Treatment of Premature Ejaculation

Dr.Hassan Ali

26 Mar, 2026

⚠ Important Note:
This content is based on clinical guidelines (AUA/EAU) for educational use. It does not replace a professional medical consultation. Please consult a specialized doctor before starting any treatment mentioned.

Premature ejaculation can be treated with a combination of sexual therapy, drugs therapy, and psychotherapy as follows:

Premature ejaculation can be treated with a combination of sexual therapy, drug therapy, and psychotherapy as follows:

A. Sexual therapy:

Sexual therapy is one of the effective ways to treat premature ejaculation, and it is characterized by the possibility of doing it at home without the need to use drug treatments.

Sexual therapy helps eliminate premature ejaculation in 60%–90% of men with premature ejaculation. Sexual therapy for premature ejaculation includes

1- Masturbate and squirt before intercourse:

The goal is to extend the time until the next flow, and directing the sexual energy from intercourse to different sex toys that do not include intercourse may relieve the tension that accompanies the intercourse process itself.

2- Pressure technology:

Immediately after feeling the erection approaching, apply light pressure with the fingers of the hand on the penis when feeling orgasm and ejaculation for 20 seconds, like holding urine when it comes out, and repeat the process when feeling close to orgasm, which improves ejaculation control and prevents the recurrence of premature ejaculation in men.

3- Use a condom:

Use a thick condom to reduce sensation and ejaculation.

4- Thinking change:

Thinking of something other than intercourse during intercourse.

5- Kegel exercises:

Strengthen your pelvic floor muscles by doing pelvic floor exercises or Kegel exercises.

B. Drug therapy:

Medications that help the treatment of premature ejaculation include many antidepressant drugs, anesthetic creams, tramadol, and PDEI-5 (sildenafil).

1- Antidepressant drugs:

Delayed ejaculation is a common side effect of antidepressant (selective serotonin reuptake inhibitor) drugs, so using a different antidepressant may improve treatment for premature ejaculation.

Fluoxetine, sertraline, and paroxetine are used to treat severe premature ejaculation, but it is not recommended to use them periodically without consulting a doctor. Its side effects may include drowsiness, loss of sexual desire, and nausea.

Dapoxetine, a fast-acting antidepressant, is prescribed to treat premature ejaculation after consulting a doctor, and its side effects include nausea, headache, dizziness, and diarrhea.

2- Anesthetic cream or spray:

Anesthetic cream or spray, such as lignocaine, is used 30 minutes before sexual intercourse and can help delay premature ejaculation.

The side effects of ointments include reduced sexual pleasure and sometimes local sensitivity, so the cream or spray must be washed off the genitals before intercourse to prevent the partner from losing sensation, causing loss of erection, or experiencing numbness of the penis.

3- Tramadol:

Tramadol may help delay ejaculation, but this medicine is not recommended for premature ejaculation because it poses an addiction risk. But it is not recommended to use them periodically without consulting a doctor.

4- PDEI-5 (Viagra-Cialis-Levitra):

PDEI-5 (phosphodiesterase-5 enzyme inhibitors) may help treat severe premature ejaculation. These medications include sildenafil, vardenafil, and tadalafil.

These medications can be used alone or in combination with selective serotonin reuptake inhibitors. But it is not recommended to use them periodically without consulting a doctor.

C. Psychotherapy:

This treatment may relieve performance anxiety and relieve stress, which contributes a lot to premature ejaculation, as treating the problem generally requires a great deal of openness and willingness from both spouses.

This article was written and reviewed by Dr. Hassan Ali - Urologist

Medical References :

Content curated according to international clinical guidelines:

American Urological Association (AUA).
European Association of Urology (EAU).
Campbell-Walsh Urology Textbook.