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10 Ways to Prevent Premature Ejaculation

Mike Bohl, MD, MPH, ALM

Reviewed by Mike Bohl, MD

Written by Geoffrey Whittaker

Published 05/15/2018

Updated 02/15/2024

Some research suggests premature ejaculation affects up to 39 percent of men (with estimates varying widely and reports often subjective). So, if you feel you’re not in tune with your ideal stamina, you’re not alone. And you’re also not stuck — most cases of premature ejaculation (or “PE” for short) are treatable.

Stopping premature ejaculation may involve a mix of various behavioral strategies and medications to help you along the way, including antidepressants, erectile dysfunction (ED) medications, kegels, therapy or masturbation. 

Read on to learn more about how each of those methods can work alone or together to keep you in the saddle longer.

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Before you go worrying about how you stack up, consider the facts. Unlike the feature-length performances in pornography, research shows that the average guy lasts between four and seven minutes during vaginal sex. 

Under the average? Well, women seem to be less concerned about this than men. In one study from 2003, researchers found that women tended to worry less about their partner’s rapid ejaculation (a term for premature ejaculation) than men did about their own time to reach orgasm and ejaculate.

In other words, there’s no reason to worry if you’re not seeing the times you’d like. PE is highly treatable, and we’re going to show you how.

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If you have premature ejaculation and think medication may help you, it’s best to contact a healthcare professional, like a urologist, to talk about your options. Generally, however, they will point to one of a wide range of treatments that include everything from medication and desensitizing agents to masturbation and control exercises.

Let’s look at your options.

Selective Serotonin Reuptake Inhibitors (SSRIs)

Research shows that antidepressants prescribed off-label can help to slow ejaculation and prolong sex for men with PE. 

In a 2007 study published in the journal Therapeutics and Clinical Risk Management, men suffering from premature ejaculation were prescribed either paroxetine, fluoxetine or escitalopram. 

All three of these drugs are selective serotonin reuptake inhibitors (SSRIs), which are usually used to treat depression and anxiety disorders.

The drugs were administered to study participants in the morning for four weeks, after which the men treated with SSRIs showed improvements in sexual function and a reduction in premature ejaculation severity using a validated questionnaire.

Interestingly, there was no difference in results between the different drugs, suggesting that all three of the SSRIs used in the study could be effective in stopping premature ejaculation.

SSRIs require a valid prescription, meaning you’ll need to talk to a licensed healthcare provider to use this type of medication. 

In some cases, SSRIs can cause side effects you should be aware of before beginning treatment. 

Hims offers access to treatment for premature ejaculation, following a consultation with one of the licensed healthcare professionals on our platform.

ED Medications

Some medications for erectile dysfunction, such as sildenafil (the active ingredient in Viagra®), may help prolong sex and reduce your risk of experiencing another sexual dysfunction: premature ejaculation.

A 2007 study published in the International Journal of Urology found that men with premature ejaculation experienced more improvements from sildenafil than they did from the SSRI paroxetine or the squeeze technique.

Another, small study published in the International Brazilian Journal of Urology, also found that a daily dosage of tadalafil (Cialis®) produced a modest increase in intravaginal ejaculatory latency time in men with erectile dysfunction.

Although these study findings are promising, it’s important to understand that research into the effects of ED medications for premature ejaculation isn’t comprehensive right now. 

In addition to sildenafil and tadalafil, other medications designed to treat ED include vardenafil (Levitra®) and avanafil (Stendra®). 

Our guide to sildenafil for premature ejaculation goes into more detail about how common ED medications work, as well as their potential effectiveness as treatments for PE.

Anesthetic Creams, Sprays and Other Products

Several topical treatments are available for premature ejaculation, including creams and sprays that contain anesthetics.

These medications are designed to be applied to the most sensitive parts and head of the penis and can change your penis’s level of sensitivity, allowing you to last longer during sex

Common ingredients in topical creams, sprays and other medications for premature ejaculation include lidocaine, benzocaine and prilocaine. Our Premature Ejaculation Spray contains lidocaine as its active ingredient.

Research shows that these topical anesthetics are effective.

One study published in the journal Andrologia found that men who used a lidocaine-prilocaine treatment were able to have sex for longer before ejaculating than men who used a non-therapeutic placebo.

Another study published in the International Journal of Impotence Research found that men with PE who used a lidocaine spray before sex experienced a statistically significant improvement in time to ejaculation and sex frequency over the course of eight weeks.

In short, using the lidocaine spray not only reduced the severity of PE,  but it also resulted in more sexual encounters overall.

Using Thick, “Extended Pleasure” Condoms

If you’re prone to premature ejaculation, you may benefit from using condoms designed to delay ejaculation

These are often labeled as “stamina” or “extended pleasure” condoms. They tend to be slightly thicker than regular condoms and sometimes have a mild topical anesthetic applied to the side of the condom that comes into contact with your penis. 

In addition to potentially slowing down time to ejaculation, using condoms provides an additional layer of protection against many sexually transmitted infections (STIs).

Can Surgery Fix Premature Ejaculation? 

Can surgery stop premature ejaculation? There are a few different surgeries available to treat premature ejaculation. However, the International Society for Sexual Medicine (ISSM) doesn’t recommend these as options. 

In their estimation, the risk for permanent damage and loss of sexual function could be too great, according to a review published in the journal, Translational Andrology and Urology

Choose your chew

Several behavioral techniques can be used as treatment options to prevent premature ejaculation, including simple techniques that can be performed during sex.

The “Stop-Start” Technique 

One of the oldest tricks in the book, the stop-start technique is exactly what it sounds like: a premature ejaculation management option where you stop sexual intercourse, then start again when you’re not about to cum. Then repeat the process until you’re ready to ejaculate.

You can practice the stop-start technique with your partner or by yourself. 

Using this process can also help you eventually feel more confident in your ability to control your orgasm and not ejaculate too quickly.

As simplistic as the stop-start strategy sounds, research shows that it’s a relatively effective way to address premature ejaculation in the short term.

For example, a scientific review published in Therapeutic Advances in Urology concluded that 45 to 65 percent of men with premature ejaculation report benefits from this technique.

However, there’s relatively little data available on the long-term results from using the stop-start technique.

Since the stop-start strategy doesn’t involve any medications or costly medical treatments, it’s a helpful first option for addressing premature ejaculation.

The “Squeeze” Technique

Another common technique used to manage premature ejaculation is the “squeeze” or “pause-squeeze” technique.

During sex, as you’re approaching orgasm and ejaculation, you (or your partner) should firmly squeeze the area between the shaft and glans of your penis to stop you from ejaculating and pinch the urethra gently closed.

Although there’s no exact amount of time that you should squeeze your penis, most resources suggest around 30 seconds. 

By using the squeeze technique, you can delay orgasm and ejaculation several times, allowing you to stop ejaculating too soon.

Like the stop-start technique, the squeeze method is generally effective, but also has certain downsides. 

Since it results in a stop in your sexual activity and pleasure, it may become an annoyance for both you and your partner. 

During the brief stop in sex, you may develop a weaker erection — something that might affect your sexual performance and enjoyment if you’re prone to erectile dysfunction.

Masturbating Before Sex

Sometimes, the easiest way to increase your time to ejaculation is to simply masturbate shortly before you plan to have sex. How not to ejaculate fast may just be a question of ejaculating sooner — before intimacy. 

While there’s no scientific evidence to support this method, many men find that masturbation shortly before sex is an effective way to delay orgasm and prevent premature ejaculation.

The idea behind this approach is that during the refractory period (a recovery phase that occurs after orgasm), most men won’t be able to orgasm for a little while.

Despite the relative lack of evidence, this is a simple, free and low-risk method you can try to slow the process of reaching orgasm and prevent yourself from ejaculating too soon.

Kegel Exercises (Pelvic Floor Exercises) 

You probably think kegel exercises are exclusively for women, but there's research out there to suggest that kegel exercises can help increase ejaculatory latency and prevent premature ejaculation in men.

For example, a 2014 study published in Therapeutic Advances in Urology found that men who performed pelvic floor muscle exercises for 12 weeks developed greater control over their ejaculatory reflex and increased their average time to ejaculation during sex.

Other research published in the journal, Physiotherapy, found that pelvic floor muscle exercises may help improve other sexual performance issues, such as erectile dysfunction.

Our detailed guide to kegel exercises lists techniques to train your pelvic floor muscles (the ones that help you stop your pee midstream) for better sexual function and performance.

Counseling or Therapy with a Sex Therapist

As discussed in our guide to the causes of premature ejaculation, psychological factors such as anxiety or guilt about engaging in sexual behavior may contribute to PE. 

If your premature ejaculation is related to your mental health or relationship problems, you may benefit from therapy and/or counseling. 

In a small study published in the National Journal of Andrology, men suffering from premature ejaculation were treated through a six-time course of behavioral therapy, two to three times per week.

After the treatment, the men were able to last longer before reaching orgasm and ejaculating during sex. The men who took part in the study and their partners also reported higher levels of sexual satisfaction.

The men in the study also reported lower levels of sexual performance anxiety and nervousness — factors that can often contribute to premature ejaculation and other sexual performance issues.

Research published in the journal Translational Andrology and Urology also shows that a mix of psychotherapy and medication is often more effective at stopping premature ejaculation than medication alone.

Several different forms of therapy are used to treat premature ejaculation and other issues that can affect your sexual health, including sex therapy and cognitive behavioral therapy (CBT).

Counseling and therapy are often combined with other treatments, such as medication, to help you overcome early ejaculation and improve your sexual experience. 

Diversionary Thoughts

Sometimes, changing what you think about during sex can help delay orgasm so you can avoid ejaculating prematurely.

This mental method is referred to as diversionary thinking. The theory is that by thinking about things other than sex, you’re less likely to reach the level of mental stimulation required to reach orgasm and ejaculate.

While some may find picturing their tax returns to be helpful, there’s no scientific research on its effectiveness. In fact, aside from a bunch of guys repeating the “think about baseball” line to each other, anecdotal evidence is all we have in support. 

Some researchers have even pointed out that these techniques tend to be unsuccessful over time because they reduce pleasure over all. 

There’s also a downside in that it can reduce the pleasure of having sex by taking you out of the moment.

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Preventing premature ejaculation is something that can be done at home. You can try:

  • Using thick condoms to decrease sensation

  • Masturbating one or two hours before sex to take advantage of the refractory period

  • Utilize techniques like stop-start or the squeeze technique to manually reduce your ejaculatory reflex.

  • Try using desensitizing sprays and creams

  • Speak to a healthcare professional about medications like SSRIs and Viagra.

Another reminder: this isn’t your fault, and it’s not something to be ashamed of. 

  • Premature ejaculation can be a frustrating, challenging issue that affects both your sex life and self-esteem. Luckily, PE is a treatable issue.

  • The best solution always starts with a conversation with a healthcare professional, who can help you determine the potential causes of your own individual PE problem, and suggest treatment options tailored to your needs.

  • Through medication, behavioral therapy or a combination of the two, many men with PE are able to increase their ejaculatory latency and enjoy a more exciting, pleasurable sex life. 

To get started treating PE, you can purchase our Premature Ejaculation Spray or consult with a licensed healthcare provider online about using sertraline or other medications.

You can find out more about how sertraline works, its effects, and more in our guide to sertraline for premature ejaculation.

18 Sources

  1. McMahon, C.G. (2007, April-June). Premature ejaculation. Indian Journal of Urology. 23 (2), 97–108. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2721550/
  2. Crowdis, M. & Nazir, S. (2020, June 28). Premature Ejaculation. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK546701/
  3. Premature ejaculation: Overview. (2019, September 12). Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK547548/
  4. Byers, E.S. & Grenier, G. (2003, June). Premature or rapid ejaculation: heterosexual couples perceptions of mens ejaculatory behavior. Archives of Sexual Behavior. 32 (3), 261-70. Retrieved from https://pubmed.ncbi.nlm.nih.gov/12807298/
  5. Chen, et al. (2009, October). A clinical study on psycho-behavior therapy for premature ejaculation. National Journal of Andrology. 15 (10), 929-31. Retrieved from https://pubmed.ncbi.nlm.nih.gov/20112744/
  6. Cooper, K., et al. (2015, September). Behavioral Therapies for Management of Premature Ejaculation: A Systematic Review. Sexual Medicine. 3 (3), 174–188. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4599555/
  7. Mohee, A. & Eardley, I. (2011, October). Medical therapy for premature ejaculation. Therapeutic Advances in Urology. 3 (5), 211–222. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3199591/
  8. Premature ejaculation: What can I do on my own? (2019, September 12). Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK547551/
  9. Turley, E. & Rowland, D.L. (2013, March 7). Evolving ideas about the male refractory period. BJU International. 112 (4), 442.452. Retrieved from https://bjui-journals.onlinelibrary.wiley.com/doi/10.1111/bju.12011
  10. Pastore, A.L., et al. (2014, June). Pelvic floor muscle rehabilitation for patients with lifelong premature ejaculation: a novel therapeutic approach. Therapeutic Advances in Urology. 6 (3), 83–88. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4003840/
  11. Myers, C. & Smith, M. (2019, June). Pelvic floor muscle training improves erectile dysfunction and premature ejaculation: a systematic review. Physiotherapy. 105 (2), 235-243. Retrieved from https://pubmed.ncbi.nlm.nih.gov/30979506/
  12. Althof, S.E. (2016, August). Psychosexual therapy for premature ejaculation. Translational Andrology and Urology. 5 (4), 475–481. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5001981/
  13. Arafa, M. & Shamloul, R. (2007, August). A randomized study examining the effect of 3 SSRI on premature ejaculation using a validated questionnaire. Therapeutics and Clinical Risk Management. 3 (4), 527–531. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2374931/
  14. Mihnas, et al. (2007, April). Can sildenafil treat primary premature ejaculation? A prospective clinical study. International Journal of Urology. 14 (4), 331-5. Retrieved from https://pubmed.ncbi.nlm.nih.gov/17470165/
  15. Akdemir, et al. (2017, March-April). Effect of tadalafil 5mg daily treatment on the ejaculatory times, lower urinary tract symptoms and erectile function in patients with erectile dysfunction. International Brazilian Journal of Urology. 43 (2), 317–324. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5433372/
  16. Atikeler, et al. (2002, December). Optimum usage of prilocaine-lidocaine cream in premature ejaculation. Andrologia. 34 (6), 356-9. Retrieved from https://pubmed.ncbi.nlm.nih.gov/12472618/
  17. El-Hamd, M.A. (2020, January 2). Effectiveness and tolerability of lidocaine 5% spray in the treatment of lifelong premature ejaculation patients: a randomized single-blind placebo-controlled clinical trial. International Journal of Impotence Research. 33, 96-101. Retrieved from https://www.nature.com/articles/s41443-019-0225-9
  18. G, M. du. (n.d.). Is there a place for surgical treatment of premature ejaculation? Translational andrology and urology. Retrieved June 2, 2022, from https://pubmed.ncbi.nlm.nih.gov/27652223/
Editorial Standards

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references. See a mistake? Let us know at [email protected]!

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Mike Bohl, MD

Dr. Mike Bohl is a licensed physician, a Medical Advisor at Hims & Hers, and the Director of Scientific & Medical Content at a stealth biotech startup, where he is involved in pharmaceutical drug development. Prior to joining Hims & Hers, Dr. Bohl spent several years working in digital health, focusing on patient education. He has also worked in medical journalism for The Dr. Oz Show (receiving recognition for contributions from the National Academy of Television Arts and Sciences when the show won Outstanding Informative Talk Show at the 2016–2017 Daytime Emmy® Awards) and at Sharecare. He is a Medical Expert Board Member at Eat This, Not That! and a Board Member at International Veterinary Outreach.

Dr. Bohl obtained his Bachelor of Arts and Doctor of Medicine from Brown University, his Master of Public Health from Columbia University, and his Master of Liberal Arts in Extension Studies—Journalism from Harvard University. He is currently pursuing a Master of Business Administration and Master of Science in Healthcare Leadership at Cornell University. Dr. Bohl trained in internal medicine with a focus on community health at NYU Langone Health.

Dr. Bohl is Certified in Public Health by the National Board of Public Health Examiners, Medical Writer Certified by the American Medical Writers Association, a certified Editor in the Life Sciences by the Board of Editors in the Life Sciences, a Certified Personal Trainer and Certified Nutrition Coach by the National Academy of Sports Medicine, and a Board Certified Medical Affairs Specialist by the Accreditation Council for Medical Affairs. He has graduate certificates in Digital Storytelling and Marketing Management & Digital Strategy from Harvard Extension School and certificates in Business Law and Corporate Governance from Cornell Law School.

In addition to his written work, Dr. Bohl has experience creating medical segments for radio and producing patient education videos. He has also spent time conducting orthopedic and biomaterial research at Case Western Reserve University and University Hospitals of Cleveland and practicing clinically as a general practitioner on international medical aid projects with Medical Ministry International.

Dr. Bohl lives in Manhattan and enjoys biking, resistance training, sailing, scuba diving, skiing, tennis, and traveling. You can find Dr. Bohl on LinkedIn for more information.

Publications

  • Younesi, M., Knapik, D. M., Cumsky, J., Donmez, B. O., He, P., Islam, A., Learn, G., McClellan, P., Bohl, M., Gillespie, R. J., & Akkus, O. (2017). Effects of PDGF-BB delivery from heparinized collagen sutures on the healing of lacerated chicken flexor tendon in vivo. Acta biomaterialia, 63, 200–209. https://www.sciencedirect.com/science/article/abs/pii/S1742706117305652?via%3Dihub

  • Gebhart, J. J., Weinberg, D. S., Bohl, M. S., & Liu, R. W. (2016). Relationship between pelvic incidence and osteoarthritis of the hip. Bone & joint research, 5(2), 66–72. https://boneandjoint.org.uk/Article/10.1302/2046-3758.52.2000552

  • Gebhart, J. J., Bohl, M. S., Weinberg, D. S., Cooperman, D. R., & Liu, R. W. (2015). Pelvic Incidence and Acetabular Version in Slipped Capital Femoral Epiphysis. Journal of pediatric orthopedics, 35(6), 565–570. https://journals.lww.com/pedorthopaedics/abstract/2015/09000/pelvic_incidence_and_acetabular_version_in_slipped.5.aspx

  • Islam, A., Bohl, M. S., Tsai, A. G., Younesi, M., Gillespie, R., & Akkus, O. (2015). Biomechanical evaluation of a novel suturing scheme for grafting load-bearing collagen scaffolds for rotator cuff repair. Clinical biomechanics (Bristol, Avon), 30(7), 669–675. https://www.clinbiomech.com/article/S0268-0033(15)00143-6/fulltext

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