Prevention and Medical Treatment of Premature Ejaculation
Often, when premature ejaculation is transient or unimportant, treatment is primarily based on psychosexual counseling. Thus, several measures or techniques may help to delay the ejaculation, in particular:
●Bring the partner to stimulate the penis until ejaculation is imminent, then pause to bring back the excitement before proceeding
●Exercise manual pressure at the base of the glans during the squeeze, when the signs of ejaculation are felt. It is advisable to press the glans between thumb and forefinger (the thumb placed on the brake) for 2 or 3 seconds to stop the ejaculation reflex.
These "exercises" must be repeated several times in order to manage to hold about twenty minutes without ejaculating. Little by little, they will allow better control of ejaculation.
Pharmacological Treatment of Premature Ejaculation
Dapoxetine is a class of selective serotonin reuptake inhibitors (SSRIs). It is marketed under the name Priligy® for the treatment of premature ejaculation in men aged from 18 to 64, since the end of March 2013 in France as in other 25 countries.
In North America, dapoxetine has not yet been approved.
Dapoxetine is not considered an antidepressant because it is eliminated very quickly by the body: there is no trace of the drug in the blood twenty hours after the intake.
Thus, it acts quickly (one or two hours after taking). According to clinical studies, it is possible to multiply the time between penetration and ejaculation by about threefold after a twelve-week treatment period. Note, however, that taking a placebo tablet also allowed, according to these tests, to increase this time by a factor of 1.5 to 26-8.
In France, dapoxetine exists in two doses (30 and 60 mg), in the form of a tablet to be taken at the request, 1 to 3 hours before the sexual activity.
The treatment is issued on medical prescription and is not taken care of by the Health Insurance. The most common side effects are nausea, headache, diarrhea and dizziness.
Local Treatment for Premature Ejaculation
Very used, apart from the official authorizations of prescription, the application of a local anesthetic on the glans allows to delay the ejaculation by "insensitising" the penis.
The products used are usually based on lidocaine, gel or spray. To avoid insensitisation of the partner, the anesthetic can be applied about twenty minutes and then washed with water before the report. In 2010, a spray combining lidocaine and prilocaine, to apply 5 minutes before the sexual intercourse, showed a good efficiency to delay the ejaculation. It could be marketed soon.