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Premature ejaculation (PE) is one of the most common sexual problems in men. Surveys suggest that around one in five men is bothered by how quickly they finish, although far fewer meet the medical definition. The good news: PE responds well to treatment.
What counts as premature ejaculation?
The International Society for Sexual Medicine defines PE by three features:
- Timing: ejaculation that always or nearly always happens within about one minute of penetration from the first sexual experiences (lifelong PE), or a clear drop to about three minutes or less (acquired PE)
- Control: inability to delay ejaculation on all or nearly all occasions
- Distress: negative personal consequences, such as frustration, avoiding intimacy or relationship strain
Many men who finish sooner than they’d like don’t have PE. They fall within the normal range but want more control. The techniques below help both groups.
Lifelong vs. acquired PE
- Lifelong PE has been present since a man’s first sexual experiences. It is thought to have a strong biological component, involving serotonin signaling in the brain and genetics.
- Acquired PE develops after a period of normal function. It is more often linked to a specific cause: erectile problems, prostate inflammation, thyroid problems, stress or relationship issues.
Common causes and triggers
- Erectile difficulties. Men who worry about losing their erection may rush, sometimes without realizing it
- Anxiety about performance, or stress in general
- Prostatitis (inflammation of the prostate)
- Thyroid problems, particularly an overactive thyroid
- Long gaps between sex, which can make it harder to last
- Relationship issues and poor communication
Treatments with the best evidence
Behavioral techniques
The stop-start and squeeze techniques teach you to recognize and control the build-up to ejaculation. Evidence suggests they work best combined with other treatments, but they cost nothing and have no side effects. See step-by-step instructions in our guide on how to last longer in bed.
Pelvic floor training
Several small studies found that 8 to 12 weeks of pelvic floor exercises improved ejaculation time and control in many men with lifelong PE.
Topical anesthetics
Lidocaine and prilocaine sprays and creams reduce sensitivity and are one of the best-studied PE treatments. A lidocaine-prilocaine spray is licensed for PE in Europe, and over-the-counter lidocaine delay sprays are widely available elsewhere.
Topical option
VigRX Delay Spray
An over-the-counter lidocaine delay spray from the VigRX brand.
- Apply 10–15 minutes before sex and wipe off the excess
- Use the smallest amount that works to avoid numbness for you or your partner
- Avoid if you’re allergic to local anesthetics
Prescription medication
Doctors may prescribe certain antidepressants (SSRIs) at low doses, either daily or before sex, because they delay ejaculation as a side effect. In some countries, dapoxetine is licensed specifically for PE. If you also have erection problems, treating those with medication often improves PE too. These need a prescription and a conversation with your doctor about side effects.
Counseling
Sex therapy, alone or with your partner, helps reduce anxiety and improves results from other treatments, especially for acquired PE.
What doesn’t work well
- Herbal “delay” supplements: no supplement has good evidence for PE
- Alcohol: it may dull sensation but weakens erections and judgment
- Numbing products used in large amounts: these can cause loss of erection and numb your partner
When to see a doctor
Talk to your doctor if PE is distressing, if it began suddenly, or if you also have erection problems, pain or urinary symptoms. It is a routine conversation for doctors, and effective treatment is available.
Is premature ejaculation permanent?
No. Both lifelong and acquired PE usually improve with treatment, and many men gain good control with behavioral techniques, topical sprays or medication.
What is the best treatment for premature ejaculation?
There is no single best option. Many men do well combining behavioral techniques with a topical anesthetic spray. Prescription medication is effective for persistent PE.
Can PE be caused by anxiety?
Yes. Anxiety is a common contributor, especially for acquired PE, and PE can also cause anxiety, creating a cycle.
Does masturbation cause premature ejaculation?
There is no good evidence that masturbation causes PE. Rushing during masturbation may reinforce quick finishing, which is why practicing stop-start alone can help.