are some drugs and numbing creams or sprays that have been shown to slow ejaculation in men with PE.
Doctors noticed that men and women on antidepressants have delayed orgasms. Drugs such as fluoxetine, paroxetine, sertraline and clomipramine affect serotonin levels. Doctors began to use these drugs "off-label" (for a different reason than the drug's original use) to treat PE. If one drug doesn't work, your doctor may have you try a different drug. If the second drug doesn't work, others will not likely help.
Drugs for PE can be taken every day or only before sex. Your health care provider will decide when you should take a drug based on your activity level. The best time to take the drug is not clear. Most doctors suggest from 2 to 6 hours before sex. PE can return if you stop taking these drugs. Most men with PE need to take these drugs on an ongoing basis.
Numbing Creams or Sprays
These creams/sprays are put on the head of the penis about 20 to 30 minutes before sex. If you leave the numbing cream/spray on your penis for longer than suggested, your erection may go away. Also, the numbing cream/spray should not be left on the exposed penis during vaginal sex because it may cause vaginal numbness. Wash the cream off your penis 5 to 10 minutes before sex. Wearing a condom can also help dull sensation.