Finishing too soon in bed, also known as ‘early climax’ or ‘premature ejaculation’ (PE) is a common sexual health concern. In fact, it’s estimated to impact as many as 1 in 5 men who are sexually active. [1]

Worried about your performance in bed? Here are some steps to try.

Topical treatments

Anaesthetic creams 

Numbing creams have a mild anaesthetic effect, which can help reduce sensitivity in the penis. This can help delay climax by decreasing the amount of sensation experienced during sexual activity. Ask your doctor to recommend a suitable cream, for example one that contains the anaesthetics lidocaine or prilocaine. [2]

Anaesthetic sprays

Like anaesthetic creams, ‘delay sprays’ can be used to give a mild numbing sensation to the penis, and may be more practical for some people. [3] 

Oral treatments

Priligy (dapoxetine)

Priligy is the only medication in the UK prescribed specifically for the treatment of premature ejaculation. It contains dapoxetine, a selective serotonin reuptake inhibitor (SSRI), which has been shown to help extend the duration of time before ejaculation by three times. [4] Although SSRIs are drugs primarily used for depression, they’re also known to cause a delay in climax. Unlike treatments for depression, which are taken daily, Priligy is only taken 1-3 hours before anticipated sexual activity. 

At MedExpress, we prescribe Priligy for premature ejaculation with no in-person appointment needed — you can learn more here.

Sertraline

Some other SSRIs, such as sertraline, can be prescribed off-label for the treatment of premature ejaculation. [5] Although not a dedicated PE treatment like Priligy, it may help you last up to 7x longer. [6] To find out more about taking sertraline for PE, it’s best to contact your GP.

Viagra (sildenafil) 

Viagra (sildenafil) is an erectile dysfunction treatment that increases blood flow to the penis, which can help you achieve and maintain an erection. Although it’s not specifically used to delay ejaculation, research has found that it may also help with premature ejaculation [7], as it can potentially help indirectly by improving erectile function and boosting confidence during sex. [8]

Behavioural Therapy

Cognitive Behavioural Therapy (CBT) 

If you believe your premature ejaculation could be triggered by psychological factors like stress, anxiety, or relationship issues, you could benefit from cognitive behavioural therapy (CBT). [9] To find options available in your local area, contact your GP. 

Psychosexual therapy

Sometimes, it may not be a psychological condition that needs to be addressed to treat PE, but troubles within your own relationship with your sexual partner, or previous sexual experiences, such as a history of sexual abuse. [10]

Manual exercises

Pelvic floor exercises

Pelvic floor exercises, also known as Kegel exercises, can improve sexual health by strengthening the muscles that help control urination, ejaculation control and healthy erections. [11] To practise them, tense your pelvic muscles for 3-5 seconds, and rest. Repeat this action up to 10 times, every few days. [12]

Squeeze technique 

One manual method you can try to delay ejaculation is the ‘squeeze’ technique. To do this, squeeze the head of the penis for 10-20 seconds when climax is approaching, and repeat as necessary throughout sexual activity. [13]

Stop-start technique 

The stop-start method is another manual method to help take control over ejaculation. Long-term results are inconclusive, but one study reported that 45 to 65 percent of men noticed short-term improvements. [14]  

To use this technique, stop all movement before reaching climax, and continue once the feeling has passed. Like the squeeze technique, you can repeat this method throughout sexual activity to prolong the length of time before ejaculation. 

Other options

Healthy diet and weight 

One of the physical factors that can affect your sexual performance is your overall health. 

Maintaining a healthy diet and weight can help in delaying ejaculation by improving your overall sexual health. A balanced, nutrient-rich diet supports healthy blood circulation, hormone regulation, and energy levels, all of which contribute to better sexual performance. Being overweight or obese can cause conditions such as erectile dysfunction and high blood pressure, which can impact sexual stamina. Regular physical activity can also improve your cardiovascular health, endurance, and confidence, helping you last longer in bed.

Masturbation before sex 

Masturbating prior to sex may help delay ejaculation, due to a factor named the ‘refractory period’. This is a period of time that occurs after ejaculation where arousal levels are naturally reduced, making premature ejaculation less likely. [15] It’s important to note that the refractory period can last anywhere between a few minutes to a day depending on factors including hormones, age and physical health, so you may wish to experiment with this method first to find which time frame works best for you.

Try different positions

Changing position during intercourse, or choosing positions that provide less direct stimulation, could help lower arousal and delay ejaculation. Changing positions also engages different muscle groups, which can divert attention away from the urge to climax. [16]

Next steps

Struggling with premature ejaculation, or other sexual health issues such as erectile dysfunction? Remember, it’s up to you and your partner to decide the ideal length of time to enjoy sexual activity, but there are steps you can take.

At MedExpress, you can complete an online consultation and receive the right medication directly to your door, with discreet delivery. To learn more and find out if you’re eligible, click here.

 References

1. Veettil Raveendran A, Agarwal A. Premature ejaculation – current concepts in the management: A narrative review. International Journal of Reproductive BioMedicine (IJRM). 2021 Jan 25;19(1).
2. Ali D, Shah S, Nadeem Bin Nusrat, Zafar N, Assad Ur Rehman. Topical Anesthetics and Premature Ejaculation: A Systematic Review and Meta-Analysis. Cureus. 2023 Aug 3;
3. New Medicine Review Fortacin ® (Lidocaine / Prilocaine) Spray Treatment of primary premature ejaculation in adult men [Internet]. 2019 [cited 2024 Sep 26]. Available from: https://www.lancsmmg.nhs.uk/media/1087/fortacin-lidocaine-prilocaine-new-medicine-review.pdf
4. McCarty E, Dinsmore. Dapoxetine: an evidence-based review of its effectiveness in treatment of premature ejaculation. Core Evidence. 2012 Jan;1.
5. 1.Primary Care guidance for prescribing SSRIs for premature ejaculation Background [Internet]. [cited 2024 Sep 30]. Available from: https://medicinesmanagement.doncasterccg.nhs.uk/wp-content/uploads/2022/09/Primary-Care-guidance-for-premature-ejaculationV1.0-Sept-2022-review-Sept-2025.pdf
6. McMahon CG. Treatment of premature ejaculation with sertraline hydrochloride. International journal of impotence research [Internet]. 1998;10(3):181–4; discussion 185. Available from: https://www.ncbi.nlm.nih.gov/pubmed/9788108
7. NHS Choices. Ejaculation problems [Internet]. 2024. Available from: https://www.nhs.uk/conditions/ejaculation-problems/#:~:text=In%20the%20squeeze%20technique%2C%20you
8. McMahon CG, Stuckey BGA, Andersen M, Purvis K, Koppiker N, Haughie S, et al. Efficacy of Sildenafil Citrate (Viagra) in Men with Premature Ejaculation. The Journal of Sexual Medicine. 2005 May;2(3):368–75.
9. Mohammadi SD, Mohammadkhani P, Dolatshahi B, Dadkhah A. Effectiveness of cognitive behavioral therapy on the signs, symptoms and clinical consequences of premature ejaculation. Japanese Psychological Research. 2013 Jun 5;55(4):350–7.
10. Crowdis M, Nazir S. Premature Ejaculation [Internet]. PubMed. Treasure Island (FL): StatPearls Publishing; 2021. Available from: https://www.ncbi.nlm.nih.gov/books/NBK546701/
11. Pastore AL, Palleschi G, Fuschi A, Maggioni C, Rago R, Zucchi A, et al. Pelvic floor muscle rehabilitation for patients with lifelong premature ejaculation: a novel therapeutic approach. Therapeutic Advances in Urology [Internet]. 2014 Feb 20;6(3):83–8. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4003840/
12. Male Pelvic Floor Exercises [Internet]. University Hospitals Sussex NHS Foundation Trust. 2022. Available from: https://www.uhsussex.nhs.uk/resources/male-pelvic-floor-exercises/
13. NHS Choices. Ejaculation problems [Internet]. 2024 [cited 2024 Sep 17]. Available from: https://www.nhs.uk/conditions/ejaculation-problems/#:~:text=In%20the%20squeeze%20technique%2C%20you
14. Mohee A, Eardley I. Medical therapy for premature ejaculation. Therapeutic Advances in Urology [Internet]. 2011 Oct 1;3(5):211–22. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3199591/
15. Levin RJ. Revisiting Post-Ejaculation Refractory Time—What We Know and What We Do Not Know in Males and in Females. The Journal of Sexual Medicine. 2009 Sep;6(9):2376–89.
16. Crowdis M, Nazir S. Premature Ejaculation [Internet]. PubMed. Treasure Island (FL): StatPearls Publishing; 2021. Available from: https://www.ncbi.nlm.nih.gov/books/NBK546701/