TREATMENT FOT MILD CASES
Cognitive behavioral therapy
This approach, also known as counseling or talk therapy, involves talking with a mental health provider about your relationships and experiences. These talk sessions can help you reduce performance anxiety or find effective ways of coping with stress and solving problems. Counseling is most likely to help when it's used in combination with drug therapy. If you have mild PE – for instance, you can last five minutes but would like to last 10 – there's probably no point in going to a doctor.Why? Because you should be able to improve matters by simple distraction techniques.This means turning your mind to something else when you sense that climax is near. For example, you can think about something totally unconcerned with sex or pinch yourself.
Local anaesthetic gel
Some men try to treat themselves with a local anaesthetic gel that's applied to the shaft of the penis shortly before intercourse.This product is advertised to the public as a good way to 'damp down' sexual sensation in the penis.It is not advise using this gel because the local anaesthetic can 'dull' the sex sensation for your partner.It can also cause a distressing skin reaction in either partner, with intense itching, redness and soreness.
'Long love' condoms
German scientists have come up with a slightly different approach that won't cause vaginal irritation.It's called the 'long love condom’ and it contains a local anaesthetic (benzocaine or lidocaine) inside it.Long love condoms are now being sold in many countries, under a variety of brand names.A few male patients have told us they do last longer with these condoms, but the man is still at risk of a sensitivity reaction to the local anaesthetic.
Treatment for more severe cases
If PE is causing you significant problems, it is best to consult an expert for treatment.
The Masters-Johnson method
This method cures the vast majority of men, provided that both partners are keen to co-operate (which isn't always the case). It's based on a special 'penis grip' developed by the American therapists Masters and Johnson. They employed it in a 're-education' course lasting weeks or months.The finger-grip abolishes the desire to climax, so if, under careful instruction, the couple use it over a period of weeks, they can usually re-train the man so he can last much longer. But please note that cure can't be achieved overnight.
In recent years, it has also proved possible to treat PE with antidepressant drugs taken a few hours before intercourse. The group that are mainly used for this purpose are the SSRIs (selective serotonin re-uptake inhibitors).The use of these drugs may seem a little odd, but delaying male climax is a well-known side-effect of certain antidepressants. For most men, that side-effect is unwanted. But for guys with premature ejaculation, it's highly desirable.Antidepressants that are commonly used for this purpose include clomipramine (Anafranil), fluoxetine (Prozac) and sertraline (Lustral).But please be warned: these are powerful drugs that can last a long time in the body, and have a considerable list of potential side-effects.Before opting for one of them, talk it over carefully with your doctor.In many countries antidepressants are now sold illegally in bars and on the street as 'last-longer pills'. We really do not recommend buying antidepressants in this casual fashion.Antidepressants are prescription-only drugs, with a potential for causing you harm. If you want to try them for premature ejaculation, make an appointment to see your General Practitioner.
Drugs by nasal inhalation
At the end of 2008, there was a good deal of controversy in Britain because a company started using large advertisement hoardings to promote its treatment for PE: a nose spray. In fact, the only point of the spray is to deliver a drug into the bloodstream more quickly than could be achieved through taking it by mouth. The drug which is mainly being used in these new nose sprays is clomipramine – which is an antidepressant. There have also been reports of sex clinics suggesting the use of the major painkiller tramadol in a nose spray. This does not strike as a good idea, in view of the drug's side-effects which include mental confusion and abdominal pain. Tramadol is related to morphine, and is widely misused by people with drug problems. It is habit-forming.
A special constriction device
In 2000, a clinical trial of a new technique for treating premature ejaculation was published in the medical press.It was developed at St George's Hospital, London, and involved wearing a slightly constricting ring below the head of the penis for 30 minutes each day. The theory was it would make the organ less sensitive.Unfortunately, at the present time the inventors of the device have not been able to publish any results of large scale trials.Don't attempt any constriction techniques like this off your own bat. Such a method should only be prescribed by an expert at a sexual problem clinic. It may or may not turn out to be useful.