If you have been experiencing problems with premature ejaculation, our online service at ZAVA can provide confidential advice and treatment. We offer two options that could help to give you more control, Priligy tablets and EMLA cream.
Simply complete our brief medical questionnaire, and a ZAVA doctor will then check to see if the treatment is right for you. They will then issue your prescription to a local pharmacy in Ireland, or you can choose to have your medication delivered directly to your door.
It is also worth considering our erectile dysfunction treatment service. Sometimes erectile dysfunction can cause premature ejaculation as well, so if you are experiencing both, it might be best to think about treating your erectile dysfunction first.
A consultation for premature ejaculation prescription costs €21.50.
Premature Ejaculation Treatment
What is premature ejaculation?
Premature ejaculation happens when a man is unable to delay or control ejaculation. Normally, this means ejaculation takes place very soon (less than a minute) after the penis enters the vagina, but in severe cases it can mean the man ejaculates before penetration.
How quick is premature ejaculation?
It is quite common for men to worry about whether or not they last long enough during sex and often, people are unsure about how long sex lasts for the average couple. Studies show that this varies, but evidence suggests that, on average, sex lasts between six and eight minutes.
What matters, is whether you and your partner are both happy with your sex life. However, if you normally ejaculate within one minute of sex, doctors usually consider this to be premature ejaculation.
Who does premature ejaculation affect?
Premature ejaculation is the most common type of ejaculation problem. Reports suggest that 1 in 3 men experience premature ejaculation. In reality the numbers are probably higher, because men prefer not to discuss premature ejaculation as part of a survey.
Causes of premature ejaculation
The causes of premature ejaculation are unclear, but they are often thought to be psychological and/or neurological. They can include stress, anxiety/performance anxiety, depression, relationship problems, or a traumatic sexual experience in the past. It can also be caused by biological factors.
Causes of primary premature ejaculation
If someone has experienced premature ejaculation throughout their sex life, doctors call this primary premature ejaculation.
Biological factors could also cause primary premature ejaculation. You may have a particularly sensitive penis. This can be caused by changes in the usual pattern of nerve signals. Doctors also think that some cases of premature ejaculation can be linked to low levels of a hormone called prolactin. Prolactin usually has the effect of dampening arousal, which in turn delays ejaculation.
Psychological causes of premature ejaculation
Often, there are psychological reasons why primary premature ejaculation occurs. It can stem from early sexual experiences. Some doctors believe that premature ejaculation can be linked to a type of conditioning, where a man has become accustomed to ejaculating quite quickly when masturbating as a teenager for example.
It can also be linked to upbringing. If you have had a very stern upbringing or if you have been taught that sex is wrong or a sin, it can be hard to let go of these thoughts as you age, which can result in problems relaxing into sex.
Similarly, a traumatic sexual experience, such as abuse, can result in ejaculation problems.
Causes of secondary premature ejaculation
If you had a history of normal ejaculation, but later started having problems, this is called secondary premature ejaculation. This could be due to biological factors including diabetes, multiple sclerosis, underactive thyroid, prostate disease and high blood pressure, along with taking recreational drugs and drinking too much alcohol.
Usually, the causes are psychological and include stress, depression, or being worried about performing sexually (previous problems with premature ejaculation or a new sexual partner).
Statistics on Premature Ejaculation
People often think that premature ejaculation is only an issue faced by young men and that it happens less frequently as men age. In fact, studies show that this is not true. Premature ejaculation is a problem that is consistent across ages. An American study found that 30% of men aged between adolescence and 59 years of age reported that they had experienced premature ejaculation at least once in the previous year. It also affects 28% of men aged 65-74 and 22% of men aged 75-85.
What premature ejaculation treatment options are there?
It is not always possible to cure premature ejaculation, but there are medications available to treat it temporarily.
Priligy is an oral medication. It contains the active ingredient dapoxetine. Men who normally ejaculate after about 1-2 minutes of sex, find that it helps them to last longer.
Priligy works by raising your serotonin levels temporarily. It is a type of antidepressant (known as a selective serotonin reuptake inhibitor or SSRI). You take it 1-3 hours before sex, and it lasts for a couple of hours afterwards. Studies show that Priligy is effective at increasing the length of time from when the penis enters the vagina to ejaculation.
Priligy is licensed for use in Ireland to treat premature ejaculation when the time between penetration and ejaculation is under 2 minutes. When prescribed to treat premature ejaculation that happens between 2 and 5 minutes from penetration, this is an ‘off-label’ use.
All medications we offer are fully licensed within Irekland. At ZAVA, we sometimes prescribe some medications, like Priligy, for conditions or circumstances that are outside of the licence (also known as ‘off-label’).
Prescribing ‘off-label’ is common practice by healthcare professionals to ensure a medication can safely benefit as many patients as possible. This is always based on updated information and evidence since the product first became available.
EMLA cream is a topical cream that is rubbed on the penis to numb sensation and in turn, slow down ejaculation. The cream contains two local anaesthetics: lidocaine and prilocaine. You put it on about a quarter of an hour before having sex. Once your penis feels numb, wash the cream off so that it does not also reduce sensation for your partner.
Please note that premature ejaculation is also an ‘off-label’ use of EMLA cream.
Side effects of premature ejaculation treatments
Numbing condoms and topical creams are designed to reduce sensation to help you control ejaculation, so they can also reduce your enjoyment of sex.
EMLA cream can cause some short-term skin irritation, such as redness, swelling or paleness where the cream was applied.
Priligy’s most common side effects are dry mouth, headache, dizziness and nausea.
The SSRI’s, paroxetine, sertraline and fluoxetine do unfortunately have several mild, common side effects, including feeling tired and nauseous, vomiting and diarrhoea and excessive sweating. Normally these side effects improve after a few weeks.
Always read the patient information leaflet supplied with your medicine for the full list of possible side effects.
Alternative Treatment Options
You can also consider mental techniques, alternative therapies, numbing condoms, psychological therapy, and other antidepressants.
Numbing condoms come with a numbing lubricant inside them to reduce sensation for the man and help him to control ejaculation. You need to put them on 30-60 seconds before you have sex so that the lube has time to work.
You can buy topical creams from sex shops to make you last longer, although they do not work as well as the medically prescribed creams, like EMLA.
What mental techniques to treat premature ejaculation are available?
There are also mental techniques that you can try. Some self-help techniques include masturbation a couple of hours before sex, taking a break during sex, thinking about something dull, using thick condoms so you can feel less, and taking a big breath in when you feel like you are about to ejaculate – to stop the ejaculatory reflex.
How can therapy help premature ejaculation?
Psychological therapy can often cure your premature ejaculation, but you need to be open to discussing your feelings for it to work. Often therapists also recommend that you stop having sex for a short while and explore other forms of pleasure with your partner, like massage or showing affection.
Another option, if you are in a relationship, is couples therapy. This will help you consider whether there are things affecting your relationship negatively and allow you to work through any issues with your partner. They can also teach you ways to train your body out of the habit of premature ejaculation. The two most common ways are the ‘squeeze’ and ‘stop-go’ techniques. You will need to practice them for them to work for you, even though they sound very simple.
What is the "squeeze" technique?
In the ‘squeeze’ technique, the woman masturbates the man until he feels that he is almost ready to ejaculate, then stops and squeezes the head of his penis for between 10 and 20 seconds. She lets go, waits for a further half a minute, then starts to masturbate him again. They repeat this process a few times before ejaculation. ‘Stop-go’ works similarly, but the woman does not squeeze the penis, instead the couple have sex, stopping and starting as required.
Priligy is a tablet used to treat premature ejaculation. You need to take it one hour before having sex and its effects last for around three hours.
How they work
Priligy tablets contain the active ingredient dapoxetine. It takes 1 - 3 hours to work.
Possible side effects include dry mouth, headache, dizziness and nausea.
In rare cases, Priligy can result in fits or seizures, low blood pressure, changes in mood or suicidal thoughts. Stop taking Priligy straight away if you experience any of these adverse effects.
EMLA is a local anaesthetic cream that numbs the skin. It helps to reduce the sensation at the tip of the penis and delays ejaculation. It needs to be applied 20-30 minutes before sex.
How it works
EMLA cream contains lidocaine and prilocaine. It works within 15 minutes.
Possible side effects include redness, mild swelling and pale discoloration where the cream is applied.
If you have an allergic reaction to EMLA stop using the cream and consult a doctor.
Dr Nicholas Antonakopoulos
Dr Nicholas Antonakopoulos graduated from the University of London in 2006. He did his postgraduate training in hospitals in the London area, and he trained for four years in Trauma and Orthopaedic Surgery before completing his training in General practice in 2015.Meet our doctors
Last reviewed: 08 Jan 2021