Premature ejaculation: causes and treatment options that work

By the Medsmingle Team · Updated 13 November 2026

Treatment depends on your symptoms, health and preferences. Prescription treatments require assessment by a qualified clinician.

Premature ejaculation (PE) means regularly ejaculating sooner than you or your partner would like, often within about 1 minute of penetration, and feeling distressed by it. It’s one of the most common sexual concerns in men, and there are several effective options.

Types and causes

• Lifelong PE: present from the first sexual experiences, likely linked to how the brain uses serotonin
• Acquired PE: starts later, often linked to anxiety, relationship stress, erectile dysfunction, prostate inflammation or thyroid problems

Behavioral techniques

• Stop-start: stop stimulation just before the point of no return, wait, then continue
• Squeeze technique: gently squeeze the head of the penis to reduce arousal
• Pelvic floor exercises may be useful for some men when guided by a trained clinician
• Couples or sex therapy for anxiety and communication

Topical numbing products

Over-the-counter lidocaine or benzocaine sprays and creams reduce sensitivity. Follow the specific product instructions to avoid numbing a partner; check whether it is compatible with your condom material.

Prescription options

• SSRIs such as sertraline or paroxetine, usually prescribed daily for this purpose, can delay ejaculation. This is an off-label use in the US, so it needs a doctor’s assessment.
• Dapoxetine is a short-acting SSRI made specifically for PE. It’s approved in many countries, including the UK and much of Europe and Asia, but not by the FDA in the US. Combination tablets that pair dapoxetine with an ED medicine aren’t approved in the US either.
• ED medicines can help men who have both ED and PE.

Safety

SSRIs can cause nausea, dizziness and, rarely, fainting, and they interact with other antidepressants, migraine triptans and tramadol. Don’t combine medicines for PE and ED without medical advice.

When to see a doctor

See a doctor if PE is causing distress, if it started suddenly, or if you also have ED, pain or urinary symptoms.

Frequently asked questions

Is premature ejaculation permanent?

Acquired PE often improves when the cause is treated. Lifelong PE can usually be well managed.

Does masturbating before sex help?

Some men find it helps, but evidence is limited.

For questions about a prescription or symptoms, speak with your own doctor or pharmacist. For website enquiries, contact our team.

General information only. It isn’t a substitute for advice from your doctor or pharmacist.

Source

AUA/SMSNA: disorders of ejaculation guideline.