Premature ejaculation (PE) is a common sexual issue, especially with young men. During sex a man ejaculates far sooner than he or his partner would like. Many teenage boys experience premature ejaculation from an early age, but it is not just limited to young men and can affect men of any age. It can have a devastating effect on both a man’s mental wellbeing as well as their relationships. Much of the information available on the web is very confusing, with commercial companies promoting only one particular type of treatment and the NHS provides very limited treatment options. In this article we take an honest look at all the treatments available, giving you the pros and cons of each.
- Medication
Medication can be prescribed by your NHS doctor. The most common brands are Priligy Dapoxetine, Paroxetine, Sertraline, and Fluoxetine. Whilst these are easy to obtain and can provide help for some men and give them greater confidence in the bedroom, there are side effects: For some men, these drugs have a limited effect, some drugs like Sertraline are prescribed for depression, for men where it works it can require increasingly higher dosages and there are side effects like nose bleeds and nausea.
- Wipes
There is an abundance of different suppliers supplying wipes for premature ejaculation. These wipes contain a very small dose of benzocaine which is wiped onto the penis. This decreases the skin sensitivity on both the head of the penis and the shaft delaying ejaculation. These can be applied a few minutes before sexual activity. Whilst this is a relatively cheap option, wipes are readily available and it can be applied very quickly, there are some downsides. The benzocaine in the wipes can also desensitise the man’s partner, causing both embarrassment and discomfort. Not only is it a temporary solution, but it is also only effective for the short term.
- Sprays
An alternative to premature ejaculation wipes is Sprays. These are essentially the same but are using a different method of delivery. It can come down to a personal choice. Wipes are generally considered more effective as it is easier to cover the whole surface of the penis including the head and the shaft. With the spray it is more of an art. But some men may feel more comfortable carrying a spray.
- Sex therapist
Out of all the other sexual disorders a man can face, like Erectile Dysfunction, Peyronie’s Disease and Chronic Pelvic Pain Syndrome, In the United States of America, Premature Ejaculation is the most consulted topic. In the UK, we are much more reserved, so the use of sex therapists is more limited. For a number of men, it is thought that their premature ejaculation is in their mind and that counselling can help, not just their medical condition, but also their mental wellbeing, especially, if they have been suffering broken relationships or depression as a result of their condition. Whilst therapy can help the emotional side, it does not help the physical side of the condition.
- Kegel exercise.
Kegel exercise or what are also known as Pelvic Floor exercises are an essential part of controlling premature ejaculation and should be undertaken twice a day. These exercises strengthen a number of the muscle groups that both delay ejaculation and also lead to better control during sex. Like all physical exercise Kegel exercises are often undertaken incorrectly and they should be taught by a specialist in premature ejaculation. Kegel exercises require a lot of practice, and routine. Once a man has started them, they have to become part of their daily life, just like walking the dog each day. Many men struggle to engage the pelvic floor and opt for a highly sophisticated treatment like the Telsa Chair and Functional magnetic stimulation, which accelerate improvements. Kegel exercise is a longer-term solution, so don’t expect to see many changes in the first couple of months.
- Stop start technique.
The stop start technique involves exciting the penis and then just before ejaculation stopping. For men with severe premature ejaculation, who release in less than five seconds, this type of technique cannot be practiced until more progress has been made. This technique can be used in conjunction with wipes and other treatments. The purpose of this treatment is to get the man to recognise the different stages of sexual arousal before orgasm. It is about learning control. Before you start this, it is always best to discuss this with a clinician who is experienced in treating men in this area, and it is rare that this technique alone will provide you with significant improvements.
- Squeeze technique
Similar to the stop start technique the squeeze technique is also about stimulating and then controlling the penis. But the method differs in that pressure is put with the index figure on the backside of the penis where the head joins the shaft and the thumb on the other side gently squeezes the penis. There is a short break and then the process is repeated. Both the squeeze and stop and start technique need to become part of a daily routine for any long-term improvements.
- Tesla Chair
The Tesla Chair is a groundbreaking technology that is used for Premature Ejaculation. It is only available in a fraction of clinics across Europe, with Shockwave Clinics in Knightsbridge, Central London (2 minutes from Harrods), being the leading clinic for the treatment of Premature Ejaculation. The Tesla Chair replicates Kegel exercises and undertakes the equivalent of 19,000 Kegel exercises in 20 minutes. But the good news doesn’t stop there. The most athletic of us can only engage around 40% of pelvic floor exercises when undertaking them manually, while the Tesla Chair engages 100% of the relevant muscles. The Tesla Chair is vastly superior to Kegel exercises and can significantly improve Premature Ejaculation in a much shorter time period. It cannot be used if you have a pacemaker, certain types of implants or conditions like atrial fibrillation.
- Functional Magnetic Stimulation
Like the Tesla Chair, Functional Magnetic Stimulation is a very sophisticated piece of technology. With this technology a man lies on a medical couch and a probe is placed directly on the penis. This treatment is undertaken when a man is fully clothed. It has the same effect as some Kegel exercises but undertakes the equivalent of 20,000 exercises in 20 minutes, working on the control of the ejaculatory muscles. It is a pain free treatment and men can resume their normal life at once afterwards. This treatment is normally undertaken in conjunction with the Tesla Chair. This treatment cannot be undertaken if a man has a pacemaker and should be used in conjunction with Kegel exercise and the stop start method.
- Tens Machine
Tens machines have been used for years for pain relief, but they are also a useful accessory for Premature Ejaculation. A tens machine sends electrical impulses directly into the penis. These are relatively inexpensive and can be used in conjunction with a number of the other aforementioned treatments. It is always best to get an expert to show you how to use this. These are a simple device and nowhere near as powerful as Functional Magnetic Stimulation or the Tesla Chair but can often be used to complement this treatment at home and be part of a longer-term care package.
- Hyaluronic acid
With this method Hyaluronic acid is injected directly into the head of the penis. This is normally undertaken manually, and the results are varied depending on the skill of the clinician. The procedure can be undertaken on the same day and unlike wipes and sprays which last a short period of time, can last for a number of months. But there are side effects both in the shorter and longer term. In the short term, the acid can result in pimples and deformities on the head of the penis, which take a while to go away plus infection is common. But on a more serious note, Hyaluronic acid can trigger Peyronie’s Disease in people where the penis bends or deforms. It has also been suggested that Hyaluronic acid could lead to erectile dysfunction in the future.
- Selective Dorsal Neurectomy
This is a surgery where the penis is cut and an incision is made and some of the penile ejaculatory nerves are cut. A man has many, many nerves and it is thought by cutting a number of these, then this will reduce the overall sensitivity. This is a specialised surgery and requires a highly experienced doctor.
- Cryoablation and Radio Frequency
Cryoablation is a surgical procedure whereby some of the ejaculatory nerves are frozen. It can be undertaken during day surgery. There are risks though. Freezing the tissue can lead to damage to nearby structures. It is also an experimental treatment which can lead to erectile dysfunction.
- Inner condom Techniques
This is a more invasive form of surgery. A condom made from a cellular dermal matrix (ADM) is fitted behind the skin of the penis shaft. For many men it is a last resort. It permanently changes sensation and improves ejaculatory times, but there are risks of infection, dissatisfaction with the changes of sensation and the risk of long-term men’s health problems.
Finally, although Premature Ejaculation affects over 10% of the male population, very few clinics in the UK are specialists in this area and are unaware of the range of treatment options available.
