Premature Ejaculation: Treatment Options

What is Premature Ejaculation (PE)?

Ejaculation in men is when the penis releases semen during sex. Premature ejaculation, also known as early ejaculation, is when you ejaculate or discharge your semen sooner than you or your partner would like. With PE, you may:

• Ejaculate before or very soon after you put your penis in someone.
• Not be able to put off your ejaculation during sex.
• Feel upset or embarrassed over your PE and avoid having sex.
• Enjoy sex less or have trouble with your relationships.

What are the causes?

Clinicians do not always know what causes PE. Mental health issues can also play a role in PE.

How does the clinician diagnose this health problem?

The clinician will do an exam and ask you questions about your PE. The clinician may or may not need to order lab tests.

How does the clinician treat this health problem?

• The clinician may suggest you talk with a counselor or sex therapist about your feelings that can cause problems in a relationship. Sometimes your clinician will order drugs to help with your PE. These may include drugs that are ordered to treat depression. These types of drugs can often delay ejaculation.
• The clinician may suggest a numbing cream or gel that you use under a condom. This helps to take away some of the sensation for a period of time and may help with PE.
• Some kinds of physical therapy or acupuncture may also help.
• You may want to try the "Squeeze Method". You or your partner stimulate your penis until you are close to ejaculation. Then, you or your partner squeeze the tip of your penis firmly until your penis becomes slightly softer. This may help you learn more about the feelings that come just before ejaculation. Then you may be able to better control when you climax.
• Some men find the "Stop and Start Method" helpful. You or your partner stimulates your penis until you are close to ejaculation. Then you stop until the urge to climax goes away. As you have more control, you or your partner stimulates your penis again. Repeat this process 3 times and ejaculate on the 4th time. Use this method a few times each week to help you better control when you climax.

Lidocaine & Prilocaine as a treatment option

You must carefully read the "Consumer Information Use and Disclaimer" below in order to understand and correctly use this information.

What is this drug used for?

It is a local anesthetic used to numb an area of the skin making it less sensitive, thus, prolonging the time it takes to ejaculate. It does not affect the amount of pleasure experienced during sexual activity.

What do I need to tell my clinician before I take this drug?

• If you or your partner are allergic to this drug or any part of this drug.
• If your partner is pregnant in which case it must not be used.
• If you have methemoglobinemia.

What are some things I need to know or do while I take this drug?

• Tell all of your health care providers that you take this drug. This includes your clinicians, nurses, pharmacists, and dentists.
• This drug may cause harm if swallowed. If this drug is swallowed, call a clinician or poison control center right away.
• A severe blood problem called methemoglobinemia has happened with drugs like this one. The risk may be raised in people who have glucose-6-phosphate dehydrogenase (G6PD) deficiency, heart problems, or lung problems. The risk may also be raised while taking certain other drugs and in infants younger than 6 months of age. Tell your clinician if you have ever had methemoglobinemia.
• Do not put on open wounds, cuts, or irritated skin.
• Use caution when using the spray. Never spray near the eyes, nose or mouth.
• Do not use this drug for longer than you were told by your clinician.
• Do not scratch or rub the skin while it is numb. Do not let it get very hot or very cold.
• If you are 65 or older, use this drug with care. You could have more side effects.

What are some side effects that I need to call my clinician about right away?

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
• Signs of methemoglobinemia like a blue or gray color of the lips, nails, or skin; a heartbeat that does not feel normal; seizures; severe dizziness or passing out; severe headache; feeling very sleepy; feeling tired or weak; or shortness of breath. This effect is rare but may be deadly if it happens.
• Slow heartbeat.
• Dizziness or passing out.
• Feeling lightheaded, sleepy, confused, or having blurred eyesight.
• Feeling anxious, nervous, excitable, shaky, or restless.
• Seizures or twitching.
• Change in balance.
• Change in speech.
• Ringing in ears.
• Depression.
• Trouble breathing, slow breathing, or shallow breathing.
• Numbness or tingling in the mouth.
• Change in how you feel hot or cold.
• Throwing up.

What are some other side effects of this drug?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your clinician or get medical help if any of these side effects or any other side effects bother you or do not go away:

• Burning, redness, swelling, or other irritation where this drug is used.
• Pale skin.
• Irritation where this drug was used.
• Upset stomach.
• Bad taste in your mouth.

How is this drug best taken?

• Use this drug as ordered by your clinician. Read all information given to you. Follow all instructions closely.
• Do not take this drug by mouth. Use on your skin only. Keep out of your mouth, nose, and eyes (may burn).
• If you get this drug in any of these areas, rinse well with water.
• It is recommended to apply the gel 20 minutes before sexual activity. The spray can be applied 5 to 15 minutes prior.
• Clean the skin before use. Make sure to dry well. Apply directly to the head and the shaft of the penis.
• Preferably, use a rubber glove to put on. If using your hands, make sure to wash them immediately after application with warm water and soap.
• For the gel, put a small layer on the area to be treated. Do not rub in. If using the spray, the recommended dose is up to 5 sprays.
• Cover the treated area with a latex condom to reduce the potential for side effects and irritation to your partner. Condoms made of polyurethane-based materials may wear down and thus should be avoided.
• Be careful until the numbness goes away. Do not do anything that may injure the treated area.

How do I store and/or throw out this drug?

• Store at room temperature. Do not freeze.
• Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.

General drug facts

• If your symptoms or health problems do not get better or if they become worse, call your clinician.
• Do not share your drugs with others and do not take anyone else's drugs.
• Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your clinician, nurse, pharmacist, or other health care provider.
• If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.