Techniques for Preventing Premature Ejaculation
Premature ejaculation occurs when a man ejaculates during sexual intercourse sooner than he or his partner would like or achieves satisfaction. Premature ejaculation is one of the most common complaints affecting men from time to time—one out of three men have indicated they have experienced premature ejaculation. It often occurs early in relationships when sexual excitement, anxiety, and overstimulation are common features. When it occurs infrequently, premature ejaculation is not generally a reason for concern.1
Premature ejaculation is identified using the following criteria:2
Ejaculation occurs within one minute of penetration.
Ejaculation cannot be controlled or delayed in all or most cases for at least 6 months3
It causes frustration and distress, and a tendency to avoid sexual interaction.
Premature ejaculation is more common in younger men who are finding out about sexual activity and sexual relationships, and in men of all ages after a long period of abstinence. Premature ejaculation is rarely caused by any underlying disease, structural or physical problems.
According to the International Society of Sexual Medicine, the average time to ejaculation is between 5 and 7 minutes.4 Men who are experiencing premature ejaculation should consider visiting a urologist. Sometimes a questionnaire like the Premature Ejaculation Diagnostic Tool will be used during their office visit.
Performance anxiety may be the major cause of premature ejaculation, and talking to your sexual partner about your feelings may help in dealing with the issue. Remember that it is a common experience for men and women. Find ways to relax more, and the problem often goes away.5
Treatment includes behavioral techniques, therapy (such as cognitive behavioral therapy or psychotherapy), and medications. Here are several tips and methods you can try to help with issues of premature ejaculation.
If your arousal levels are getting too high and a climax is beginning, take a deep breath and think about something else, something very boring if possible—you’ve probably heard the popular culture advice, “think about baseball!” When you are less aroused but maintaining an erection you can then continue.
If you find yourself nearing climax, withdraw your penis from your partner and allow yourself to relax enough to prevent ejaculation. By starting and stopping sexual stimulation, you can learn to prolong the sexual experience and delay ejaculation.
This method involves either the man or his partner squeezing (fairly firmly) the end or the tip of the penis for 10 to 20 seconds when ejaculation is imminent, withholding stimulation for about 30 seconds, and then continuing stimulation. This can be repeated until ejaculation is desired. The stop-and-start method can be used with the squeeze method as well.6
Stimulate your partner to a state of high arousal before you have your genitals touched, that way ejaculation and orgasm can be achieved about the same time.
Practice different methods by yourself to learn how your body responds to stimulation and how to delay ejaculation. Getting to know your feelings and sensations gives you the chance to gain confidence.7
Creams can be used to desensitize the end of the penis. They act like a local or topical anesthetic. These medications include creams, gels, or sprays such as lidocaine, prilocaine, or benzocaine, which cause reduced sensitivity of the penis. Thicker condoms can also desensitize by decreasing sensitivity and therefore stimulation, thus prolonging the sexual act.8
Other medications include selective serotonin reuptake inhibitors, or SSRIs, which are prescribed for use as needed (“on demand”), or, as with paroxetine, as off-label daily dosing. Phosphodiesterase-5 inhibitors, such as sildenafil (Viagra), may be used effectively if premature ejaculation occurs with erectile dysfunction.
Opioid medication such as tramadol (prescribed off-label) may be considered. A combination of both anxiety reduction and medication can be used as well.
A Word From Verywell
Remember getting good at sex and overcoming premature ejaculation can take a bit of time. Practice makes perfect. If you find that things are not improving then help is available from sex therapists who are experts in this field.