Premature Ejaculation: Do Topical Treatments Work?

Premature Ejaculation: Do Topical Treatments Work?

Topical treatments for premature ejaculation (PE) can be effective, but formal medical research on such products is limited, researchers say in a new Sexual Medicine Reviews paper.

Men with PE climax before they want to and often feel that they can’t control the timing of their ejaculation. For some men, the problem occurs from their first sexual experience (lifelong PE). For others, it starts happening after a period of normal sexual functioning (acquired PE). Either way, PE can be distressing for couples who wish their sexual encounters could last a bit longer.

While the time frame considered bothersome varies from couple to couple, the International Society for Sexual Medicine (ISSM) considers PE to be ejaculation that occurs within one minute from vaginal penetration (lifelong PE) or within three minutes of penetration (acquired). According to the ISSM definition, the situation occurs most of the time and has a negative effect on a person’s wellbeing. (For example, a man with PE might avoid sexual relationships because he is so anxious about disappointing a partner.)

PE is one of the most common sexual complaints among men, but it’s sometimes challenging to treat. Currently, topical medications – ones that can be applied directly to the penis as creams or sprays – are the “first line” therapies, but they haven’t been widely researched by scientists.

To learn more, researchers analyzed medical studies and clinical experiences. Based on their review, they commented on several types of PE treatments:

  • EMLA cream. This cream, called “eutectic mixture of local anesthetics” or EMLA, combines lidocaine and prilocaine, two medications that cause numbness. In the studies, patients used the cream 10 to 30 minutes before having intercourse. Most of them saw improvements in their PE symptoms. To avoid transferring the cream to a partner, experts recommend washing the penis before sex and using a condom.
  • Lidocaine and prilocaine spray. This preparation comes in a metered dose, which means men should get the same amount of spray every time they use it. Studies have found that men using the spray took longer to climax compared to men who used a placebo spray.
  • Severance secret cream. The nine ingredients in this cream derive from natural products and include ginsenoside, eugenol, and bufosterioid. The cream is meant to provide numbness and might help with erections, too. In studies, men with PE had improvements and any side effects were mild.
  • Resiniferatoxin. This substance, which comes from cactus plants, is intended for men with lifelong PE. In studies, men were instructed to soak the tip of their penis in a solution for 30 minutes, then wash it before intercourse. The treatment was found to be more effective for uncircumcised men. Some men experienced pain, swelling, discomfort while urinating, and reddening of the skin.
  • Over-the-counter treatments. The researchers found no controlled studies of over-the-counter treatments in terms of safety of effectiveness.
  • Medicated latex condoms. No controlled trials of medicated condoms were found; instead, the researchers consulted online forums. The condoms discussed contained benzocaine, an anesthetic. Forum participants noted that the condoms were easy to use and worked quickly, but there were instances of decreased sensitivity. Some men developed contact dermatitis as well.

The study authors added that psychotherapy, paired with medical treatments, may also help men with PE.

Overall, they concluded that topical treatments “are an effective and well-tolerated option for treatment of PE.” However, they recommended more research on effectiveness and safety.


Sexual Medicine Reviews

Butcher, Michael J., DO, et al.

“Topical Agents for Premature Ejaculation: A Review”

(Full-text. Article in press. Published online: April 12, 2019)

You may also be interested in...

Other Popular Articles

What Is Jelqing, and Does It Actually Work?

The term “jelqing” refers to a set of penis stretching exercises that some believe can make the penis bigger. Although the practice has gained attention and popularity in blogs and internet forums in recent years, there is no scientific evidence that it is an effective way to permanently increase the size of one’s penis. In fact, in some cases, jelqing may actually cause damage to the penis, so it is a good idea to get all the facts before setting off to try it.

What Is Sensate Focus and How Does It Work?

Sensate focus is a technique used to improve intimacy and communication between partners around sex, reduce sexual performance anxiety, and shift away from ingrained, goal-oriented sexual patterns that may not be serving a couple.

What Is the Average Penis Size?

If you have ever wondered how your penis compares to others in terms of size, you are not alone. Many men are curious to know how their penises stack up compared to the average. Unfortunately, general curiosity can sometimes give way to full-on obsession and anxiety about penis size. This can be an unhealthy and often unnecessary fixation, especially because most men who think their penises are too small have perfectly normal-sized penises.

What Is Edging and Why Do People Do It?

Edging is the practice of stopping sexual stimulation before reaching orgasm to prolong a sexual experience. The term stems from the concept of approaching the metaphorical “edge” of orgasm but stopping before going over the edge.

Can Sex Reduce Menstrual Cramps?

The SMSNA periodically receives and publishes ‘guest editorials.’ The current article was submitted by Mia Barnes, a freelance writer and researcher who specializes in women's health, wellness, and healthy living. She is the Founder and Editor-in-Chief of Body+Mind Magazine.

Having sex while you experience menstrual cramps is healthy and can provide significant benefits. While it might not be the first activity that comes to mind when your PMS or period cramping begins, many people enjoy sex to reduce menstrual cramps, experience increased pleasure and benefit from other advantages. Learn more about having sex while menstrual cramps are happening and how it can help your body.

Can Sex Throw off Your Vaginal pH Balance?

The SMSNA periodically receives and publishes ‘guest editorials.’ The current article was submitted by Mia Barnes, a freelance writer and researcher who specializes in women's health, wellness, and healthy living. She is the Founder and Editor-in-Chief of Body+Mind Magazine.

Your vagina is a pretty powerful organ. It is a pathway for menstrual blood and babies. It also is a main player in sexual intercourse. You might hear about your vagina’s pH and worry that yours is at risk. Here’s what to know about vaginal pH, including the impacts sex could have.

Find a Provider

Find a provider who specializes in sexual medicine in your area.