Psychological Therapy

Psychological therapy is a way to work through the feelings and emotions that may lead to problems with sexual relationships. The goal of this type of therapy is to learn the source of problems and find solutions that may help PE. You might want to involve your sexual partner in discussions about how to manage premature ejaculation because the issue may affect their sexual satisfaction, and there may be things they can do to help. It can also help couples learn to grow closer. Psychological therapy can help you become less nervous about sexual performance. It can also give you greater sexual confidence and understanding to help your partner’s satisfaction. Psychotherapy involves educating both the male patient and the female partner. This can happen in the context of relationship counselling as well as psychosexual therapy. Meditation is also included in this therapy.This type of therapy can be used as the only treatment, or it may be used along with medical or behavioral therapy.

Behavioral Therapy

Behavioral therapy uses some techniques and exercises to achieve delay in ejaculation. The goal is to help you train your body for long time in sex. Some techniques are the squeeze method and the stop-start method and Kegel exercises. Sexual therapy focuses on perception and feelings with the goal of improving communication between partners, increasing sexual skills, self-confidence and reduce anxiety during sexual intercourse. It is believed that behavioural therapies result in increased IELT.

Stop-Start Method:- In this method, you and your partner stimulates your penis until just before ejaculation. When you are about to ejaculate, you and your partner stops until the urge to ejaculate lets up. As you regain control, you and your partner start stimulating your penis again. This process is repeated three times. You ejaculate on the fourth time. You repeat this method three times a week until you have gained more control.

Squeeze Method:- With this method, you and your partner stimulates your penis until you are close to ejaculation. When you are close, you or your partner firmly squeezes your penis just below the glans so your erection partly goes away. The goal is for you to become aware of the sensations leading to climax. The squeeze method may help you better control and delay ejaculation on your own.

Pre-coitus masturbation:- Masturbation before intercourse can delay the ejaculation.

Kegel Exercise:- Pelvic floor muscles exercise will help to gain control over ejaculation. Kegel will increase your capacity to hold the semen.

Climax Control Condoms:-Trojan Extended Pleasure condoms come with Climax Control Lubricant to help keep you going while you’re going at it. The clear lube has a special active ingredient to help prevent premature ejaculation and provide greater staying power.These condoms have a special lubricant that is formulated with a numbing substance, typically benzocaine. Your most sensitive nerve endings are found at the tip of your penis, and this lube lessens the sensation in that part. Durex Extended Pleasure,Trojan Extended Pleasure, are helpful in PE.

Thought Redirection:- Divert your attention from sexual act for 2-3 sec when you are about to ejaculate. 

Medical Therapy

No medicine have been approved in the United States to treat PE except Dapoxetine. Still, there are a number of medicines, numbing creams and numbing sprays that slow ejaculation in men with PE.Your Sexologist will advise when you should take a medicine based on your activity level. PE can return if you stop taking these medicines. Most men with PE need to take these medicines on an ongoing basis. So,herbal treatment is best for long term results.

Dapoxetine:- Serotonin is the most important neurotransmitter in ejaculatory control. Dapoxetine is an Serotonin Selective Reuptake Inhibitor (SSRI) with fast onset of action. Available in tablet form ‘Priligy’ of 30 mg and 60 mg.  It is contraindicated in cases of moderate to severe hepatic disease, heart failure, ischemic cardiac disease and carriers of pacemakers.

Desensitisers:- Topical creams and spray are there to achieve numbness in the penis such as EMLA,SS Cream,TEMPE i.e.PSD502.The combination of lidocaine and prilocaine topical anaesthetics for the treatment of PE. A creme with 5%lidocaine-prilocaine is effective in increasing mean IELT 6 to 8 minutes.  Cutaneous spray solution of lidocaine (150 mg/mL) and prilocaine (50 mg/mL) are there to treat PE. Spray solution rapidly absorbs in non-keratinized epithelium and has effect 5 minutes right after application. It is odourless, doesn´t require the use of a condom. Side effects are hypoesthesia, loss of erection, genital erythema and local burn. SS-cream (Severance Secret cream) is made up of extracts from 9 natural herbs for treating premature ejaculation (PE).

Selective serotonin reuptake inhibitors:- SSRIs are there to treat PE.Sertraline 50–200 mg, fluoxetine 20–40 mg and citalopram 20–40 mg and Duloxetine and Escitalopram Adverse effects include fatigue, yawning, mild nausea, loose stools, or perspiration.

Tricyclic antidepressants:- The most used drug for this group is clomipramine in the dosages of 10 to 50mg.By inhibiting the reuptake of catecholamines, it increases the adrenergic effects.

Central acting opioid analgesic:- Tramadol can increase IELT.Mechanism of action may be due to modulation of the nervous central system, reuptake of serotonin and norepinephrine.

Herbal Therapy

Herbal treatment for PE is the best treatment in my opinion because of no side effects and long lasting. Many herbs are there to treat PE. Some of them are:

Akarkara

Irani Akarkara

Salam Mishri

Shilajit

Brahmi

Amla

Gokshura

Keeda jadi (Cordyceps sinensis)

Ashwagandha