Treating premature ejaculation

Although studies show that around three percent of men are currently experiencing premature ejaculation (PE), estimates suggest up to 30 percent of men may be affected by it. Many men feel embarrassed to seek help for this condition, but it can be treated.

What is premature ejaculation?

PE is when a man feels that he ejaculates too soon during sex. A study looked at 500 couples from five different countries and found that sex tends to last around five and a half minutes. However, this is highly variable and depends on what the couple feels is satisfying for both partners.  Any man can experience PE at one time or another. When it happens regularly, it can have an impact on the couple's relationship.

What are the types of PE?

For a small number of men, PE can be lifelong (primary), where PE has occurred since the start of sexual activity. Secondary PE develops after the man has had a period of time without any instances of PE.

What are the causes of PE?

These can include:

• Medical causes, like thyroid conditions or prostate problems

• Psychological causes, such as depression, anxiety and stress

• Alcohol and recreational drug use

When should I see my GP?

Consider making an appointment with your GP if:

• You're worried that you may have PE or if you feel upset about experiencing PE

• You think your symptoms may stem from a physical condition or a medicine you're taking

• Your PE is causing tension in your relationship with your partner

It's important to go to your GP so they can rule out or diagnose an underlying physical condition that may be causing your PE. Your GP will be able to assess you and may run some tests to check if your symptoms are due to a medical condition. If needed, you'll receive the appropriate treatment. Treating any underlying physical condition should help resolve PE. Psychological causes like anxiety and depression can often be effectively managed, either with medicines prescribed by your GP, with talking therapy or a combination. There are also self-management techniques you can try at home. You're likely to see an improvement in symptoms once the underlying condition is well controlled. Speak to your GP if you need help to reduce your alcohol intake or to stop taking recreational drugs. This can help to reduce your PE symptoms, as well as being likely to improve your overall health and wellbeing. 

How can I manage symptoms myself?

Wear a condom

This can help men who have a particularly sensitive penis. You may be able to find thicker condoms or condoms with local anaesthetic, both can help to reduce sensitivity. Your pharmacist will be able to advise you about the most suitable condom option for you.

Take a deep breath if you feel you're about to ejaculate

This is a reflex that can temporarily halt the progression of your climax.

Stop for a short moment during sex

This can help to clear your head. Try thinking of something completely different to help put off ejaculation.

Avoid having long periods of time between sexual activity

This includes between sexual intercourse and masturbation, as this makes PE more likely. Masturbating two to three hours before having sex may help with your symptoms.

Consider an online clinic

The Boots Premature Ejaculation Online Clinic can provide access to a prescription-only medicine called Priligy (subject to stock availability and clinician approval. Charges apply). A discreet online consultation will assess whether the treatment is suitable for you.

Speak to your pharmacist

They may be able to recommend a local anaesthetic cream or spray that you can apply to your penis before sex to decrease sensation. However, your partner may also feel its effects during penetrative sex.

How does therapy for couples help?

PE can put a couple's relationship under strain, and a stressful relationship can itself cause PE. Discussing any problems with a psychologist can often improve the relationship and help to resolve PE symptoms. During therapy, the couple may also learn about different techniques you can try to help delay ejaculation. Here are some common ones:

The 'squeeze' technique

This involves having your partner masturbating you to the point of ejaculation then squeezing on the head of the penis for about 10 to 20 seconds. Then, wait for half a minute before starting all over again. The cycle is repeated for a few more times before allowing ejaculation to occur.

The 'stop-go' technique

This uses the same principles as above, but your partner doesn't squeeze on the penis. This is usually harder but it's a natural progression from the 'squeeze' technique. Once the couple feels more comfortable, they can have sex normally, stopping or proceeding as they need.

Which medicines can treat my symptoms?

If self-help methods don't work, you may want to consider medication through your GP or an online service like the Boots Premature Ejaculation Online Clinic (subject to stock availability and clinician approval. Charges apply). A medicine called dapoxetine (Priligy) has been developed specifically to help treat PE. It shouldn’t be taken daily but can be taken when needed, one-to-three hours before sex (but only a maximum of one tablet a day). Priligy is the treatment option in our online clinic. Dapoxetine isn't suitable for everyone. Before prescribing it, your GP will need to make sure that you don't have certain medical conditions and that it doesn't interact with any other medicines you're taking, like antidepressants. If you choose to access the medicine through the Boots Premature Ejaculation Online Clinic, one of our online clinicians will check suitability during a discreet online consultation.

Is it PE or ED?

Erectile dysfunction (ED) is when a man can't achieve or maintain an erection. Some people will find themselves affected by both, particularly as both conditions can be caused or made worse by anxiety. In such circumstances, ED is treated first and then PE symptoms often resolve naturally. 

Next steps

• Visit your GP to have the cause of your PE diagnosed

• Try self-help methods, such as wearing thicker condoms or practicing self-management techniques

• Seek therapy as a couple where you may be able to resolve relationship difficulties and learn techniques that help delay ejaculation