Medical Treatment for Premature Ejaculation: Drugs, Creams and Methods
First-line treatment in premature ejaculation is usually medical (drug) treatment. The aim is to increase satisfaction for both the man and his partner by prolonging ejaculation time (IELT). On this page I discuss the medicines, the delay creams and sprays, the behavioural techniques and their real effectiveness in honest terms.
How Does Medication Prolong Ejaculation Time (IELT)?
Premature ejaculation is, broadly, ejaculation occurring in most intercourse much sooner than desired (usually before one to two minutes) and without control. The goal of medical treatment is to delay the ejaculation reflex and thereby prolong the IELT.
Which Drugs Are Used for Premature Ejaculation?
Dapoxetine (On-Demand SSRI)
Dapoxetine was developed specifically for premature ejaculation and is the only licensed medicine for this indication. It is taken on demand 1–3 hours before intercourse; it is absorbed rapidly and prolongs ejaculation time significantly. Temporary side effects such as nausea and dizziness may occur.
Other SSRIs (Daily Use)
Some SSRIs such as paroxetine and sertraline may be used daily off-label in premature ejaculation. Their effect becomes more pronounced with continued use; however, the complaint may return when the medicine is stopped. These drugs should only be used on the advice of a physician.
Delay Creams and Sprays
Local anaesthetic creams and sprays containing lidocaine and prilocaine delay ejaculation by temporarily reducing sensitivity at the head of the penis. They act quickly; the correct dose and timing of application matter.
When Erectile Dysfunction Is Also Present
If erectile dysfunction accompanies premature ejaculation, PDE5 inhibitors (erection medicines) may be added to the treatment; this can improve both the erection and ejaculatory control.
Behavioural Techniques (Stop-Start and Squeeze)
The stop-start and squeeze techniques are behavioural methods that teach a man to manage arousal before ejaculation. When applied together with drug treatment, success may increase. Where anxiety and performance concerns are prominent, sexual therapy is also helpful.
What If Drug Treatment Is Insufficient?
In premature ejaculation that does not respond adequately to drugs, sprays and behavioural treatment — particularly where it is due to excessive sensitivity of the glans — procedures such as selective dorsal cryoablation (nerve cooling) or selective dorsal neurectomy are considered. These methods aim to reduce sensitivity at the head of the penis in a near-permanent way.
Key points
- First line: medical treatment (drug plus cream/spray) and behavioural techniques.
- Dapoxetine: the only licensed drug for premature ejaculation, used on demand.
- Daily SSRIs are effective off-label; the complaint may return when stopped (not a cure).
- Delay creams/sprays: local anaesthetic, fast and practical.
- If erectile dysfunction is present, a PDE5 inhibitor may be added.
- If drugs are insufficient: nerve cooling (SDC) or neurectomy is considered.
- The effectiveness of herbal products is not proven; consult a physician.
Frequently Asked Questions About Premature Ejaculation Medication
Which is the best drug for premature ejaculation?
There is no single best drug; treatment is selected for the individual. The only licensed medicine specifically for premature ejaculation is dapoxetine, taken on demand. In addition, some SSRIs used daily and delay creams or sprays are used. The appropriate option is determined by examination.
How is dapoxetine used and is it effective?
Dapoxetine is usually taken on demand 1 to 3 hours before intercourse and prolongs ejaculation time significantly. Temporary side effects such as nausea and dizziness may occur. It must only be used on the advice of a physician.
Do SSRIs cure premature ejaculation permanently?
SSRIs are effective while they are being taken; when the medicine is stopped, the complaint often returns. They are therefore a treatment that provides control rather than a permanent cure. In patients seeking a lasting solution, surgical options are considered.
Do delay creams or sprays work?
Local anaesthetic creams and sprays containing lidocaine and prilocaine can delay ejaculation by temporarily reducing the sensitivity of the head of the penis. They act quickly; correct use and dose are important.
How much do premature ejaculation medicines cost?
Because the medicine, treatment plan and duration vary from person to person, and because Turkish healthcare regulations do not permit fixed prices to be published, no figure can be given here. You may contact the clinic for a plan that suits you.
What is done if medication does not work?
In premature ejaculation due to excessive sensitivity of the glans that does not respond to drugs, sprays and behavioural treatment, procedures such as selective dorsal cryoablation or neurectomy are considered.
What are the side effects of these medicines?
With SSRIs, nausea, dry mouth, dizziness, drowsiness or reduced sexual desire may occur; with creams there may be temporary numbness or reduced sensation in the partner. Side effects are usually mild and are managed with medical follow-up.
Do herbal or natural methods cure premature ejaculation?
The effectiveness of most herbal products has not been proven scientifically and the safety of their contents may be uncertain. Consulting a physician for an evidence-based approach is the most reliable course.
The medicine and treatment plan most suitable for you is determined by examination. Get in touch for an assessment or an appointment.
Scientific References
- Althof SE, McMahon CG, Waldinger MD, et al. An Update of the International Society of Sexual Medicine’s Guidelines for the Diagnosis and Treatment of Premature Ejaculation. J Sex Med. 2014;11(6):1392–1422.
- European Association of Urology (EAU). Guidelines on Sexual and Reproductive Health — Premature Ejaculation. 2024.
- McMahon CG, Althof SE, Kaufman JM, et al. Efficacy and safety of dapoxetine for the treatment of premature ejaculation: integrated analysis of randomized controlled trials. J Sex Med. 2011;8(2):524–539.
This content is for general information only and does not replace examination by a specialist. Medicines should be used only on the advice and prescription of a physician. For diagnosis and treatment, please consult a specialist physician.