Behavioral Techniques to Delay Ejaculation
Crowdis M, Leslie SW, Nazir S.
About the Reviewer
Your healthcare providers can come up with a plan to treat your premature ejaculation. Remember, this is a common problem and you’re not alone. Sign up for our Health Essentials emails for expert guidance on nutrition, fitness, sleep, skin care and more. Learn more about the Health Library and our editorial process. Cleveland Clinic’s health articles are based on evidence-backed information and review by medical professionals to ensure accuracy, reliability and up-to-date clinical standards. Premature Ejaculation ( [Updated 2023 Feb 7].
- Start therapy early with a healthcare provider.
- Learn about psychological factors affecting performance.
- Use behavioral techniques to increase endurance.
- Consider antidepressants like SSRIs under medical supervision.
- Explore natural supplements such as L-arginine or herbal remedies.
- Practice mindfulness and stress reduction strategies.
- Avoid performance anxiety through relaxation exercises.
- Maintain a balanced diet to support sexual health.
- Limit distractions and focus on intimate connection.
- Track triggers or patterns that lead to early ejaculation.
- Use lubricants to decrease sensation and prolong intimacy.
- Seek support from sex education resources.
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| Procedure | Purpose | Risks | Recovery Time |
|---|---|---|---|
| Penile Nerve Surgery | Reduces nerve sensitivity for longer control | Infection, numbness | Several weeks |
| Intracavernosal Injections | Enhances blood flow, delays ejaculation | Pain, fibrosis | Immediate |
| Vasectomy Reversal | May indirectly improve ejaculatory control | Infection, scarring | Several months |
Accessed 9/27/2023. NOTE: Some of the information provided contains graphic, medical images which individuals may find upsetting Click here to use our feedback form & send us your comments about this section of the BAUS website; this will help us to improve it for the benefit of our patients Premature ejaculation (PE) is the most common type of ejaculation problem. It is also referred to as rapid ejaculation. This is where the male ejaculates before he and/or his partner wants to.
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There is wide variation in what PE means to different individuals in different situations. For example, it may range from ejaculating in foreplay, to being able to have penetrative intercourse for many minutes (but which is still not enough to satisfy the male/the partner).
- Recognize signs of performance anxiety and address them.
- Use distraction techniques to divert focus from orgasm.
- Combine treatments like behavioral therapy and medication.
- Limit caffeine intake which can increase arousal.
- Practice deep, slow breathing to relax before sex.
- Consider topical anesthetics to desensitize.
- Use distraction and timing techniques to improve control.
- Educate yourself about normal sexual response.
- Attend couple's therapy to improve communication.
- Keep a positive attitude and avoid shame.
- Explore different positions to find what prolongs pleasure.
- Stay committed to a treatment plan for the best results.
The average time taken to ejaculate during intercourse is around 5½ minutes. However, it’s up to each couple to decide if they’re happy with the time taken – there’s no definition of how long sex should last. Occasional episodes of premature ejaculation are common and aren’t a cause for concern.
8. Is premature ejaculation permanent?
Your urologist can help direct you to these health professionals. Your provider may recommend certain medications to help with PE. Antidepressants are one of the first-line therapies for PE as they can help delay ejaculation. This is an “off-label” use (not approved by the Food and Drug Administration). Be sure to discuss the side effects of this medication with your urologist to be sure it’s appropriate for you.
Sertraline (Zoloft®) for PE
Antidepressants your provider might prescribe include the tricyclic antidepressant clomipramine (Anafranil®) or selective serotonin reuptake inhibitors (SSRIs), for example: Anesthetic (numbing) creams and sprays you apply to the head and shaft of your penis is another potential first-line medication option to delay ejaculation. Your penis absorbs the anesthetic cream or spray in about 10 to 30 minutes. It causes you to experience less sensitivity in your penis. It’s important to wash your penis before sex to prevent numbness to your partner’s genitals. Erectile dysfunction medications, which include sildenafil (Viagra®), tadalafil (Cialis®), vardenafil (Levitra®) and avanafil (Stendra®), may help treat premature ejaculation, particularly in people with underlying erectile dysfunction. However, if you’re finding that over half of your attempts at sex result in premature ejaculation, it might help to get treatment.
I am a Sex Coach that specializes in male performance struggles
With this technique, you or your partner stimulates your penis close to the point of orgasm, then stops the stimulation for about 30 seconds until you regain control of your response. Repeat this “start and stop” approach three or four times before allowing yourself to orgasm. Continue practicing this method until you have gained good control. With this technique, you or your partner stimulates your penis close to the point of orgasm then gently squeezes the head of your penis for about 30 seconds so that you begin to lose your erection. Repeat this technique a few times before allowing yourself to orgasm.
Physical causes
Continue practicing this technique until you’ve gained control in delaying your orgasm. With this technique, the idea is to focus your attention on ordinary nonsexual things during sexual activity. Naming sequences are a good way to focus your attention. For example, visualize naming all the businesses you pass on your drive to the gym or naming all the players on your favorite sports team. If the cause of your premature ejaculation is psychological, emotional or due to relationship issues — like performance anxiety, depression, stress, guilt or a troubled relationship — seek the help of a psychologist, psychiatrist or sex therapist. If either you or your partner feel that orgasm is happening much too soon, there may be a degree of PE. In many cases, premature ejaculation does matter, because it makes people unhappy and frustrated.
| Supplement / Remedy | Possible Benefit | Notes |
|---|---|---|
| Ginseng | May improve sexual stamina | Consult physician before use |
| Zinc Supplements | Supports testosterone levels | Dosage as per guidelines |
| Ashwagandha | Reduces stress, enhances stamina | Not scientifically conclusive |
| Kegel Exercises | Strengthen pelvic floor muscles | Daily routine |
In severe cases, PE can threaten or even ruin a relationship – simply because it spoils the sex lives of both partners.
How it works
Erectile dysfunction (you can’t maintain a firm erection for intercourse) Chronic pelvic pain syndrome (long-term pain and cramping in your pelvic area plus long-term urinary tract symptoms and sexual dysfunction) Talk to your healthcare provider if you believe you have premature ejaculation or if ejaculating too soon is affecting your sex life. It’s normal to feel embarrassed about discussing sex with your healthcare provider, but know that PE is a common condition and that your provider isn’t there to buy cenforce pills judge you. Wearing a condom can decrease sensitivity to your penis and help delay ejaculation. If you have erectile dysfunction, you can’t get or maintain an erection. If you have premature ejaculation, you have an erection, but you reach orgasm and ejaculate earlier than you or your partner would like.
How does Premature Ejaculation Occur?
Erectile dysfunction can lead to premature ejaculation. This happens because you know you can’t maintain an erection, leading to quick ejaculation so you don’t lose your erection. Because of this connection between these two conditions, your urologist will want to figure out if you have erectile dysfunction and, if so, treat that first. While it’s true that drinking alcoholic beverages can delay orgasm, it’s not a recommended treatment for premature ejaculation. There can be many reasons for premature ejaculation. Most cases of premature ejaculation do not have a clear cause. Various psychological and physical factors can cause a man to suddenly experience premature ejaculation, including: Physical causes prostate problemshormonal problems including an over or underactive thyroid glandusing recreational drugs hormonal problems including an over or underactive thyroid gland Psychological causes depressionstressrelationship problemsanxiety about sexual performance - particularly at the start of a new relationship, or when a man has had previous problems with sexual performance anxiety about sexual performance - particularly at the start of a new relationship, or when a man has had previous problems with sexual performance It is possible, but less common, for a man to have always experienced premature ejaculation since becoming sexually active.
| Innovation | Description | Potential Benefits | Current Status |
|---|---|---|---|
| Digital Biofeedback Devices | Real-time feedback on muscle activity | Enhances control with practice | In development |
| Virtual Reality Therapy | Simulated sexual scenarios for testing control | Customizable, engaging | Experimental |
| New Pharmacological Agents | Novel drugs targeting specific neural pathways | Possibly fewer side effects | Under research |
early sexual experiences that influence future sexual behaviour; a strict upbringing and beliefs about sex; and some men may find their penis is extra sensitive.
21. Does Viagra delay climax?
In certain cases, your provider may prescribe tramadol, an opiate medication. While alternative therapies also exist for PE treatment, there isn’t enough evidence to prove they’re effective. Most people find relief using one or more of the treatments above. Behavioral therapy and using different methods to delay ejaculation tend to be the most helpful. No, it actually worsens the problem because it makes you more sensitive to sexual stimulation.
A Note on Gender and Sex Terminology
By involving your partner and seeing the appropriate healthcare professionals, you may be able to control your ejaculations and enjoy your sex life again. Yes, you can prevent PE depending on what’s causing it. It’s best to discuss your feelings with your healthcare provider so they can help you determine a cause and recommend the appropriate treatment. There are many treatment methods you can use to avoid PE. Premature ejaculation itself isn’t harmful but other health problems may contribute to the development of premature ejaculation. If your ejaculation is earlier than desired (before or soon after penetration) with minimal stimulation and you have little control over it, you should consider seeking further advice from your GP Premature ejaculation (PE) can be lifelong (often dating back to the first sexual experience) or acquired (occurring later in life with previously satisfactory ejaculation time); PE can be situational (occurring under specific circumstances or with a specific partner); We do not know accurately how common it is but between 1 in 3 & 1 in 5 men (20-30%) are thought to have PE; Less than a quarter of men with PE actually seek medical advice for their condition; PE can be associated with erectile dysfunction (impotence) and with rapid loss of erection after ejaculation; and PE can cause significant patient distress and bother.
- Consider professional counseling for psychological causes.
- Use behavioral exercises like stop-start method.
- Take prescribed SSRIs to delay ejaculation.
- Practice pelvic floor relaxation techniques.
- Maintain a healthy, balanced diet.
- Limit exposure to performance pressure.
- Engage in shared sexual experiences with partner.
- Use condoms with numbing agents if suitable.
- Track progress to stay motivated.
- Incorporate relaxation techniques before intimacy.
- Avoid rushing; focus on quality over speed.
- Seek group or couple therapy if needed.
Your GP should work through a recommended scheme of assessment for men with troublesome premature ejaculation. This will normally include one or all of the following: The cause of premature ejaculation is unknown; it appears unrelated to performance anxiety, hypersensitivity of the penis or nerve receptor sensitivity Premature ejaculation may have a genetic tendency, running in some families.
Find your care
Getting to the root cause of PE is the first step in finding the best treatment. Sometimes, treating the underlying cause — like depression or hormonal disorders — can be all you need to stop ejaculating early. Be sure to discuss all your options with a healthcare provider. Premature ejaculation is often easily treated with a few simple steps, so it’s important to see your provider if you’re experiencing premature ejaculation. Although it may be uncomfortable to talk about sexual problems, know that your providers want you and your partner to have a satisfying sex life. It is also associated with prostate inflammation (prostatitis), thyroid disorders, emotional or pyschological disorders and previous traumatic sexual experiences. Psychosexual counselling, mindfulness therapy, cognitive behavioural therapy (CBT) and other associated techniques form the cornerstone of managing this condition, and may help men with less troublesome premature ejaculation.