FREE ONLINE CONSULTATION. START PE VISIT
Reviewed by Vicky Davis, FNP
Written by Nicholas Gibson
Premature ejaculation (PE) is a common sexual performance issue that can occur in men of all ages and backgrounds.
Like other forms of sexual dysfunction, premature ejaculation can be a difficult experience, both for you and for your partner. Luckily, it’s a condition that can be treated using medications, such as selective serotonin reuptake inhibitors (SSRIs) and topical creams and sprays.
If you have PE, you may have looked into creams and sprays that contain the active ingredient lidocaine to reduce sensitivity and delay ejaculation.
Lidocaine treatments such as creams, sprays and other products (even lidocaine condoms) all work in the same way, but there are a few main differences that you should be aware of before choosing one type of treatment product over the other.
Below, we’ve compared lidocaine creams and sprays as treatments for premature ejaculation to help you find the best option for you.
We’ve also discussed some other options to consider if you’re affected by premature ejaculation and want to improve your sexual performance.
Lidocaine is an anesthetic that works by reducing nerve activity in specific areas of your body, making the targeted areas less sensitive to touch.
As one of the world’s most widely used anesthetics, lidocaine can be found in just about every branch of medicine. It’s used in dentistry, as a local anesthetic for surgical procedures, and for preparing certain areas of the body for the insertion of equipment.
If you’ve been to the dentist for a root canal, wisdom tooth removal or any other kind of surgical treatment, there’s a good chance that lidocaine was used to numb your gums before and during the procedure.
Lidocaine comes in several forms. It’s often injected into tissue to numb it before surgery. It’s also available as a gel, cream, ointment and as a spray for use on the skin, in the airway or in other areas of the body.
As a topical anesthetic, lidocaine makes your skin and other tissue less sensitive, reducing the effects of touch or other forms of stimulation.
When it comes to premature ejaculation, lidocaine works by making certain parts of your penis less sensitive, helping you to avoid feeling overly stimulated during sex and helping you to last for longer in bed.
Because sensitivity is one of the most important aspects of sexual stimulation, anesthetics like lidocaine can have a big impact on your ability to delay ejaculation.
Generally speaking, the biggest difference between the lidocaine that’s used for dentistry and other procedures and lidocaine as a premature ejaculation treatment is the dosage.
For dental procedures and surgery, a fairly large dose of lidocaine is used to completely numb the area. For premature ejaculation, a smaller dose is used to reduce sensitivity but still give a pleasurable, enjoyable feeling during sex.
This means you won’t be completely numb, only that you’ll feel slightly less than normal during sex or foreplay.
Like other anesthetics, lidocaine can cause side effects when it’s overused or applied to the skin improperly. Most of the potential side effects of lidocaine treatments are similar to those of other topical anesthetics.
Common side effects of lidocaine creams and sprays include excessive numbness and irritation of the skin in the area of application. Some lidocaine topical products can also cause edema -- a form of swelling caused by trapped fluid.
Products that contain lidocaine can cause allergic reactions and drug interactions, including with common medications for high blood pressure, infections, epilepsy, cancer and other conditions.
You may have a higher risk of experiencing issues from lidocaine if you have sensitive skin, or if you have previously experienced side effects from topical anesthetics.
To reduce your risk of experiencing issues while using lidocaine cream or spray, it’s important to inform your health care provider about any medications you currently use or have recently used, as well as any relevant health conditions.
It’s also important to seek medical attention if you feel any pain, discomfort or have other issues while using lidocaine cream or spray.
Lidocaine cream works by numbing the skin on your penis. This reduces sensation and makes it easier for you to control your orgasm and ejaculation during sex.
Most forms of lidocaine cream are designed to be applied to the glans, or tip, of your penis. This part of your penis contains a large number of nerve endings, making it highly sensitive to sexual stimulation.
The idea behind topical treatment with lidocaine numbing cream is that by making the glans less sensitive, you’ll feel less during sex and have a lower risk of ejaculating early.
Some types of lidocaine cream contain a mixture of lidocaine and prilocaine, a different type of topical anesthetic.
Studies show that lidocaine-prilocaine creams work well for stopping premature ejaculation. In a study from 2002, researchers found that a 5% lidocaine-prilocaine cream increased the average pre-ejaculation period by 8.7 minutes (+/- 1.7 minutes) when applied before sex.
In addition to treating premature ejaculation, lidocaine cream is also used to numb the skin and reduce pain before some procedures. It’s widely prescribed to treat skin injuries, such as burns, insect bites and scratches.
The numbing effects of lidocaine cream can last for up to three hours. You may notice that the anesthetic gradually wears off a few hours after the cream is applied to your penis or other parts of your body.
Lidocaine cream usually starts to work within a few minutes, although it may take 20 minutes or longer to become fully effective.
In one study, researchers recommended applying lidocaine-prilocaine cream approximately 20 minutes before sexual contact. When used more than 30 minutes before sex, lidocaine cream may contribute to excessive numbness and loss of erection.
The biggest advantage of lidocaine cream is that, for most men, it works. Applied around 20 to 30 minutes before sex, lidocaine-prilocaine cream can produces an increase in pre-ejaculation time for most men, letting you and your partner enjoy sex for longer.
Lidocaine-prilocaine is also inexpensive and readily available from most pharmacies, making it an easy medication to buy if you have a prescription from your doctor.
The biggest disadvantage of lidocaine cream is that, since it’s a cream, it can get messy. After you apply lidocaine-prilocaine cream, you’ll need to thoroughly wash your hands to make sure you don’t accidentally apply the anesthetic to other parts of your body.
Some lidocaine-based anesthetic creams may also need to be rinsed off 20 to 30 minutes after application to avoid transferring the cream to your partner during sex.
This means that you’ll need to have a bathroom nearby if you opt for a cream-based medication to treat premature ejaculation.
Lidocaine spray works the same way as lidocaine cream -- by making your penis less sensitive to touch. Like lidocaine-prilocaine cream, lidocaine spray is designed to be applied to the glans, or tip, of your penis, as well as the underside of the shaft.
Unlike many cream-based medications, most lidocaine sprays only contain the local anesthetic lidocaine, without any other topical anesthetics.
Studies of lidocaine spray show that it works quickly and effectively as a treatment for premature ejaculation.
For example, in a study published in 2003, researchers found that use of a lidocaine-prilocaine spray increased men’s average intravaginal ejaculation latency time (IELT) from 84 seconds to 11 minutes and 21 seconds.
In short, when used properly, lidocaine spray can produce a significant improvement in sexual performance, helping you to avoid premature ejaculation and last for as much as six or seven times as long in bed.
Although lidocaine spray does reduce penis sensitivity, it doesn’t appear to have any impact on orgasm quality or overall sexual experience.
Like lidocaine cream, lidocaine spray is often used as a local anesthetic for medical procedures, including surgery for the skin. It’s also used as a local anesthetic during surgical procedures for the oral cavity and airway.
Lidocaine spray typically lasts for one to three hours. Like with lidocaine cream and other topical anesthetics, you may feel a gradual increase in your penile sensitivity as the effects of lidocaine spray wear off.
Most research suggests that lidocaine spray takes about 10 to 20 minutes to start working. In one study published in the International Journal of Impotence Research, experts found that a lidocaine 5% spray increased ejaculation time when used 10 to 20 minutes before sex.
Like lidocaine cream, the biggest benefit of lidocaine spray is that it works. Used properly, a typical dose of lidocaine spray can increase your average time to ejaculation by a significant amount, helping you and your partner enjoy more satisfying sex.
Another advantage of delay sprays that contain lidocaine is that compared to lidocaine cream, they tend to be faster-acting and easier to apply. This can make a spray a helpful option if you need a topical treatment that can be applied quickly before sex.
You’ll still need to wash your hands after applying lidocaine spray, but the fact that it’s a spray instead of a cream-based treatment means cleaning up is usually quicker and easier.
Since most lidocaine sprays come in a metered-dose spray bottle, it’s also easier to apply the right dose to your penis before sex.
Just like with lidocaine cream, one of the biggest disadvantages of delay spray is that you also need to wash it off your hands after use. However, like we mentioned above, because this is a spray-based product, cleanup is generally quicker and easier than with cream.
It’s also possible for lidocaine spray to slightly reduce your sensitivity level during sex. Studies of lidocaine spray show that while you might feel a mild numbness in your penis, there usually isn’t any negative impact on your overall sexual experience.
Most of the time, you’ll be able to change your lidocaine spray dosage over time to get the best combination of improved sexual performance and minimal sensitivity loss.
In addition to sprays and creams, numerous other options are available for treating premature ejaculation. These include techniques that you can use during sex to delay ejaculation, habits and lifestyle changes, as well as prescription medications.
Several techniques are commonly used to slow down the process of orgasm and ejaculation, including the “stop-start” method and the “squeeze” technique, which involves gently pressing on the area between the glans and shaft of your penis when you feel orgasm approaching.
Other common tactics for delaying ejaculation and increasing stamina include masturbating in advance of sex, using diversionary thoughts to avoid reaching orgasm and switching to thicker condoms to reduce sensitivity.
Sometimes, making small changes to your daily lifestyle can help to reduce the severity of PE and improve your sexual function.
For example, research has found that regular physical activity is associated with a lower risk of developing premature ejaculation. Certain exercises, such as pelvic floor exercises, may also help to reduce the severity of PE and improve performance during sexual activity.
Our guide to stopping premature ejaculation goes into more detail about lifestyle changes that you can make to last longer in bed and improve your general sexual function.
While there’s currently no medication approved by the FDA specifically for treating premature ejaculation, several existing medications are used off-label to slow down ejaculation and help with sexual performance.
These include the prescription antidepressants sertraline (the active ingredient in Zoloft®) and paroxetine (Paxil®).
We offer sertraline and paroxetine as part of our selection of premature ejaculation treatments, following a consultation with a licensed healthcare provider who will determine if a prescription is appropriate.
Lidocaine provides real advantages for your sexual stamina and ability to control ejaculation -- a key reason it’s an active ingredient in our Delay Spray for Men.
Interested in treating premature ejaculation and improving your sexual performance? Our guide to lidocaine spray as a premature ejaculation treatment goes into more detail on everything you need to know about lidocaine sprays and other PE treatments.
You can also learn more about other treatments for premature ejaculation in our detailed guide to premature ejaculation pills.
Dr. Vicky Davis is a board-certified Family Nurse Practitioner with over 20 years of experience in clinical practice, leadership and education.
Dr. Davis' expertise include direct patient care and many years working in clinical research to bring evidence-based care to patients and their families.
She is also an active member of the American Academy of Nurse Practitioners.