Men
Premature Ejaculation
Premature ejaculation is the clinical term for an involuntary male orgasm that happens sooner than desired, leading to distress for one or both partners. For reference, the average time of sexual intercourse for most couples is about five minutes and only very few make it past ten minutes. Premature ejaculation affects up to 30 percent of men, although some estimates place that number even higher. It’s not so much the absolute timing — after all, some couples may be fully satisfied with short but intense intercourse — but that the man ejaculates even though he doesn’t yet want to.
The drivers behind premature ejaculation aren’t fully understood yet, but it’s more common in younger men and often the condition goes away with age. For many men it’s a life-long problem. Genetic predisposition, psychological issues, chronic stress, low serotonin levels, hyperthyroidism and other factors can be contributing factors, but most often, an exact cause will not be determined,
There are several effective and inexpensive medications available that will help you get ejaculation under control and delay it up to the normal five minute level (more on this at the end of this article). But before taking pills, you can try natural remedies for premature ejaculation. Given how widespread the problem is across different countries and cultures, there’s a long list of natural cures that claim to improve ejaculation control. Below we list the most popular remedies and help you separate fact from myth.
Premature ejaculation has been troubling men for at least two millennia, and it thus doesn’t surprise that two of the oldest civilizations, China and India, hold rich arsenals of herbal treatments against it. India’s Ayurvedic medicine counts kamini vidrawan ras and yauvanamrit vati as herbs that are effective against premature ejaculation. Chinese traditional medicine praises yimusake and qilin for the same purpose. All these herbs are available as over-the-counter supplements in the form of pills or powders.
A 2017 meta review of several studies on the effectiveness of these herbal remedies concluded that Ayurvedic herbs yielded a one minute gain in ejaculation time, while the Chinese herbs yielded a two-minute improvement. However, the quality of most studies wasn’t very good and data availability on side effects and contraindications with other drugs is sparse. Moreover, since these are natural products, there’s also a risk of contamination (pesticides, heavy metals, etc.) and lack of standardization leading to wide variation in effect.
There are many supplements on the market that promise to treat premature ejaculation, aside from the Indian and Chinese herbs discussed above. Over-the-counter supplements typically include zinc and magnesium. Zinc has been shown to marginally boost testosterone production, which may help with erectile dysfunction. However, boosting testosterone may in fact worsen premature ejaculation. Studies have found that men who have early orgasms typically have higher testosterone levels than men who do not. In this case, increasing testosterone levels, by for example, taking zinc supplements, will likely worsen premature ejaculation.
As for magnesium, there is no evidence that it significantly affects time to ejaculation.
Essential oils, including Ayurvedic herbs like ashwagandha, but also thyme, sandalwood and clove oil, are sometimes used by men to treat premature ejaculation. However, there’s little scientific evidence to support these treatments. Clove oil can act like an anesthetic, desensitizes the penis, and leading to a slight delay in ejaculation.
However, the effectiveness of clove oil is inferior to medical anesthetics like lidocaine and prilocaine. These are available as creams and sprays and applied on the penis shortly before sex for a numbing effect that delays ejaculation. Talk to your doctor to learn more about the use of anesthetics for treating premature ejaculation.
Orgasms happen because of a complex interplay of physical and mental factors. Behavioral therapy therefore, can also help to get your orgasm timing under control. Therapy can help you relax and boost your sexual confidence, and there’s the option to get your partner involved in it, too. In fact, engaging your partner — whether through therapy or simply through an open discussion — is always a good idea. It will make her or him understand your problem and feel better. When you no longer need to hide anything, you can better relax during sex.
Couples therapy can also help clear up misconceptions. Sometimes, especially in new relationships, a man may think that not lasting long is a very big deal. Therapy can help find out how important the duration of sexual intercourse really is to your partner. Often, foreplay and intimacy prior to sex, may give your partner far more pleasure than the intercourse itself.
Given how many men are troubled by premature ejaculation, many psychologists specialize in helping with this condition, and a wide range of counseling options are available for you to explore.
Special exercises can enable you to postpone ejaculation past the normal five minutes. The so-called squeeze method is one popular exercise. After having stimulated your penis close to the point of ejaculation, your partner firmly squeezes the penis to kill off the ejaculation urge. This exercise is then repeated several times. Practiced over the course of several months a few times a week, this exercise can teach you how to delay your climax on your own, without the aid of squeezing.
Pelvic floor training is another option. This type of exercise includes stopping your urine midstream, and exercising your anal sphincter muscles by contracting them like you want to prevent passing gas (do this initially in a prone position). Hold the contracted position for a few seconds every time and repeat the contraction 10-15 times during each round of exercise. A 2014 study showed that these exercises will make your pelvic muscles stronger and give you better ejaculation control, If practiced frequently for 3-4 months.
Perhaps the simplest and most universally tested exercise of all is masturbation. Masturbating 1-2 hours before you have sexual intercourse will temporarily desensitize your penis and capacity for sexual arousal, which means you’ll last longer during ensuing sex.
Now that you know all about the natural remedies against premature ejaculation, let’s briefly look at what medical options exist. While there are no pills on the market specifically made or approved for treating premature ejaculation, doctors often prescribe SSRI antidepressants for this purpose. The research record shows that they are quite effective at delaying male orgasms by about 5-6 minutes when taken ad-hoc a few hours prior to sex. They are even more effective when taken daily, but carry a higher risk of side effects in this case.
The American Urological Association has recommended the use of SSRIs, like sertraline (Zoloft) or fluoxetine (Prozac), for treating premature ejaculation. You won’t have to take pills regularly, just prior to sex when you feel you require a little pharmaceutical help. This limits the risks of experiencing side effects, which are common for regular SSRI users.
Every man responds differently to the different SSRIs available, so you’ll likely need to experiment a little to find which drug is right for you. Sertraline and fluoxetine are the most popular choices.
If you are interested in learning more about sertraline and other SSRIs, talk to your doctor. They can help you set a treatment plan and tell you about possible side effects.
Reviewed by Dr Roy Kedem, MD
Information last reviewed 07/12/21
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