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)