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What are some of the treatments for premature ejaculation?

Some doctors will prescribe drugs called selective serotonin reuptake inhibitors (SSRIs) to treat premature ejaculation. Though these are antidepressants, they’re prescribed “off-label” for premature ejaculation because of their common side effect of dampening sexual stimulation. Another medical treatment option is an anesthetic cream, like lidocaine.

Some men have had luck treating the problem with a drug called Tramadol, but this drug can potentially be addicting, so doctors are cautious about prescribing it.

Certain drugs can help men address premature ejaculation.

Newer research is finding that drugs in a class known as PDE-5 inhibitors (which include Viagra, Cialis, Levitra, and other erectile dysfunction drugs) are helpful in men whose premature ejaculation results from erectile dysfunction. In some men, a PDE-5 inhibitor plus an SSRI works better than either of those two options alone.

There is a small subset of men with primary premature ejaculation who have a short frenulum, which is the elastic band of tissue that connects the penis to the foreskin. Normally the frenulum is long and supple enough that it doesn’t cause problems, but when it’s too short, premature ejaculation can be a result. Fortunately, frenulectomy (removal of the frenulum) can successfully treat these cases.

Pelvic floor exercises can strengthen weak pelvic floor muscles, and a weak pelvic floor can impair a man’s ability to delay ejaculation. You can find instructions on doing helpful Kegel exercises on many reputable medical websites. Another exercise recommended by some doctors is known as the pause-squeeze technique. Here’s how you do it:

Start sexual activity as usual and continue until you are almost ready to ejaculate

At this point, have your partner firmly (but not painfully) squeeze the end of your penis where the head joins onto the shaft, squeezing for a few seconds, until the urge to ejaculate abates.
Repeat as necessary. Keep in mind that the pause-squeeze technique requires practice.

A 2015 meta-analysis of behavior therapy, drug therapy, and combination therapy found a small, but statistically significant improvement in results when drug therapy for premature ejaculation is combined with behavioral therapy (like the pause-squeeze technique, masturbating an hour or two before sex, or strengthening the pelvic floor).

Premature ejaculation happens on occasion to just about all men. It’s only considered a disorder if it happens consistently and causes personal distress. Though it’s not the easiest topic to broach with your doctor, talking to a professional is the first step in treating premature ejaculation. Left untreated, it can cause greater personal stress and even relationship problems. For couples trying to conceive, premature ejaculation can cause problems if ejaculation doesn’t occur intravaginally.

Fortunately, there are a number of ways to treat premature ejaculation, from the mechanical (condoms) to the behavioral to the pharmacological. There’s simply no reason to suffer in silence if premature ejaculation is a problem. Solutions exist, and you deserve a satisfying sex life as much as anyone else!

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