How to Stop Premature Ejaculation 

Premature ejaculation, or ejaculating before you or your partner wanted to, is a common problem that strikes most men at some point in their lives. Several factors can influence when ejaculation occurs, but it can be controlled with some forethought or, in extreme cases, medical intervention. Here are some strategies for help, listed from easiest to most difficult.

Steps

Method One: Quick Fixes

1. Wear a condom. It sounds too simple to be true, but it works for a lot of men. Condoms reduce stimulation for most men, which should prolong the time before ejaculation 
   • Steer clear of condoms that are marketed as extra thin. You can always upgrade to a brand that allows more stimulation later.
   • Some condoms are coated with a slight numbing gel on the inside. This can help you put off ejaculation for longer without causing numbness to your partner. (Just make sure you know which side is where when you put it on.)
2. Use an analgesic creams and sprays. There are two classes of these products. The first is the traditional "numbing" creams and sprays that have been on the market for some time. The upside is that you'll feel less sensation, which will delay ejaculation. The downside is your partner will suffer a loss of sensation as well. This defeats the purpose of the agent.
   • There is a new class of topical medications that use absorption technology to deliver a mild anesthetic to the sensory nerves below the stratum corneum (top layer of skin) of the penis. There are two benefits: (1) the man achieves ejaculatory control but maintains sexual sensation and (2) the transference to his partner is greatly reduced.
   • There are two products on the market targeted for PE which utilize this absorption technology. The first, named PSD502, has shown very good results with PE patients in clinical trials but is not yet available in the U.S. due to lack of FDA approval. The agent named Promescent is available over-the-counter in the U.S. via FDA monograph 348.10.
3. Apply strategic pressure. Here are two quick ways to delay ejaculation in the middle of intercourse:
   • Perineum pressure: Pressing on the perineum, a spot midway between your scrotum and your anus, will help to stop ejaculation because this spot reaches through to the prostate gland. It is the prostate that contracts and expands during orgasm and then expels the ejaculation fluid. Ask your partner to apply this loving pressure for you.
   • Testes tug: When a man nears orgasm his scrotum rises up closer to his body. You can delay ejaculation by gently pulling your testes down and away from your body. Your partner can also do this for you.

Method Two: Technique Changes

1. Slow down intercourse. If you're feeling pressured to perform, you might rush to ejaculation before you're ready. Try these tips for bringing your anxiety down a notch:
   • Take climaxing out of your expectations. Instead of viewing intercourse only as a means of achieving orgasm, reframe it as relaxing, pleasurable time with your partner that you'll enjoy regardless of ejaculation. Discuss this new mindset with your partner, so that he or she can stop pressuring you, intentionally or not.
   • Think nonsexual thoughts. If you notice yourself getting too excited, stop and turn your attention to something decidedly unsexy, like rush-hour traffic, smarmy politicians, or the old classic, baseball. Only dwell on it long enough to give yourself a short break from arousal, maybe 5 to 10 seconds, then refocus your attention on your partner.
2. Try edging. Edging, or orgasm control, is the practice of maintaining a high level of sexual arousal while delaying ejaculation. It takes practice, but it gets easier over time. Here are two methods recommended by the National Institutes of Health to stop premature ejaculation^[3]:
   • Stop-and-start method: Have intercourse as usual until you feel yourself coming uncomfortably close to orgasm. Immediately and abruptly cease all stimulation for 30 seconds, then start again. Repeat this pattern until you're ready to ejaculate.
   • Squeeze method: Have intercourse as usual until you feel like orgasm is seconds away. Abruptly stop other stimulation and gently squeeze your thumb and forefinger around the part of the penis where the glans meets the shaft (or your partner could do this). After squeezing for a few seconds, pause all stimulation for another 30 seconds before resuming intercourse. Repeat this pattern until you're ready to ejaculate.
3. Change positions. Some intercourse positions put less pressure on the glans (or the most sensitive part of the penis). Here's what to do:
   • Try "passive" positions. Lie beneath your female partner, or try a side-by-side (or spooning) position.
   • Avoid "active" positions. Missionary and rear-entry positions place the most stimulation and friction on the glans, so consider taking them off the menu for now.

Method Three: Long-Term Fixes

1. Do PC muscle exercises. Flexing and strengthening your pubococcygeus (PC) muscle can help you exert more control over ejaculation. (Note that these are also called Kegel exercises, which you might have heard about women doing. The muscle is the same in both sexes.)^[4]
   • Locate your PC muscle. Put one or two fingers right behind your testicles. Pretend that you are urinating, then try to stop the flow with a quick muscle contraction. That muscle you just used to stop the flow from the bladder is your PC muscle.
   • Flex the muscle regularly. Try to do 10 to 20 squeezes in a set, 2 or 3 times a day. Do a set whenever you're bored or stationary — like when you're sitting at your desk or in traffic. No one will be able to see that you're doing them.
   • Squeeze your PC muscle when you feel ejaculation coming on. Once the muscle is strong enough, you should be able to hold it off.

Method Four: Medical Intervention

1. Know when to see a doctor. If you routinely ejaculate less than a minute and a half after beginning vaginal intercourse, and none of the above fixes have worked, it might be time to see a medical professional. You can visit a sex therapist, psychologist, or psychiatrist for help.
2. Know what treatment options to expect. The treatment that your doctor recommends will depend on your age, overall health and sexual history, but here's a rundown of the most common routes:
   • A short-acting SSRI: Researchers suspect serotonin has an effect on ejaculation, and have found a certain class of selective serotonin reuptake inhibitors can help delay it. Dapoxetine is usually prescribed for this; FDA approval is pending in the US.
   • Tramadol: A mild oral analgesic, Tramadol's been shown to increase serotonin levels, which can lead to greater ejaculation control.
   • Clomipramine: A tri-cyclic anti-depressant, Clomipramine has been used to treat premature ejaculation for decades.
   • Intracavernous vasodilator therapy: In extreme cases, your doctor might suggest injecting a vasodilator directly into your penis before intercourse. Though this is usually a successful option, it's not something to start lightly.