How to stop premature ejaculation?

What is premature ejaculation?

Premature ejaculation (PE) is a common sexual problem in which ejaculation happens sooner than a man or his partner would like, with limited ability to delay it. The International Society for Sexual Medicine defines lifelong PE as ejaculation that always or nearly always occurs before or within about one minute of penetration, together with difficulty delaying ejaculation and associated distress. Acquired PE involves a clinically significant and bothersome reduction in ejaculatory latency after a period of normal sexual function. [2] Therefor, it can occur from the start of a man’s sexual life or develop later, and may be influenced by psychological, relationship or physical factors.

Reported prevalence varies substantially depending on how PE is defined. A recent systematic review found a weighted mean prevalence of about 14%, while estimates for lifelong PE were around 12%; broader surveys using less strict definitions have reported substantially higher rates. [3]

Occasional episodes are common and not a cause for concern; it's the persistent, distressing pattern that's worth acting on. Both psychological and physical factors can be involved. Psychological ones include performance anxiety, worry about sexual performance, stress, depression and relationship difficulties, while physical factors include prostate or thyroid problems and the use of recreational drugs. [1]

In most cases it can be improved (or managed) rather than permanently cured, and many men who persevere make good progress. Effective premature ejaculation treatment ranges from behavioural techniques to medication, and most men find an approach that helps to enhance their sexual performance. There isn't one fix that suits everyone. Some men benefit from combining behavioural approaches with medication or other treatments, while the NHS notes that most men improve with persistent treatment. [1]

Techniques you can try during intimacy to delay ejaculation

   

These behavioural techniques train you to recognise the build-up of arousal during sexual stimulation so you can hold back before the point of no return. The evidence for these techniques is limited, but they may help some men delay ejaculation for generally have few physical adverse effects. They generally require regular practice, and involving a partner can be helpful. [1, 2]

The stop-start method

You or your partner stimulate the penis until you feel close to ejaculating, then stop until the sensation passes, and repeat several times before allowing ejaculation. The aim is to learn what the point of no return feels like so you can ease off before reaching it. It helps to practise alone at first and then bring it into sex with a partner. 

The NHS describes this as the “stop-go” technique, and once you feel more confident, you can use it during sex, pausing and starting as needed. Progress tends to be gradual, and it takes repetition before the sense of control becomes reliable. [1, 2]

The squeeze technique

The squeeze technique works the same way, but this technique involves applying pressure to the head of the penis: you (or your partner) gently squeeze for around 10 to 20 seconds when close to ejaculating, wait about 30 seconds, then resume. The NHS suggests practising during masturbation first before using it during sexual intercourse. 

Some individual studies have reported substantial increases in ejaculation time with behavioural techniques, but across studies the evidence remains limited and results vary considerably. [2] Where improvements were measured, they tended to hold for a few months, but long-term data are thin. [1, 2]

Pelvic floor exercises for better control

The pelvic floor muscles help control ejaculation, so training them may improve control. In a randomised trial of men with lifelong PE, 57% regained control of the ejaculation reflex after 12 weeks of pelvic floor rehabilitation, with average time to ejaculation rising from under a minute to around two minutes. 

A systematic review found that pelvic floor training appears effective for PE, but the studies were small and of low-to-moderate quality, and no standard exercise programme has been agreed. 

In practice the kegel exercises involve repeatedly contracting and relaxing the muscles you would use to stop the flow of urine or hold in wind. Exercise programmes often combine short contractions with longer holds, but the optimal frequency and duration have to be established individually. Some programmes add biofeedback or electrical stimulation to help you target the right muscles, usually through a specialist. [4, 5]

Ways to reduce sensitivity

Heightened sensitivity of the penis can play a part in PE. So some options serve to manage premature ejaculation by dulling sensation a little before or during sex. These options can be used on their own or combined with behavioural techniques, depending on the individual situation.

Condoms and timing beforehand

A thick condom can reduce sensation and help some men last longer, and condoms are also effective when combined with a topical anaesthetic. Masturbating an hour or two before a sexual encounter is another simple approach the NHS suggests, since a second ejaculation is often easier to delay. Some couples also find that a position where your sexual partner is on top helps, as it makes it easier to pause or pull back when close to ejaculating. [1]

Topical anaesthetic creams and sprays to manage premature ejaculation

Local anaesthetics containing lidocaine and prilocaine reduce sensation on the head of the penis to lengthen time to ejaculation, and come as either a cream or a metered spray. Emla cream for PE is a commonly used example of the cream form. 

In a placebo-controlled trial of a lidocaine-prilocaine spray, average time to ejaculation rose by about 3.8 minutes, compared with 0.7 minutes for a dummy spray. Meta-analyses have found topical local anaesthetics to be among the most effective treatments for increasing ejaculation latency over short treatment periods. 

Lidocain/Prilocaine creams are generally used off-label for PE, and one practical caution applies: wash off any excess before sex, as the anaesthetic can transfer to a partner and reduce their sensation and sexual pleasure too. [6, 7]

When medication can help with ejaculation problems

   

When behavioural and physical approaches aren't enough, medication may be the next step to consider for the treatment of premature ejaculation. Treatment is usually stepwise, and the right option depends on the cause, whether erection problems are also present, and your own preference, so it's worth weighing this up with a clinician rather than choosing on price or convenience alone. [10]

Priligy (dapoxetine) is the only oral medicine licensed in the UK for premature ejaculation. It's a short-acting SSRI taken on demand, one to three hours before sexual activity and no more than once in any 24 hours. The usual starting dose is 30 mg, which a doctor may increase to 60 mg if the response isn't enough and the lower dose is tolerated, with your response typically reviewed after four weeks or six doses. In a meta-analysis it increased average time to ejaculation by roughly 1.2 minutes over placebo, with the 60 mg dose more effective than 30 mg; common side effects include nausea, dizziness and headache, mostly with the first dose. It shouldn't be taken with alcohol, which can add to dizziness and the risk of fainting, and it isn't suitable for everyone, including some men with heart, liver or kidney problems or those taking certain other medicines. [8, 9]

Off-label daily SSRIs (selective serotonin reuptake inhibitors) are another route. Antidepressants such as paroxetine, sertraline and fluoxetine (and sometimes clomipramine) also delay ejaculation; taken daily, they usually need one to two weeks to reach full effect. In a network comparison, paroxetine tended to produce among the strongest delays of the SSRIs. [1, 7]

PDE5 inhibitors such as sildenafil are more often used to treat erectile dysfunction, but research suggests they may help PE, particularly where erection problems are also present. Premature ejaculation may occur alongside erectile dysfunction, and treating coexisting erectile dysfunction may also approve ejaculatory control in some men. Combining a PDE5 inhibitor with an SSRI has performed better than an SSRI alone in pooled trials, though the evidence is mixed and of uncertain quality. Any prescribing decision should be made with a clinician who can check suitability and interactions. [10, 11]

Emotional support and talking therapies in premature ejaculation

Anxiety, stress and relationship strain can trigger or worsen PE, and many men experiencing premature ejaculation notice these feelings feed the problem. Previous traumatic sexual experience or early sexual experiences involving anxiety, pressure, rushing or fear of being interrupted may contribute to learned patterns of rapid ejaculation that can persist in later sexual relationships.

Psychosexual counselling can help you, and a partner if you have one, work through relationship issues and learn techniques to delay ejaculation. Counselling can help address relationship difficulties and may reduce performance anxiety.  Early support may help prevent anxiety and avoidance from becoming persistent parts of the sexual problem.

Sex therapy is available on the NHS in some areas, though this varies by region, and it can also be arranged privately. The evidence for talking therapy on its own is limited, as few controlled trials exist. Combined with medication, though, it performs well: a 2025 review found that cognitive behavioural therapy plus an SSRI prolonged time to ejaculation and improved control and sexual satisfaction more than the SSRI alone. [1, 2, 12]

How to prevent premature ejaculation from getting worse

One difficult sexual experience can feed worry about the next, and that pressure can make PE harder to shift, turning performance anxiety into part of the problem. Addressing it early rather than avoiding sex, keeping the setting relaxed, and involving your partner can stop that pattern taking hold before it affects your wider sex life. Tackling contributing factors such as stress and recreational drug use may also help. [1, 2]

When to speak to a doctor

   

It's worth seeing a GP, pharmacist or sexual health service if:

• PE is persistent and bothering you or your relationship
• you suddenly experience premature ejaculation, which can occasionally point to a physical cause such as a thyroid or prostate problem
• it comes alongside problems getting or keeping an erection

If you want help with premature ejaculation, a GP will usually ask about your sexual history and when the problem started, and may examine you or refer you to a specialist or sexual health service. Where PE occurs together with erectile dysfunction, doctors usually treat the erection problem first, since the two can be linked. A clinician can rule out underlying causes, check which treatments are suitable for you, and discuss options that shouldn't be started without advice. [1, 10]

Frequently asked questions about premature ejaculation

How long do behavioural techniques take to work?

They need regular practice over weeks, not days. In trials, behavioural programmes ran from about 2 to 12 weeks, and improvements that were measured often held for a few months afterwards. Expect gradual progress rather than an instant change. [2]

Can you stop premature ejaculation without medication?

For many men, yes. Behavioural techniques, pelvic floor exercises, condoms, topical anaesthetics and psychosexual counselling can all help without oral medication, and some of these can be started at home. The evidence for behavioural methods on their own is limited, and some men get the best results by combining approaches, or by pairing them with medication. If simple measures haven't helped after a fair try, that's a good point to speak to a pharmacist or GP. [1, 2]

Does numbing cream help you last longer?

Yes, for many men. Lidocaine-prilocaine creams and sprays reduce sensation and lengthen time to ejaculation, helping you delay orgasm; in one trial a spray added roughly three minutes over a placebo. Wash off any excess before sex so it doesn't transfer to your partner. [1, 6]

Can Priligy (dapoxetine) help to cure premature ejaculation?

No. Dapoxetine is taken on demand before sex and works while it's in your system; it isn't a cure and isn't meant for continuous daily use. If PE is bothering you long term, it's worth discussing ongoing options and any underlying causes with a clinician. [9, 10]

Can premature ejaculation come back after treatment?

It can. On-demand medication works each time you take it rather than fixing the underlying tendency, and behavioural gains can fade without regular practice. Changes in stress, health or relationships can also bring it back. Continuing helpful behavioural techniques and addressing contributing factors may help maintain improvements; if PE returns, discuss this with your GP or pharmacist rather than increasing the dose yourself. [1, 2, 9]

Are premature ejaculation and erectile dysfunction related?

Yes. Premature ejaculation (PE) and erectile dysfunction (ED) can occur together in sexually active men, and one condition may sometimes contribute to the other. For example, a man who is worried about losing his erection may rush sexual activity and ejaculate sooner, while repeated PE can create performance anxiety that makes maintaining an erection more difficult. If both problems occur regularly, it is worth discussing them with a healthcare professional, as identifying which problem developed first can help determine the most appropriate treatment options.

Can medical conditions cause premature ejaculation?

Yes. Premature ejaculation (PE) can sometimes be associated with underlying health conditions, including prostate inflammation (prostatitis), thyroid disorders and erectile dysfunction. Changes in hormone levels or the nervous system may also play a role in some cases. If PE develops suddenly after previously normal ejaculation, or occurs alongside pain, urinary symptoms or erection problems, a medical assessment can help identify and treat any underlying cause.