Medically reviewed by Katelyn Hagerty, FNP
Written by Our Editorial Team
Last updated 6/1/2021
You’ve been thinking about sex all day, and now the main event is here… and it’s over almost as soon as it started. What happened?
Premature ejaculation can be an extremely frustrating and embarrassing condition for many guys.
Long-term side effects of premature ejaculation can lead to low self-esteem, decreased confidence in the bedroom and a whole host of sexual anxieties.
Luckily, there is a potential solution to your problem: premature ejaculation therapy.
In this article, we’ll dive into what premature ejaculation therapy is, if it’s effective and alternative treatment options if sex therapy isn’t your vibe.
Premature ejaculation (PE) is exactly as it sounds. It’s a condition that causes you to ejaculate before you intend to, and/or have trouble controlling when you reach orgasm during sexual intercourse.
The precise origin of PE is unknown, although it is likely to include both biological (genetic and neurobiological) and psychological factors (interpersonal issues, performance anxiety and cognitive distortions).
PE is one of the most common sexual dysfunctions in the world, and affects men of all ages, backgrounds and body types.
PE can cause sexual performance issues and confidence issues in the bedroom, and according to a recent study, affects up to 39 percent of men worldwide.
Premature Ejaculation Therapy (PET) is an integration of dynamic systems, behavioral and cognitive approaches within a short-term therapy model.
The basic principle of therapy is to learn how to control ejaculation. Therapy also addresses the ever-growing snowball effect that PE has on a man, his sexual partner and the couple as a whole.
These snowball effects often include performance anxiety, low self-esteem, avoidance of sexual activity, their partner’s or partners anger and hostility and a significant decrease in the quality of their relationships.
PE is not a singular sexual dysfunction. It actually includes four subtypes: lifelong, acquired, natural and subjective. Each subtype has unique psychological factors and issues.
Therapy for men and couples with PE not only addresses sexual skills and techniques, but also focuses on issues of self-esteem, performance anxiety and interpersonal conflict.
Researchers describe three common factors that make sex therapy for PE effective. These factors include:
Empowering the patient to experience themselves as having the ability to create change and impact factors within the moment
Providing a safe and empathetic environment where the patient can explore obstacles, choices and meanings of his psychological and behavioral dilemmas
Conveying hopefulness and realistic expectations regarding outcomes
According to research, these three components should be included in the psychological treatment of men and couples suffering from PE.
You can read our guide to premature ejaculation hypnosis for information on another tool believed to help PE.
In short, yes. Behavioral therapy for premature ejaculation is effective.
The long answer is that you’ll see the best results when you combine PE therapy with other strategies, such as erectile dysfunction medication and behavioral techniques.
Combined therapy provides men with a medication to delay ejaculation while they learn behavioral techniques to delay ejaculation and address the relevant psychological and interpersonal issues they’re experiencing.
The most convincing combination therapy study found that the combination of medication and sex therapy was twice as effective as medication alone.
The study compared men given dapoxetine 30mg (a drug that is currently being reviewed by the FDA, but is legal in over 60 countries) to men receiving dapoxetine 30mg plus brief PE therapy.
After 24 weeks, the dapoxetine-only group demonstrated a two-fold increase in latency time, while the medication plus therapy latency time increased almost four-fold.
There are four additional studies that confirm that the combination of behavioral therapy and medication is more effective for men with PE than medication-only treatment.
In a study conducted on 90 men with PE, both the test group and control groups were given medicine therapy. The test group also received comprehensive behavior therapy for 6 weeks.
The results of this study indicated a significant difference between the two groups, with efficacy of medication and behavioral therapy for PE nearly three times as effective as medication alone.
In another study, one group of men were given an SSRI (citalopram) alone, while another group was given citalopram plus behavioral therapy for PE.
The results of the study found that sexual satisfaction was reportedly highest in the combination medication and behavioral therapy group.
According to the results of this study, the combination of citalopram and behavioral therapy is an effective treatment for premature ejaculation.
If you aren’t ready for therapy quite yet, or it’s just not your thing, there are other premature ejaculation treatment options available including drug therapies, topical medications and techniques.
Sertraline is a selective serotonin reuptake inhibitor (SSRI) used off-label as a treatment for premature ejaculation.
Off-label means that the FDA has not approved sertraline to treat this type of condition.
There isn’t an “official” dose for sertraline prescribed for premature ejaculation, but healthcare providers will typically prescribe up to 50mg per day to improve sexual function.
You probably know it as the “little blue pill” that treats ED (Viagra®), but we bet you didn’t know that it may also work to treat premature ejaculation.
While the mechanism for treating premature ejaculation with this drug is unknown, a 2007 study showed that men with PE who take Viagra tend to have longer ejaculation times than their peers.
However, we should also state that this research is still emerging, that there are very few studies about sildenafil (generic Viagra) and PE, and that more research is probably needed before your healthcare provider will be eager to write you a prescription for Viagra to treat your PE.
Lidocaine is a topical medication that is widely used and can be effective for treating premature ejaculation.
When used in spray or cream form (like our Delay Spray for Men), lidocaine can make your penis less sensitive to touch and reduces the physical sensations of sex.
As such, simple anesthetic creams or sprays may be just the thing to help you last longer in bed.
Drugs and therapy aren’t the only way to help rapid ejaculation. Some techniques such as the “stop-start” strategy or the “squeeze” technique are easy and effective when used properly.
Results from one study indicate that as many as 65 percent of men with PE notice benefits from using the “stop-start” and “squeeze” strategies.
However, these techniques aren't 100 percent effective, which means that you still might come a little too early even if you do them perfectly.
We talk more about the stop-start and squeeze techniques in our Home Remedies for Premature Ejaculation guide.
Masturbating before sexual intercourse can be a great way to increase your time to ejaculate and avoid PE.
Did you know that each time you orgasm, you begin a new refractory period? The refractory period is a phase in which you'll find it difficult to orgasm again.
Therefore, when done properly, masturbating before sex restarts your refractory period, making you last longer in the bedroom.
Read more about the refractory period in our Refractory Period: What It Is, Duration & How to Shorten It guide.
Premature ejaculation can be a devastating and embarrassing medical condition. If you’re currently struggling with PE, know that it is a problem many men face, and that you are not alone.
Premature ejaculation therapy can be an incredibly effective strategy, especially when used in combination with medication.
If you’re interested in learning more about PE therapy and medication, make an appointment with your healthcare provider to discuss your options.