Premature ejaculation (PE), also known as premature climax or early ejaculation, can occur at any stage of a man’s life. The exact cause of PE is unknown, but doctors and researchers believe there are psychological, behavioral, and medical factors which may contribute to the condition. Your doctor will work with you to identify any contributing factors. Your treatment plan may include psychological therapy, behavioral therapy, medicine, or a combination of these.

Psychological Treatments

Psychological factors such as depression, stress, unrealistic expectations, and lack of confidence are all factors which can contribute to PE. An individual counselor, couples counselor or a sex therapist can teach you how to relax, communicate with your partner, and identify issues in your relationships which may be affecting intimacy. Your therapist can also give you suggestions on how to enhance sexual satisfaction in your relationships. While psychological treatment can be effective for treating PE on its own, you may benefit from a multifaceted approach which combines psychological therapy, behavioral therapy, and medication.

Behavioral Therapy

Behavioral therapy makes use of exercises to treat premature ejaculation. Masters and Johnson developed the squeeze method in which a partner stimulates the man’s penis until just before ejaculation, and then firmly squeezes the shaft of the penis to lessen arousal and prevent ejaculation. This exercise aims to teach a man to be aware of the sensations leading to orgasm, and then regain control of ejaculation. The stop-start method is an exercise where the partner stimulates the man’s penis until just before ejaculation, and then stops all stimulation until the man regains control. The exercise is repeated three times until the man is permitted to ejaculate the fourth time. Therapists recommend that couples practice the stop-start method three times a week until the man gains good control over his ejaculations.

Although behavioral methods may temporarily alleviate symptoms of PE, the exercises rely on working with a partner, and may not provide a permanent solution to the problem.

Medications

Although the use of antidepressants and local anesthetics have not been approved by the US Food and Drug Administration (FDA) for treatment of premature ejaculation, some doctors prescribe them “off-label” (medication prescribed for a different illness than it was developed for) because it helps their patients.

Some studies suggest that low levels of serotonin cause delays in ejaculation. As such, antidepressants which increase serotonin in the brain can be prescribed to delay ejaculation.Local anesthetic creams can be applied to the head of the penis to reduce sensitivity during arousal. Prior to actual intercourse the cream should be washed off so it does not cause vaginal numbness.

Speak with your doctor about which treatment approaches are right for you.