Methods to improve premature ejaculation
Premature ejaculationPremature Ejaculation (PE) is one of the most common sexual dysfunctions in men. It is defined as the inability to control ejaculation, resulting in premature ejaculation (typically an intravaginal ejaculation latency time (IELT) of < 1–2 minutes), which can cause distress or affect the satisfaction of one's partner.
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Premature ejaculation can be divided into primary (lifelong, present from the first sexual experience) and secondary (acquired, caused by psychological, disease or lifestyle factors).
The good news is:Premature ejaculation can be effectively improved in most cases.The success rate of improvement is high (especially with comprehensive therapies). The following are common methods listed in order of strength of evidence, starting with the most recommended.
Behavioral therapy and self-training (first-line, non-drug, no side effects, strong evidence)
These methods are the safest, lowest cost, and most effective in the long term. Many people can significantly extend their time (from tens of seconds to several minutes) using only these methods.
- Kegel exercises (pelvic floor muscle training)
Strengthening the bulbospongiosus and ischiocavernosus muscles can improve ejaculatory control.
Instructions: Tighten your perineal muscles (PC muscles) as if you are holding back urine, hold for 5 seconds and relax. Repeat 10-20 times per set, 3-5 sets per day.
Advanced: Rapid contraction (contracting in 1 second and releasing in 1 second), or combined with a biofeedback device.
Studies show that 12 weeks of training can increase IELT from <1 minute to more than 2–3 minutes, with significant improvement in 82% patients. - Stop-Start Technique
When masturbating or having intercourse, stop stimulation completely when you feel you are about to ejaculate (excitement level 8-9). Wait 30-60 seconds for the excitement level to drop to 5-6 before continuing. Repeat this 3-5 times before allowing yourself to ejaculate.
Practicing three times a week for several weeks can significantly improve control. - Squeeze Technique
When you are about to ejaculate, use your thumb and forefinger to firmly squeeze the coronal sulcus below the glans for 5–10 seconds until the urge to ejaculate subsides. Repeat this exercise.
This is a classic approach, highly recommended by the Mayo Clinic and guidelines from multiple countries. - Edge control(Edging)
Stimulate repeatedly until the edge (slightly before PONR), then stop and repeat multiple times before finally ejaculating.
This can raise the ejaculation threshold, making the final orgasm more intense. Many people have doubled their stamina after practicing for 1-2 months. - Other tipsMasturbate once 1-2 hours before intercourse (to reduce sensitivity), wear a thicker condom, change positions (female on top or lying on her side to reduce stimulation), and prolong foreplay (to distract attention).
Drug-induced improvement (fastest and most effective, with the strongest evidence)
- Dapoxetine (Priligy)
The only approved short-acting SSRI specifically for improving premature ejaculation, taken as needed (30–60 mg 1–3 hours before sexual activity).
It can extend IELT by 3–4 times or more and is currently a first-line drug (approved in China, Hong Kong and many European countries). - Other SSRIs (off-label use)
For example, paroxetine, sertraline, and fluoxetine can be taken daily or as needed.
Paroxetine is the most effective, but requires a doctor's prescription. Side effects include dizziness, nausea, and decreased libido (usually short-term). - Local anesthetic
Apply lidocaine/procaine spray or cream to the glans penis 10–20 minutes before sexual intercourse to reduce sensitivity.
It's simple and effective, but it might make your partner numb too (using a condom can avoid this). - otherTramadol (on demand) or PDE5 inhibitors (such as Viagra, if combined with erectile problems).
Psychological/sexual improvement (strong evidence for psychogenic premature ejaculation).
- Performance anxiety, stress, and relationship problems are often the main causes.
- Seek help from a urologist or a sex therapist/psychologist to learn relaxation techniques, communication skills, and how to reduce "performance stress."
- The effects are better when partners participate together (e.g., practicing behavioral therapy together).
Other emerging/auxiliary methods (moderate evidence, select as appropriate)
- Low-energy external shockwavesStimulating penile blood vessels and nerves may improve control in some studies, but this is not the mainstream approach.
- Traditional Chinese Medicine/AcupunctureFor example, Zhi Bai Di Huang Wan, Jin Suo Gu Jing Wan, and acupuncture at Guan Yuan/Shen Shu points are suitable for psychogenic or kidney deficiency types, but the evidence is weaker than that for behavioral/medical reasons.
- OperationPenile dorsal nerve micro-control or hyaluronic acid injection can reduce sensitivity, but the effect varies from person to person (some people can last 5 minutes or more), but there are risks (such as permanent numbness), so it is not a first-line treatment.
Recommended order of improvement (latest guidelines and consensus)
- Try behavioral therapy + pelvic floor muscle training + edge control first (the safest approach, many people get better with just this).
- If the effect is not enough, add local anesthetic spray or dapoxetine (fastest).
- If the problem persists, consult a urologist for a comprehensive evaluation (to rule out prostatitis, thyroid problems, etc.) and consider psychological improvement or a combination of medications.
- Severe or refractory → Consider shockwave therapy/surgery, but professional evaluation is required.
Premature ejaculation is mostly treatable or significantly improveable, so don't blame yourself or delay seeking treatment. Hong Kong has many urology specialists (such as urology departments in public hospitals and private urology clinics) where you can seek anonymous treatment. Doctors there have seen many cases, so there's no need to feel embarrassed. Early intervention will greatly improve the quality of your sex life.
