Topical Sprays and Creams for Premature Ejaculation

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In other words, ejaculation occurs before a man wants it to happen. It may occur before or after beginning foreplay or intercourse. Some men experience a lot of personal distress because of this condition. As many as one in five men experience difficulty with uncontrolled or early ejaculation at some point in life.

Additional information

Specific instructions are adapted to the individual and unique characteristics of each patient. With the instructions from the therapist, the patient begins a series of daily masturbatory exercises designed to help him understand his ejaculation pattern and gain control. In summary, under the right circumstances and with ongoing motivation, ejaculation disorders can be overcome. The most important lesson to be learned by men and their partners is that there is hope and there are therapies that can help resolve the distress of ejaculatory difficulties. Often the first step, deciding to seek treatment and finding the proper professional is the most difficult.

Information to gather in advance

The most common sexual dysfunction for men is ejaculatory disorder. These include rapid or premature ejaculation (75%), delayed (8%) often nerve or drug induced, no ejaculation, and retrograde ejaculation from incompetence of bladder neck (ejaculate goes back into bladder instead of out) which occurs after a TURP. The DSMIV describes premature ejaculation as persistent or recurrent ejaculation within minutes. Statistics list 4 to 39% of men have premature ejaculation. Treatment is usually with SSRI’s and Sildenafil (Viagra™). When premature ejaculation happens so frequently that it interferes with the sexual pleasure of a man or his partner, it becomes a medical problem.

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Several factors may contribute to premature ejaculation. Psychological problems such as stress, depression and other factors that affect mental and emotional health can aggravate this condition.

What causes premature ejaculation?

Buproprion may be used but it is not all that effective. The patient must be checked to see if there are reversible causes before being given medication. There is research still needed women libido pills in this area. How does treatment for premature ejaculation work? All treatments focus on the same thing: how to delay ejaculation.

Transcutaneous posterior tibial nerve stimulation (TPTNS)

There are several treatments available that work well for PE, especially when used in combination. They include psychological approaches, behavioral techniques to control ejaculation during sex, condom use, topical anesthetics applied directly to the penis, and oral medications. Many men combine 2 or more of these therapies for the best all-around treatment. For the time being, we’ll focus on the 2 most common types of premature ejaculation pills available by prescription, SSRIs and PDE5 inhibitors. Certain prescription meds that can help delay ejaculation are prescribed off-label as premature ejaculation pills. However, there is growing evidence that biological factors can make some men more prone to experience premature ejaculation. Rarely, premature ejaculation can be caused by a specific physical problem, such as inflammation of the prostate gland or a spinal cord problem.

Supplement Name Main Ingredients Claim Typical Dosage Available Forms Price ($)
Semenax L-arginine, Tribulus terrestris Libido boost, delay As directed Capsules 30-60
Premature Eject Maca root, Ginseng Improve control 2 capsules/day Capsules 20-40
Max Performer Fenugreek, Zinc Longer endurance Once daily Tablets 25-50
ProLonger L-Tyrosine, Horny Goat Weed Delay climax 1-2 capsules Capsules 15-35

The key symptoms of premature ejaculation include: ejaculation that routinely occurs with little sexual stimulation and with little control decreased sexual pleasure because of poor control over ejaculation Premature ejaculation is diagnosed based on typical symptoms.

  • Delay pills might reduce sensation, extending intercourse time.
  • The safety profile of herbal pills is less documented than pharma drugs.
  • Patients should monitor for side effects and inform their doctor.
  • Psychological factors like anxiety can be addressed alongside pills.
  • Proper dosage and timing are key to maximizing benefits.

To understand your problem, your doctor will need to discuss your sexual history with you.

  • Pills may work by desensitizing penile nerves temporarily.
  • Certain antidepressants are used off-label for PE.
  • Not all pills are suitable for every age or health condition.
  • Effectiveness varies among individuals; patience is necessary.
  • Some formulations combine multiple ingredients for synergy.

The more your doctor knows, the better he or she can help you. If your sexual history fails to reveal significant mental or emotional factors that may contribute to premature ejaculation, your doctor may want to examine you. Your doctor may examine your prostate or do neurological tests (tests of your nervous system) to determine if there is a physical problem that could be causing premature ejaculation. Sometimes, premature ejaculation goes away on its own over weeks or months.

Are there natural treatments for premature ejaculation besides medications?

There are 2 main classes of oral premature ejaculation medicine available by prescription: antidepressants, especially SSRIs, and PDE5 inhibitors. Though these oral meds are currently prescribed as a treatment for premature ejaculation, the FDA hasn’t approved any oral medication specifically for PE. As a result, any premature ejaculation pills you’re prescribed are being used off-label. Certain antidepressants have the side effect of delaying orgasm. Since the chemical serotonin can help delay ejaculation, antidepressants that increase serotonin levels in your brain may be used to treat PE.

Lidocaine 2.5% and prilocaine 2.5% (EMLA)

This class of antidepressants is called selective serotonin reuptake inhibitors (SSRIs). Sertraline is a common SSRI that may be prescribed off-label as a PE treatment. Research shows that this med often works well, whether it’s used daily or on an as-needed basis. Take this medication as your doctor prescribes it, either each day or as needed before sexual intercourse. When used daily, this med takes 5-10 days to start working, and it will be 2-3 weeks before you see its full effects. Working to relieve stress or other psychological issues may help the situation to improve.

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The disorder may be lifelong or acquired, global or situational, with different treatments. Discussion included the criteria for clinical trials. Objective assessment is made by number of thrusts and intra-vaginal latency time, but there is no information regarding a normal range of number of thrusts, and the average intercourse lasts 4-7 minutes according to current literature. The classic definition of rapid ejaculation is if the man ejaculates within 1 minute of penetration. It is theorized that the central regulation is by dopamine and penile hypersensitivity, so treatment may be with Sildenafil and local anesthetic.

The Psychological Component: Addressing the Mind

If you have premature ejaculation there is a 91 % chance that a first degree relative (father, brother, son) will also have it. SSRI’s which are used for depression are a first line treatment as well. They may be used before intercourse or taken every night. This treatment works better for people whose rapid ejaculation is acquired. Since Sildenafil is more effective than SSRI’s, a combination of an anti-depressant, local anesthetic and Sildenafil is effective in 97% of the time. Other men have lasting difficulties with premature ejaculation, and require professional help. Some men respond to treatment promptly, while others struggle with this problem over a prolonged period.

Brand Name Active Ingredient Duration of Effect Typical Dose Side Effects Price Range ($)
Fortacin Lidocaine 30-60 minutes 2 sprays per use Numbness, irritation 15-25
Emla Cream Lidocaine & Prilocaine 30-45 minutes Apply 10-15 mins before Loss of sensation 10-20
Dapoxetine (Priligy) Dapoxetine 1-3 hours 30 mg as needed Dizziness, nausea 1.5-2.5 per pill
Super Ejaculation Tramadol (off-label) 2-4 hours 50 mg Drowsiness, constipation 12-18
Amlodipine Amlodipine (off-label) Varies 5-10 mg daily Swelling, fatigue 5-12

There is no known way to prevent premature ejaculation.

Premature Ejaculation Risk Factors

Viagra is also prescribed for many men with early ejaculation. Viagra helps to maintain the erection after ejaculation and reduces the refractory time before a second erection can be obtained. These medications may be combined with various creams aimed at reducing sensitivity. After successful intercourse and renewed confidence, men begin to learn the signs of pending ejaculation and ultimately learn to gain increased control. Sex therapy for early ejaculation includes learning a behavioral program designed to improve self-control.

Sex therapy

In a therapeutic program, the first step is usually education. It is important that the couple have an understanding of the problem, it’s origins, the prognosis and the need to work together toward a satisfying solution. The partner must also understand that the man is not being selfish and that ejaculatory control is unsatisfying for him as well. The most common behavioral approach taught by sex therapists is either the squeeze technique or an approach described as “start and stop”. These techniques, originally developed by Masters and Johnson, require patience, practice and a commitment to solving the problem. However, you should consider the following advice: If you experience feelings of anxiety, guilt or frustration about your sex life, consider seeking psychotherapy or sexual therapy.

Preparing for your appointment

Oral ED drugs are part of a class of medications known as phosphodiesterase-5 (PDE-5) inhibitors. Again, the FDA has not approved these meds as PE treatments, though they are FDA-approved to treat erectile dysfunction. In some cases, premature ejaculation is a side effect of erectile dysfunction. When ED is the underlying cause of PE, your doctor will treat the erectile dysfunction first. For many patients, successfully treating ED will also solve the premature ejaculation problem.

2. Magnesium

If you suffer from both sexual conditions, a drug like sildenafil can be a beneficial all-around treatment. Want to get more information on your options or any of the specific meds we prescribe? Talk to a Lemonaid doctor or nurse practitioner about your symptoms. When appropriate, our medical team prescribes meds like sildenafil (Viagra) and tadalafil (Cialis). Premature ejaculation occurs when a man reaches orgasm and ejaculates too quickly and without control. Keep in mind that anyone can experience sexual problems.

Pill Type Effectiveness Rate (%) Onset of Action Duration of Effect User Satisfaction (%) Notes
Lidocaine-based sprays 70-85 5-15 mins 30-60 mins 75 Quick, numbing effect
Dapoxetine tablets 60-80 1-3 hours 1-3 hours 70 Prescription required
Natural supplements 40-60 Varies Varies 50 Limited scientific evidence
Tramadol off-label 75 30 mins 2-4 hours 80 Additional risks involved

If you experience premature ejaculation, try not to blame yourself or feel inadequate. Try speaking openly with your partner to avoid miscommunication.

When to call a professional

The anti-depressant with sildenafil is signficantly better than the SSRI alone. Although this is currently the preferred therapy, medical insurance typically covers 30 pills for SSRI’s and only 4 sildenafil tablets per month. If that doesn’t work a local anesthetic like Emla cream (with a condom to protect the partner) should be added to the regimen. If that still is not effective the patient make you intracavernosal injection. Fast acting SSRI’s specifically for rapid ejaculation are currently in development.

2. Condoms

Delayed ejaculation carries with it issues of inability to achieve orgasm and infertility. Anti-depressants or agents which act centrally such as Valium, anti-hypertensives and alchohol abuse all can affect this. First it is important to evaluate if this is a psychological problem, but a physical assessment must be made as well. A common cause is pudendal neuropathy, caused by a crush to the perineum such as from bike riding with a narrow saddle. If the delayed ejaculation is situational is is probably psychologic; if it is generalized the problem is probably biologic.