Your physician may recommend a combination of medication and behavioral therapy tips to deal with P.E. No two people are alike, and it may take some time and experimentation to find the methods that work best for you. Some men experience significant improvement with learned techniques so medication isn’t for everyone.
Some techniques we may recommend include:
Topical Anesthetics: Topical anesthetics can be applied to the penis just before sexual activity. They come as creams, lotions, or sprays and are available over-the-counter. The advantage of topical applications is that the side effect rate is low and they are effective to some degree in almost everyone to decreasing sensation and prolonging the time before ejaculation.
Condoms: Condoms can help with PE by decreasing penile sensitivity and have the added benefit of reducing the likelihood of transmission of sexually transmitted infection or unwanted pregnancy. Using a spray, cream, or lotion with a condom is surprisingly effective for some men. It delays orgasm, gives some men just the right amount of pleasurable sensation, and when used with a topical anesthetic prevents the spread of the anesthetic to a partner.
Behavioral modification: The squeeze and start-stop techniques are 2 different strategies that can be practiced during masturbation or sexual activity and, over time, can improve control over the timing of ejaculation.
Psychotherapy: Counseling, whether in person, by telephone, or by text messaging, may increase the likelihood of success for some patients. The reality is that men who have had lifelong issues have often suffered silently with a burden that weighs on them every time they consider developing a physical and emotional attachment to another person. They face disappointing the very person they hope to please the most. For many men, it terminates relationships before they begin and can lead to isolation and a loss of companionship. Men with PE face increased risks of divorce and relationship stress, often more as a result of the emotional consequences of having PE than from the PE itself. Uncovering the reasons the PE developed are as important as breaking the cycle with medical interventions.
Also, psychotherapy can be enormously helpful in restoring a man’s sense of value and worth beyond the ability to delay an orgasm, which often restores their capacity to experience sex as they had before PE developed.
Combination Therapy: Any of the above treatments can be combined with any one or more of the other treatments. Although it’s often best to keep things simple, the good news is that combination therapy can help treat men who don’t respond satisfactorily to single mode therapies.