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Reviewed by Jill Johnson, FNP
Written by Our Editorial Team
Premature ejaculation can be frustrating to navigate, but there are thankfully multiple treatment options available for managing the condition.
Some popular ones include topical anesthetics like benzocaine and lidocaine. Used clinically as pain killers, their numbing effects work to reduce sensation in the penis, allowing sexual stimulation to continue for longer periods of time before ejaculation occurs.
Sound promising? We think so, too.
Read on to learn more about benzocaine and lidocaine, and how to determine which might be right for you.
First, it’s helpful to understand the nature of premature ejaculation (PE) — which is defined by the American Urological Association as “ejaculation that occurs sooner than desired, either before or shortly after penetration, causing distress to either one or both partners.”
Among the three major buckets of sexual dysfunction in males, ejaculatory dysfunction, erectile dysfunction and decreased libido, premature ejaculation is indicated as the most prevalent disorder based on research.
Premature ejaculation can be rooted in a variety of causes ranging between physical, chemical, emotional, and psychological complications. These include:
A penis that is extra sensitive to stimulation
While premature ejaculation seems like a simple enough concept to grasp, its clinical presentation can have some variance.
In a 1970 study, famed sex researchers Masters and Johnson defined PE as the inability to delay ejaculation until a female partner achieved orgasm fifty percent of the time, assuming that PE was the reason for the partner’s inability to reach orgasm.
Another study published in 1974 defined PE as an inability to control the timing of one’s ejaculation, bringing us closer to our modern day definition of the condition.
As far as a specific length of time for intercourse before ejaculation occurs, many healthcare professionals agree that ejaculation within one minute of starting sexual activity would be considered premature.
In absence of a set clinical measure however, a person’s own perception about the time it takes to reach ejaculation is strongly considered during the diagnosis process.
As a result, medical providers will ask in-depth and personal questions about a patient’s medical history in order to arrive at a PE diagnosis.
One final consideration for premature ejaculation diagnosis is the time period when the condition was first observed. PE is considered primary if its onset corresponded with a person becoming sexually active for the first time, and secondary if it developed later on in life.
Let’s get into how benzocaine and lidocaine can be effective treatments for premature ejaculation.
As we covered above, topical anesthesia can be an effective treatment for premature ejaculation.
Topical anesthetic like a benzocaine gel or lidocaine spray are usually used to numb an area of the body before medical procedures in order to reduce a patient’s pain perception.
You can even use them as an over-the-counter product to soothe a sore throat. As such, researchers have found another use for these medications — numbing sensation in the penis.
As a treatment for premature ejaculation, both benzocaine and lidocaine need to be applied for the correct amount of time to ensure effectiveness without numbing the penis to the point where it causes the loss of erection or inability to stay erect.
These concentrated creams, sprays, gels or wipes are applied for 10 to 30 minutes, or until sensation has been adequately reduced, and then washed off so as not to affect sensation for your sexual partner.
Benzocaine is a topical anesthesia used for pain management, and particularly to inhibit the pain caused by the injection of needles. It is FDA-approved for use in the form of a gel, liquid and lozenge, while benzocaine spray has not received approval.
The use of benzocaine as a topical treatment for pain management is generally considered safe, although it does have the potential to cause allergic reactions and other hypersensitivity related reactions. These reactions are largely seen in children and the elderly population.
Lidocaine, formerly known as lignocaine, was discovered to be an effective pain reducer in the 1940’s and quickly saw its use spread due to its safety in comparison to earlier anesthetic agent options.
It is used both as an injection and as a topical anesthetic to manage localized pain, and rarely has side effects in general, but especially when applied topically. It is commonly used to numb mucous membranes in the mouth, throat and rectum.
This bucket of treatment involves working with a medical provider, counselor or sex therapist to modify physical and emotional habits around having sex.
It can include activities you perform by yourself or with your partner to help you learn how to delay orgasm, by bringing yourself close to orgasm and then reducing stimulation.
You can also work through the condition mentally to address performance anxiety, depression, and issues with your relationship dynamic.
Antidepressants, specifically selective serotonin reuptake inhibitors (SSRIs) are an “off-label” treatment for premature ejaculation. This means that while the drug has been approved by the Food and Drug Association, it has not been approved for this particular use.
Medications like this help to balance the levels of hormones and neurotransmitters that are available for use in the brain and include sertraline, paroxetine, escitalopram, citalopram and fluoxetine.
One additional antidepressant used to treat PE is clomipramine, generic for Anafranil®, and has a similar mechanism to those listed above.
Erectile dysfunction (ED) medication is also used to treat premature ejaculation, particularly when erectile dysfunction is an underlying cause of the PE. Drugs for this include Cialis®, Stendra®, Viagra® and Levitra® and their respective generic versions tadalafil, avanafil, sildenafil and vardenafil.
ED medications have some variance in how long they need to be taken before planned sexual activity in order to be effective.
More recent research from 2020 has also shown some promise in reducing sensation in the penis with injections of hyaluronic acid, a medication that has long been used for the augmentation of soft tissues. However, wider studies need to be conducted.
If you’re looking for ways to manage your erectile dysfunction that don’t include taking a pill, or if you’re searching for a quick fix as you work through therapies to help you last longer before ejaculation, topical anesthesia like lidocaine or benzocaine might be the fix you’re looking for.
For the purposes of treating premature ejaculation, both have been found to be effective so deciding on one you’d like to try will have you well on your way.
Just remember, don’t leave it on too long, and wash it off before you get down to business — for the pleasure of both you and your partner. Of course, we fully support solo sex too!
For your optimal ED treatment plan, it’s helpful to consult with a healthcare professional.
Dr. Jill Johnson is a board-certified Family Nurse Practitioner and board-certified in Aesthetic Medicine. She has clinical and leadership experience in emergency services, Family Practice, and Aesthetics.
Jill graduated with honors from Frontier Nursing University School of Midwifery and Family Practice, where she received a Master of Science in Nursing with a specialty in Family Nursing. She completed her doctoral degree at Case Western Reserve University.
Jill is a national speaker on various topics involving critical care, emergency and air medical topics. She has authored and reviewed for numerous publications. You can find Jill on Linkedin for more information.