Benzocaine vs Lidocaine for PE

Benzocaine and Lidocaine are very similar medications with the same mechanism of action. Premature ejaculation is when ejaculation occurs sooner than desired during sex. Premature ejaculation should not be a cause for concern, however, it can be frustrating and make sex less enjoyable.

When the penis is sexually stimulated, nerves in the penis send signals to the brain and spinal cord. The ejaculation reflex is triggered when a certain level of stimulation and arousal is reached. The brain also plays a part in the triggering ejaculation, independent of genital stimulation.

Benzocaine and Lidocaine work by desensitizing the skin of the penis, thereby blocking or reducing stimulation and signaling. This in turn delays ejaculation, leading to a longer duration of sexual intercourse.

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So what is the difference between Benzocaine and Lidocaine?

Lidocaine is a stronger anesthetic than Benzocaine. According to FDA regulations, Benzocaine products can have a maximum concentration between 3% to 7.5%. Lidocaine products are carefully regulated due to potential toxicity. Lidocaine can only be sold in an 11mg dose-metered bottle, and there is a limit of 10 sprays or doses of Lidocaine per use. There is no limit on the amount of Benzocaine that can be applied, and it’s effectiveness depends on the amount used.

Benzocaine products

Benzocaine condoms: Benzocaine condoms are simple to use and can be worn in the exact same way as regular condoms. Simply apply the condom and wait approximately 5 minutes for numbing to take effect. A drawback of Benzocaine condoms is that they aren’t as effective as other options containing a higher concentration or amount of medication. There are more concentrated creams and gels that can be tailored to help you last longer.
Benzocaine creams or gel: Benzocaine cream or gel is a good compromise between Lidocaine spray and Benzocaine condoms. It can have a longer effect than the condoms and the quantity can be adjusted.
Benzocaine products are safe to use with condoms, while Lidocaine has to be to cleaned off before condom use, as it can be corrosive to latex.
Benzocaine sprays: Some sprays use Benzocaine rather than Lidocaine, although Lidocaine is more effective. If you want a product that can be used with a condom, only Benzocaine is an option.
Benzocaine wipes: This is a new product and can be hard to find. The most readily available brand-name Benzocaine wipe is called Preboost. The wipes have a concentration of 4% Benzocaine, thus making them as effective as the Benzocaine condoms. However, they do not provide protection against STDs, so if you need to use a condom, Benzocaine cream is a better alternative.

Lidocaine products

Lidocaine condoms: Lidocaine condoms are not available, as Lidocaine can be corrosive to latex, leading to leeks or tears. Benzocaine only, is available for use with condoms.
Lidocaine creams and gels: Due to potential toxicicty, Lidocaine creams and gels are not available over the counter and require a prescription from a doctor. Approximately 300mg of lidocaine will be toxic to most men. Hence, regulation is needed to avoid overuse and toxicity. Elma cream, a mixture of lidocaine and prilocaine, is FDA-approved for the treatment of premature ejaculation.
Lidocaine spray: Lidocaine sprays are sold in dose-metered bottles. Each spray distributes about 10mg of Lidocaine. Approximately 10 sprays can be used each time. If the spray is overused, the concentration of Lidocaine present in the blood can reach toxic levels. Hence the instructions on the bottle should be followed closely.

The effect of Benzocaine or Lidocaine will differ from patient to patient. In order to determine which product suits you best, you should consider trying both. Generally, Lidocaine is more effecive than Benzocaine in treating premature ejaculation.

References

Dr Felix, "Using EMLA cream for premature ejaculation", in Drfelix.co.uk, , 2020, <https://www.drfelix.co.uk/health-center/using-emla-cream-for-premature-ejaculation/> [accessed 24 February 2020].
P Côté-Léger, "Benzocaine vs Lidocaine for Premature Ejaculation - PE Help", in Premature Ejaculation Help, , 2020, <https://prematureejaculation.help/benzocaine-vs-lidocaine-premature-ejaculation/> [accessed 24 February 2020].