Premature Ejaculation Treatment: Methods, Options and Costs

Written by: Op. Dr. Ahmet Semih Güleser (Urology & Andrology Specialist · Medical Registration No. 165407)
Published: 19 July 2026 • Last updated: 24 July 2026
This content was prepared by a urology specialist with reference to current scientific literature (EAU, ISSM, PubMed).

What Is Premature Ejaculation and Can It Be Treated?

The definition of premature ejaculation is sexual activity lasting under one minute. In broader terms, it can also be described as dissatisfaction experienced by the partners after intercourse. The target duration is determined entirely by what the patient and his partner want. For this reason treatment must be individual. Before treatment begins, a detailed examination is required so that the problem can be understood precisely.

According to the definition of the International Society for Sexual Medicine (ISSM), premature ejaculation has three components: short duration (ejaculation within approximately one minute of penetration), loss of control (inability to delay ejaculation) and the resulting personal or relationship distress. Diagnosis is not made by looking at duration alone; this is why the examination asks about control and satisfaction as much as about time.

Lifelong (Primary) and Acquired Premature Ejaculation

When the problem has been present since the first sexual experience, it is called lifelong (primary) premature ejaculation; in this group nerve sensitivity is usually prominent and treatment is more difficult. When a man who previously had no difficulty develops the problem later, it is called acquired premature ejaculation; here a correctable cause such as erectile dysfunction, prostate inflammation, thyroid disease or intense stress is looked for. Because this distinction changes the treatment plan directly, it is the most important step of the examination.

What Are the Treatment Methods for Premature Ejaculation?

  1. Behavioural therapy: The basic aim in treatment is to break the body’s habit of ejaculating early. Before medication and interventional treatment, attention to a few small points can prevent premature ejaculation. Once the ejaculation reflex has started it cannot be controlled; it is therefore more useful to work on controlling arousal. Small changes such as breathing deeply during intercourse, positioning the legs apart to reduce tension in the hip muscles, and changing tempo and position when needed can help prolong ejaculation time.
  2. Topical delay agents: Although delay sprays and condoms can be used, they are not preferred very often because of their effect on sexual pleasure. Reduced pleasure at an older age may bring erectile dysfunction with it.
  3. Medical treatment: In suitable patients, drug treatment can give useful results. There are two different approaches: medicines taken before intercourse, and medicines used continuously.
  4. Shockwave therapy (Li-ESWT): Shockwave therapy is frequently used in patients who have erectile dysfunction alongside premature ejaculation. Its most important advantage is the absence of side effects, while the requirement of six sessions is regarded as a disadvantage.
  5. Glans augmentation (penile head filler): Long-term treatment of premature ejaculation is possible with filler applied to the head of the penis. Various materials can be chosen for the procedure. The absorption time of these materials varies from person to person.
  6. Masturbation devices: Exercises performed with masturbation devices increase ejaculatory control. Mobile applications that guide how these devices should be used are particularly beneficial.

Which Treatment Suits Whom?

A detailed page exists for each of the methods below. The choice of method is made according to the type of premature ejaculation, its duration, any accompanying erectile dysfunction and the patient’s expectations.

Medical TreatmentDelaying the ejaculation reflex with medicines taken before intercourse or used continuously.Read more →
Delay SpraysTopical local anaesthetic applications, correct usage rules and their limits.Read more →
Glans AugmentationA reversible application that prolongs duration by reducing sensory density at the head of the penis.Read more →
Shockwave Therapy (Li-ESWT)A drug-free method of six sessions, preferred in patients who also have erectile dysfunction.Read more →
Selective Dorsal CryoablationUltrasound-guided cold energy method for refractory lifelong premature ejaculation.Read more →
Selective Dorsal NeurectomyA surgical nerve procedure for carefully selected cases, and realistic expectations.Read more →
MethodOnset of effectDurabilityKey characteristic
Behavioural therapyWeeksContinues with regular practiceNo side effects, requires patience
Delay sprayMinutesLimited to that intercourseEasy access, risk of reduced sensation
Medical treatmentHours – weeksWhile it is being usedHigh level of evidence, medical follow-up essential
Shockwave therapyOver the course of the sessionsMonthsDrug-free, also contributes to erection
Glans augmentationImmediateMonths (depending on absorption)Reversible, single session
Combined protocolAssessed within 2 monthsLong termDesigned for refractory cases

Combined Treatment in Severe and Refractory Premature Ejaculation

If intercourse lasts under one minute, the condition may be regarded as severe premature ejaculation. In some patients the duration is measured in seconds. Treatment is particularly difficult in patients who have had the problem from the very beginning. With a protocol designed specifically for this patient group, successful results can be achieved. These patients receive a combination of glans augmentation, shockwave therapy and medication. In patients who follow the treatment carefully, partner satisfaction can increase considerably. The treatment is assessed over a total of two months.

Important: In lifelong cases that do not respond to medication, advanced methods targeting nerve density (selective dorsal cryoablation or neurectomy) may come into consideration. These methods are not suitable for every patient and should be planned only when the candidate is appropriate and the possible risks of altered sensation have been explained clearly.

Cost of Premature Ejaculation Treatment

Costs vary entirely according to the treatment applied. Treatment must be individual, and an examination by an andrology specialist is therefore essential. Remember that any medication used without examination will make your problems worse. Under Turkish healthcare advertising regulations, fixed prices cannot be published on a medical website.

Frequently Asked Questions About Premature Ejaculation

Below how many minutes is considered premature ejaculation?

In the medical definition, ejaculation within approximately one minute of the beginning of intercourse is regarded as premature ejaculation. Independently of duration, loss of control over ejaculation and the personal or relationship distress this causes are also part of the diagnosis. The target duration is set according to the individual and his partner.

Can premature ejaculation be cured completely?

When the diagnosis is correct, ejaculation time can be prolonged significantly in most patients. In acquired premature ejaculation, correcting the underlying cause usually produces more lasting results. In lifelong premature ejaculation, treatment is generally combined and requires continuity.

Can premature ejaculation be treated without medication?

Yes. In mild and moderate cases, behavioural therapy, breathing and position adjustments, control exercises with masturbation devices and drug-free methods such as shockwave therapy may be sufficient on their own. The choice of method is made after examination.

Are delay sprays and creams harmful?

Used at the correct dose and in the correct way they are generally safe; however, because they reduce sensation, continuous use may negatively affect sexual pleasure and, over time, erection quality. Waiting and cleaning rules must be followed after application so that the agent does not transfer to the partner.

What is done in severe and refractory premature ejaculation?

In cases where intercourse is measured in seconds and medication alone does not help, combined treatment is applied: glans augmentation, shockwave therapy and drug treatment are planned together. The outcome is assessed at the end of a total period of two months.

How much does premature ejaculation treatment cost?

Under Turkish healthcare regulations, fixed prices cannot be published. Cost varies entirely according to the treatment applied; behavioural therapy and medication differ from combined protocols involving filler, shockwave therapy or surgery. Because treatment is planned individually, precise information can only be given after an andrology examination — you may contact the clinic.

Appointments & Information

The treatment plan that suits you is determined by examination.
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Scientific References

  • Althof SE, 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.
  • McMahon CG, et al. Efficacy and safety of dapoxetine in men with premature ejaculation. J Sex Med. 2011;8(2):524-539.
  • Güleser AS, Eren A. Medium-term outcomes of selective dorsal cryoablation in medically refractory lifelong premature ejaculation: 24-month follow-up. Rev Int Androl. 2026.
  • Culha MG, et al. J Sex Med. 2025;22(11):1383-1389.
  • EAU Guidelines on Sexual and Reproductive Health. 2024-2026.

This content is for general information only and does not replace examination by a physician. Response to treatment varies between individuals. For a personal assessment, please consult a specialist in this field.