Urology Blog - Dr. Petronio Melo

Premature Ejaculation Medication: Treatments and Solutions to Delay Ejaculation

premature ejaculation medication



Understanding premature ejaculation

Premature ejaculation is a common problem among men, affecting approximately 20% to 30% of the male population at some point in their lives. This sexual dysfunction is characterized by the inability to control or delay ejaculation during intercourse, resulting in personal and marital dissatisfaction.


The importance of seeking medical help

Although it is a common problem, many men are hesitant to seek medical help to treat premature ejaculation, either because of embarrassment or because they believe that there is no solution. However, it is essential to seek professional guidance, as premature ejaculation may have underlying causes that need treatment, such as physical or emotional health problems. In addition, premature ejaculation can negatively affect self-esteem, sexual satisfaction and the quality of relationships.


The purpose of this article

This article aims to provide you with detailed information about the premature ejaculation medication and treatments available to combat premature ejaculation. We will address pharmacological and non-pharmacological options, as well as the importance of an individualized approach to the treatment of this condition. Throughout the text, we will discuss the effectiveness and safety of treatments, providing valuable information for those seeking solutions to delay ejaculation and improve their sex life.

By providing a comprehensive understanding of treatment options for premature ejaculation, we hope to encourage men to seek medical help and find the solution that best suits their needs. Information is a powerful tool in coping with this condition, and our goal is to contribute to improving the quality of life and sexual satisfaction of men affected by premature ejaculation.

Throughout this article, we will explore the following topics:

  1. What is Premature Ejaculation?
  2. Non-pharmacological approaches
  3. Remedies for Premature Ejaculation
  4. When to See a Urologist
  5. Conclusion

Based on this information, we hope that you will find the guidance you need to make informed decisions about treating premature ejaculation and that you will feel encouraged to seek medical help. Remember that premature ejaculation is a treatable condition, and seeking professional advice is the first step to improving your sex life and relationships.


What is Premature Ejaculation?


Definition and diagnostic criteria

Premature ejaculation is a male sexual dysfunction in which a man ejaculates faster than desired during intercourse. While the exact definition can vary, diagnostic criteria generally include:

  1. Persistent or recurrent ejaculation before, during, or shortly after penetration with minimal sexual stimulation.
  2. Inability to control or delay ejaculation during most sexual intercourse.
  3. Negative personal consequences, such as distress, dissatisfaction, frustration and/or the avoidance of sexual intimacy.

There are two main types of premature ejaculation: primary (or lifelong) and secondary (or acquired). Primary premature ejaculation occurs from the onset of sexual activity and is more common in younger men. Secondary premature ejaculation can develop later in life and can be associated with physical or emotional factors.


Possible causes and risk factors

The causes of premature ejaculation can be complex and varied, involving biological, psychological and social factors. Some of the possible causes and risk factors include:

  1. Biological factors:
    • Chemical imbalances in the brain: Low levels of serotonin, a neurotransmitter responsible for controlling mood and arousal, may be linked to premature ejaculation.
    • Increased penile sensitivity: Some men may have increased penile sensitivity, leading to premature ejaculation.
    • Hormonal issues: Hormonal imbalances, such as low testosterone levels, can contribute to premature ejaculation.
    • Inflammation or infection in the prostate or urethra: These conditions can increase your risk of developing premature ejaculation.
    • Genetic Factors: There is evidence that premature ejaculation may have a genetic component.
  1. Psychological factors:
    • Anxiety: Worry about sexual performance or pressure to satisfy a partner can lead to premature ejaculation.
    • Depression: Men with depression may be more likely to experience premature ejaculation.
    • Stress: Chronic or acute stress can negatively affect sexual performance and contribute to premature ejaculation.
    • Relationship problems: Conflicts or lack of communication with the partner can increase the risk of premature ejaculation.
    • Negative sexual experiences: Trauma or negative experiences related to sex can lead to premature ejaculation problems.
  1. Social factors:
    • Cultural or religious pressure: Some cultures or religious beliefs may promote the idea that sex is sinful or forbidden increasing anxiety and the risk of premature ejaculation.
    • Inadequate sex education: The lack of correct information about sex and sexual performance can lead to unrealistic expectations and anxiety, leading to premature ejaculation.

It is important to note that it is not always possible to identify a specific cause for premature ejaculation, and many cases may involve a combination of factors. When seeking medical help, the urologist will consider the patient’s history, perform physical examinations and, if necessary, order laboratory tests to determine the underlying cause and develop an appropriate treatment plan.

By understanding the causes and risk factors of premature ejaculation, we can better address the problem and seek effective treatments. Throughout this article, we will discuss the various treatment options available, from non-pharmacological approaches to specific remedies to help delay ejaculation and improve sexual satisfaction.


Non-pharmacological approaches


Ejaculation control techniques

Ejaculation control techniques are behavioral strategies that help men learn to control and delay ejaculation. Some of the more common techniques include:

  1. “Start-stop” technique: This technique involves stopping sexual stimulation just before you feel like you are about to ejaculate and resuming activity after the sensation subsides. Repeating this process several times during intercourse can help increase control over ejaculation.
  2. “Compression” technique: During sexual intercourse, when you feel that you are about to ejaculate, gently squeeze the base of the glans penis with your thumb, index and middle fingers. This compression helps stop ejaculation and can be repeated several times until the man feels he has more control over ejaculation.
  3. Deep breathing and relaxation: Learning to control your breathing and relax during lovemaking can help reduce the anxiety and tension associated with premature ejaculation.


Sex therapy and psychotherapy

Sex therapy and psychotherapy can be effective treatment options for men suffering from premature ejaculation, especially when the cause is psychological. These therapeutic approaches help patients explore and address emotional, relationship, or communication issues that may be contributing to premature ejaculation. Additionally, therapy can help improve self-esteem, reduce anxiety, and develop stress-coping skills.

Sex therapy, in particular, can be done individually or as a couple and involves the guidance of a therapist who specializes in sexual issues. The therapist can recommend specific exercises and techniques to improve ejaculation control and emotional intimacy between the couple.


Kegel exercises and pelvic floor strengthening

Kegel exercises are techniques used to strengthen the pelvic floor muscles, responsible for controlling ejaculation and erection. Regular practice of Kegel exercises can help improve endurance and muscle control, delaying ejaculation and leading to a more satisfying sex life.

To perform Kegel exercises, follow these steps:

  1. Identify the pelvic floor muscles: The pelvic floor muscles are the same muscles you contract to stop the flow of urine. Practice contracting these muscles for a few seconds and then relaxing them.
  2. Perform the contractions: Contract your pelvic floor muscles for 3 to 5 seconds, then relax for the same amount of time. Repeat this process 10 to 15 times per session, at least three times a day.
  3. Maintain correct technique: Make sure you don’t tighten your abdominal, buttock, or thigh muscles during Kegel exercises. Focus only on your pelvic floor muscles and breathe normally.
  4. Gradually increase duration and intensity: As you gain strength and control, gradually increase the duration of contractions and the number of repetitions.

Kegel exercises can be performed in any position, but it’s easiest to start by lying on your back or sitting in a comfortable position. With consistent practice, men can start to notice improvements in ejaculation control within a few weeks to months.

In summary, non-pharmacological approaches such as ejaculation control techniques, sex therapy and psychotherapy, and Kegel exercises can be effective in treating premature ejaculation. However, it is important to remember that each case is unique and it may be necessary to combine these strategies with other treatment options, such as medication, to achieve the best results.


Premature Ejaculation Medication


Topical anesthetics

Topical anesthetics, such as lidocaine and prilocaine, are creams, gels or sprays that can be applied directly to the skin of the penis to help reduce sensitivity and delay ejaculation. These products work by temporarily numbing the applied area, allowing for greater control over ejaculation.

It is important to follow the manufacturer’s instructions for correct application and the proper amount of product. In addition, it is recommended to use a condom to avoid transferring the anesthetic to the partner during sexual intercourse.


Selective serotonin reuptake inhibitors (SSRIs)

Selective serotonin reuptake inhibitors (SSRIs) are a class of antidepressant drugs that have been effective in treating premature ejaculation. Some of the more common SSRIs include fluoxetine, paroxetine, sertraline, and dapoxetine.

These drugs work by increasing the amount of serotonin, a neurotransmitter, in the brain, which can help delay ejaculation. SSRIs are usually taken daily, but dapoxetine can be taken as needed, a few hours before intercourse.

While SSRIs are generally safe, they can cause side effects such as nausea, drowsiness, dizziness, and decreased sex drive. It is important to consult a doctor before starting SSRIs to treat premature ejaculation, as these medications can interact with other medications and cause complications.


Other off-label drugs

In addition to topical anesthetics and SSRIs, other medications have been used off-label to treat premature ejaculation. These include:

  1. Tricyclic antidepressants: Like SSRIs, tricyclic antidepressants such as clomipramine can help delay ejaculation by increasing the amount of serotonin in the brain. However, tricyclics are more likely to cause side effects and are usually reserved for cases where SSRIs are not effective or not well tolerated.
  2. PDE5 inhibitors: Medications such as sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra) are primarily used to treat erectile dysfunction, but may also be helpful for some men with premature ejaculation. These medications work by improving blood flow to the penis, which can help prolong the duration of an erection and delay ejaculation.


Efficacy, safety, and side-effect considerations

When choosing a medication to treat premature ejaculation, it is important to consider the medication’s effectiveness, safety, and potential side effects. Response to treatment can vary between individuals, and what works for one person may not be effective for another. Therefore, it may be necessary to experiment with different treatment options to find the most appropriate approach for each case.

In addition, it is crucial to consult a physician before starting any pharmacological treatment, as he or she can assess medical history, health conditions, and medications being used in order to determine the best treatment option and prevent potential drug interactions or side effects. unwanted.

Side effects of premature ejaculation medications can vary and include allergic reactions, skin irritation, dizziness, nausea, drowsiness, headaches, decreased sex drive, and others. If severe or persistent side effects occur, it is important to contact your doctor immediately.

In summary, there are several drug options to treat premature ejaculation, including topical anesthetics, SSRIs and other off-label medications. Each option has its advantages and disadvantages, and the choice of the most appropriate treatment should be based on a medical assessment and discussion of individual expectations and concerns.


When to See a Urologist


Signs that premature ejaculation is affecting quality of life and relationships

Premature ejaculation can be an uncomfortable and frustrating condition for many men, and in some cases, it can significantly affect quality of life and relationships. Some signs that premature ejaculation is having a negative impact include:

  1. Sexual dissatisfaction: If premature ejaculation is constantly preventing you or your partner from enjoying sexual intercourse, it may be time to seek medical help.
  2. Stress and anxiety: Constant worry and stress about sexual performance can increase anxiety and further aggravate premature ejaculation.
  3. Avoiding intimacy: If premature ejaculation causes you to avoid intimate situations or have difficulty maintaining relationships, this could be a sign that it’s time to see a urologist.
  4. Low self-esteem: Premature ejaculation can affect self-esteem and confidence, leading to feelings of inadequacy or shame.


Importance of medical evaluation and personalized approach to treatment

Seeking the guidance of a urologist is essential to properly address premature ejaculation and ensure the best treatment approach. During the consultation, the doctor will assess your medical history, symptoms, possible underlying causes, and discuss your concerns and expectations regarding treatment. This assessment will allow the physician to develop a personalized treatment plan, taking into account the specific needs and goals of each patient.

Medical evaluation is also important to rule out or treat possible underlying medical conditions that could be contributing to premature ejaculation. In addition, the urologist can provide information and guidance on non-pharmacological strategies such as ejaculation control techniques and sex therapy, as well as advise on the proper and safe use of medications, if necessary.

In summary, it is important to see a urologist when premature ejaculation is negatively affecting quality of life and relationships. Medical assessment and a personalized approach to treatment are key to ensuring the best results and improving sexual satisfaction and emotional well-being.




Reaffirm the importance of addressing the problem of premature ejaculation and seeking appropriate treatment

Premature ejaculation is a common problem among men and can have a significant impact on quality of life and relationships. Addressing this issue and seeking appropriate treatment is crucial to improving sexual satisfaction and emotional well-being. Fortunately, there are several treatment options available, including non-pharmacological approaches and medications. Each individual is unique, and the best treatment for premature ejaculation varies from person to person. It is important to remember that medical help is essential to determine the best treatment option and ensure the safe and effective use of medications.

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Dr. Petronio Melo

CRM-SP 157.598 – RQE 70.725

  • Ph.D. from the Faculty of Medicine, University of São Paulo (USP)
  • Certified in Robotic Surgery by Intuitive Surgical
  • Member of the American Urological Association (AUA)
  • Member of the Brazilian Society of Urology (SBU)



Dr. Petronio Melo

CRM-SP 157.598

– Urologista, Andrologista e Cirurgião Robótico

– Certificação em Cirurgia Robótica pela Intuitive Surgical (Sunnyvale, Califórnia, EUA).

– Doutorado na Faculdade de Medicina da Universidade de São Paulo (USP)


Agende com um especialista

Throughout this article, we discuss various treatment options and solutions for premature ejaculation, from non-pharmacological approaches to specific medications. Premature ejaculation is a common condition, but it’s not something you have to deal with alone. The help of a medical professional is essential to identify the best treatment approach and ensure satisfactory results.

If you are facing difficulties with premature ejaculation and would like to obtain more information, clarify doubts and seek adequate treatment, I invite you to contact us. Our highly qualified team is ready to help you find the best solution for your needs.

Schedule an appointment at our office located at Rua Domingos de Morais, 2187, Bloco Paris – conj. 210, Vila Mariana, São Paulo, SP, Brazil, CEP 04035-000. To contact us and book your appointment, call (11) 91060-1374 or (11) 2659-4092.

Also, don’t forget to visit our website at https://www.drpetroniomelo.com.br and our GMB at https://goo.gl/maps/KgCNzjkcHbsrW3sz6 for additional information about our practice and the services we offer.

Don’t let premature ejaculation affect your quality of life and relationships. Contact us today and take the first step towards a healthier and more fulfilling sex life. We look forward to helping you achieve your goals and ensuring your long-term well-being.

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