PE treatment options compared

There's no shortage of information on premature ejaculation treatment. Most of it just lists the options, though.

Priligy. Topical sprays. The stop-start technique. The squeeze method.

They can all help, just not in the same way. Pick one at random, and you might start with the option that suits you least.

This guide breaks down what each premature ejaculation treatment actually involves. And it helps you work out which is worth trying first, based on how long you've had it, whether a partner's involved, and how fast you want results.

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Is there a single best premature ejaculation treatment?

Premature ejaculation (PE) is generally defined as ejaculating sooner than you or your partner would like during sex. Occasional episodes are common. They're not something to worry about.

Despite how common it is, most men never mention it to a doctor or pharmacist. It's awkward to bring up, and it's not always obvious what can help.

PE is usually split into two types. And the type you have changes which premature ejaculation treatment is likely to work fastest.

Lifelong PE has been there since your first sexual experiences. Acquired PE develops later. It often shows up alongside a new relationship, a stressful period, or heavier drinking.

Clinical guidance generally favours medication first for lifelong PE. Behavioural techniques alone tend to be slower and less reliable without a prescription option too.²

For acquired PE, anxiety or a specific trigger is often behind it. Behavioural approaches tend to do more of the work here. That difference is the basis for the advice further down.

There's no single best premature ejaculation treatment. It depends on whether your PE is lifelong or recent, and how quickly you want results.

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What causes premature ejaculation?

In many cases, there's no single identifiable cause. Physical factors can play a role too, like prostate and thyroid problems, or recreational drug use. So can psychological factors, like performance anxiety, stress, depression, or relationship pressure.¹

For the full breakdown, our guide on what causes premature ejaculation covers it in more depth.

What matters here is simpler. Whatever's driving it, there are effective options. Most men see a meaningful improvement with the right one.

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What are the main premature ejaculation treatments, and how do they compare?

Priligy (dapoxetine)

Priligy is currently the only medicine licensed in the UK specifically for premature ejaculation.² It contains dapoxetine, a short-acting SSRI (selective serotonin reuptake inhibitor) you take on demand, 1 to 3 hours before sex rather than daily.⁴

It's licensed for men aged 18 to 64 who ejaculate within around two minutes of penetration and find this distressing.²

The most commonly reported side effects are dizziness, headache, and nausea. It can occasionally cause a drop in blood pressure that leads to fainting. Because of this, Priligy must not be taken with alcohol or with erectile dysfunction medication, since both increase that risk.⁴

Give it at least four weeks, or six doses, before deciding whether it's working for you. Your response should be reviewed again every six months if you continue.¹ For a full explanation of how it works, see our guide on how Priligy works for PE.

Priligy must not be combined with alcohol or erectile dysfunction medication, and needs at least 4 weeks or 6 doses before you can judge if it's working.

Stop-start and squeeze technique

These are the two most established behavioural techniques for premature ejaculation.

With the squeeze technique, you (or a partner) squeeze the head of the penis firmly for 10 to 20 seconds as you approach climax. Then wait around 30 seconds before resuming.¹ The stop-start technique works the same way, just without the squeeze - pause stimulation until the urge passes.

Short-term success rates sit around 50 to 60%. Results tend to fade if you stop practising, though, and they generally work best alongside medication rather than alone.³

Masturbating an hour or two before sex is also worth trying.¹ Our guide on lasting longer in bed walks through both techniques, plus pelvic floor exercises, step by step.

Squeeze technique: squeeze for 10 to 20 seconds as you approach climax, then wait around 30 seconds before resuming. Short-term success sits around 50 to 60%.

STUD 100 and specialist condoms

STUD 100 is a topical spray. It contains lidocaine, a local anaesthetic that temporarily reduces penile sensitivity. Apply it a few minutes before sex. You don't need a prescription to try this one out.

A systematic review of topical anaesthetics, the drug class STUD 100 belongs to, found them an effective option for delaying ejaculation.⁵

Use a condom alongside it, though, to avoid transferring the numbing effect to your partner. Thicker condoms alone can help too, just by reducing sensation, without needing a separate product.

Off-label SSRIs and PDE5 inhibitors, for GP-led cases

Some doctors prescribe daily SSRIs, like paroxetine, sertraline, or fluoxetine, to help with PE. This isn't their licensed use, though.¹

PDE5 inhibitors such as sildenafil, usually prescribed for erectile dysfunction, have shown some benefit for PE too.¹

These routes sit outside what's available through an online consultation. They need a full assessment from a GP, since daily antidepressants and combination treatment carry a different risk and monitoring profile to an on-demand treatment like Priligy. They're generally reserved for cases where other options haven't helped.

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How do you choose the right premature ejaculation treatment for you?

PE you've had for as long as you can remember: starting with Priligy is likely the best bet. Guidelines favour medication first for lifelong PE, and it gives a faster, more predictable result than techniques alone.²

PE that's started more recently, tied to a new partner, stress, or drinking: try the stop-start or squeeze technique first, alongside cutting back on alcohol if that's a factor. Acquired PE often responds well to addressing the trigger directly.

You want something to use tonight, with no prescription: STUD 100 or a thicker condom gives an immediate result while you decide on a longer-term approach.

Erectile dysfunction is also a factor: speak to a GP or prescriber before starting anything. PDE5 inhibitors can sometimes help with both conditions together, but combining them with Priligy is not safe, so this needs a proper assessment first.

You'd rather avoid medication altogether: the stop-start and squeeze techniques, combined with pelvic floor exercises, can produce a lasting improvement, though they take weeks of consistent practice and work better with a supportive partner.

Lifelong PE usually responds best to medication first. PE that's started recently often responds well to technique and addressing the trigger.

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Why does combining treatments often work best?

Most men do better combining an on-demand treatment with an ongoing behavioural practice. Don't just pick one and stick with it forever.

Behavioural techniques work better alongside medication than alone. And Priligy doesn't teach your body anything long-term, it just buys you more control on the night.³

Try STUD 100 or the squeeze technique for immediate confidence. Work on stop-start practice over several weeks too. It's a reasonable starting point for most men, whichever type of PE you have.

Most men do better combining an on-demand treatment with an ongoing behavioural practice, rather than picking one for good.

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When should you see a GP about premature ejaculation?

There's no need to put up with premature ejaculation, and there's no shame in raising it. Speak to a GP or pharmacist if:

• It's causing you distress or affecting your relationship
• It's started suddenly and you also have other symptoms, such as erectile difficulties or fatigue
• Self-help options and STUD 100 haven't made a difference after a few weeks
• You're not sure which premature ejaculation treatment is suitable for you given other medications or health conditions

See a GP if PE is causing distress, started suddenly alongside other symptoms, or hasn't improved with self-help after a few weeks.

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References

1. NHS. Can premature ejaculation be controlled? nhs.uk
2. National Institute for Health and Care Excellence. Premature ejaculation: dapoxetine. Evidence summary ESNM40. NICE; 2014. nice.org.uk
3. GPnotebook. Premature ejaculation (PE). gpnotebook.com
4. Electronic Medicines Compendium. Priligy 30 mg and 60 mg film-coated tablets SmPC. eMC; 2021. medicines.org.uk/emc
5. Ali A, et al. Topical Anesthetics and Premature Ejaculation: A Systematic Review and Meta-Analysis. Cureus. 2023. doi:10.7759/cureus.42913

This article is intended for informational purposes only and does not replace professional medical advice. Always read the patient information leaflet supplied with your medication and speak to a healthcare professional if you have specific concerns.