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Last updated October 25, 2019. 5 minute read

Lidocaine and benzocaine for treatment of PE

While there’s no slo-mo button for sex, there are a number of products and medical solutions that do pretty much the same thing. Two of the most effective are products that contain lidocaine and benzocaine.

Self Written by Michael Martin
Reviewed by Mike Bohl, MD, MPH

If you’ve experienced premature ejaculation (PE), you’ve probably wished that you could hit the controls and slow things down. That way, you and your partner could have a better sexual experience—and you don’t have to keep replaying your embarrassing moment in slow motion in your head. The good news: You have that power. While there’s no slo-mo button for sex, there are a number of products and medical solutions that do pretty much the same thing. Two of the most effective are products that contain lidocaine and benzocaine.

Vitals

  • Premature ejaculation (PE) is the most common male sexual dysfunction.
  • It happens when a man ejaculates sooner than he or his partner would like.
  • To treat PE, you can apply a product containing lidocaine or benzocaine to your penis before sexual activity.
  • Lidocaine and benzocaine are safe when used as directed.

What is premature ejaculation (PE)?

Premature ejaculation (or PE) is the most common form of sexual dysfunction among men (Martin, 2016): roughly 1 in 3 of us experience it (Carson, 2006). Also known as rapid ejaculation, premature climax, or early ejaculation, PE is a sexual dysfunction in which a man ejaculates sooner than he or his partner would like.

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PE can be treated with over-the-counter topical anesthetics (like benzocaine and lidocaine), behavior modification techniques, or prescription meds. Over-the-counter treatments have few side effects, but must be applied just before sex. Behavior modification techniques help many men, but they take time and effort. Prescription medications help men last longer without using a topical anesthetic before sex but can have side effects.

Read more about premature ejaculation here.

What is lidocaine?

Lidocaine (brand name Xylocaine, among others) is a local anesthetic, meaning that it’s used to numb a specific area. It comes in many forms, including a liquid for injection during surgery, a topical spray, cream, or liquid, and an oral medication.

Lidocaine is often used as a skin patch for pain relief, or to numb mucous membranes (like the mouth and throat) before medical procedures. It’s sometimes used as a topical anesthetic—a lidocaine spray or other solution that’s applied to the skin.

Lidocaine has been on the market since the FDA approved it in 1948. Lidocaine is widely considered to be safe and effective at what it does: decreasing sensation in a certain part of the body.

In the U.S., lidocaine is approved as an over-the-counter product for skin numbing, as long as the amount of lidocaine is limited to 4%.

And, perhaps most relevant to what brought you here: Lidocaine is used in products that slightly numb the penis with the aim of preventing premature ejaculation. Some products containing lidocaine that aim to treat PE include lidocaine sprays like Promescent and K-Y Duration Desensitizing Spray. Some brands of condoms contain a bit of lidocaine on the inside. This has the effect of reducing sensation, which can make you last longer.

What is benzocaine?

Benzocaine is also a local anesthetic. Like lidocaine, it’s also as a topical anesthetic—something you apply to a part of the body to numb it.

For example, you’ll find benzocaine in a number of preparations that reduce the pain of toothaches, cold sores and canker sores (brand name Orajel, plus generics) and sore throats (Cepacol lozenges, Chloraseptic spray). Benzocaine can also be found in products that claim to reduce skin irritation and itching from scrapes, cuts, poison ivy, and insect bites (like the brand name Lanacane).

Benzocaine has been in use since 1902, and it’s widely regarded as safe. Like lidocaine, benzocaine is used in creams, gels, sprays, and wipes that slightly numb the penis with the aim of preventing premature ejaculation. Some of these products include K-Y Duration gel and Roman Swipes. Some brands of condoms contain benzocaine on the inside, which works to reduce sensation.

Both lidocaine and benzocaine are pretty well-tolerated as a local anesthetic, and adverse effects are rare. But some people have allergic reactions to benzocaine, so they can be prescribed lidocaine as an alternative.

If you have questions about PE or PE treatments, it’s a good idea to seek medical advice from a health care provider.

How do lidocaine or benzocaine work to treat PE?

To treat PE, you can apply a product containing lidocaine or benzocaine—such as a cream, gel, or single-packet wipe—to your penis before sexual activity.

That will lower sensation in the penis and may help you last longer before ejaculating during sex. These products are formulated to reduce overstimulation without eliminating sensation altogether.

Lidocaine and benzocaine products can take as little as five minutes to take effect, and the numbing effects wear off after about 90 minutes.

As part of a 2017 study published in the American Journal of Urology, 21 men who reported PE were given 4% benzocaine wipes to use before sex with their monogamous partner. After two months, those men reported “significant improvement” in intercourse duration, “greater improvement in distress relating to intercourse, control of ejaculation, and satisfaction with sexual intercourse” compared to a placebo group (Shabsigh, 2017).

Are topical anesthetics like lidocaine or benzocaine safe to use?

Yes, but there is important advice to follow regarding their use. In 2009, the FDA issued a public health advisory regarding potentially serious side effects of improper use of topical anesthetics (Pharmacy Times, 2019). This advisory was sent out after two women died after using this medication before laser hair removal. In 2018, the FDA strengthened its warnings after repeated cases of people using large amounts of over-the-counter benzocaine (FDA, 2018). These patients developed methemoglobinemia, a life-threatening condition in which the blood turns bluish and loses its ability to deliver oxygen to the body’s tissues effectively.

Some simple rules to follow:

  • Follow the package directions
  • Use the lowest strength and amount of the medication necessary
  • Apply sparingly and only to the area necessary
  • Do not apply to broken or irritated skin
  • Do not wrap the area with dressing or apply heat to the skin after using these medications
  • If you start experiencing pale, blue, or gray-colored skin, lips, or nail beds, shortness of breath, fatigue, confusion, headache, lightheadedness, or a rapid heart rate, seek medical attention immediately.

What else can I do to treat PE?

Medication

Some antidepressants are known as selective serotonin reuptake inhibitors (SSRIs), like sertraline (brand name Zoloft), which have the side effect of delaying ejaculation. Premature ejaculation can also be a side effect of erectile dysfunction (ED). Using medication like sildenafil (brand name Viagra) or tadalafil (brand name Cialis) can make it easier to achieve and prolong an erection, so your brain doesn’t feel like you have to rush through sex.

Edging

The practice of edging, or the start/stop technique, can help you retrain when you have an orgasm. Men with or without PE have benefited from this technique. The International Society for Sexual Medicine’s Guidelines for the Diagnosis and Treatment of Premature Ejaculation states that this training technique can give men enhanced control over ejaculation. In this technique, you stimulate yourself to the point that you think is just before an orgasm and stop observing the sensations. The goal is to get to know the place in sexual excitement known as ejaculatory inevitability, so you can back off before coming and prolong sex.

You can find detailed instructions about how to practice edging here.

The squeeze technique

This is a commonly recommended therapy for PE. Begin sexual activity as usual, until you feel almost ready to ejaculate. Then, have your partner squeeze the end of your penis, at the point where the head (glans) joins the shaft. Hold the squeeze for several seconds, until the urge to come retreats. You can do this several times in one session. Make sure you have a satisfying orgasm at the end — you’re retraining your body to have sex in a new, more pleasurable way, so you want to ensure you don’t feel anxious or deprived.

Read more about how to perform the squeeze technique here.