What is premature ejaculation (PE)?

Premature ejaculation is when a man ejaculates earlier than desired during sexual activity. The length of time taken to ejaculate can be a personal preference for each couple and there’s no definition of how long sex should last. 

If you find that you’re ejaculating more quickly than you and your partner would like, we can help with prescription premature ejaculation treatments like Priligy which boosts serotonin, or EMLA cream which numbs the feeling in the penis temporarily.

Premature ejaculation can also be treated through psychological counselling.

What causes premature ejaculation? 

There are many possible causes of premature ejaculation (PE), both physical and psychological. 

The causes of premature ejaculation are not fully understood by doctors. However, serotonin levels in your body affect appetite, sleep and sex drive. If there is a lack of serotonin in the brain then a man may experience premature ejaculation.  

Premature ejaculation can be caused by factors like: 

• stress
• emotional distress
• guilt
• excessive excitement 
• relationship issues
• performance anxiety
• binge drinking 

Medical factors which can cause premature ejaculation include: 

• anxiety
• depression
• thyroid problems
• diabetes
• high blood pressure 
• prostate disease 
• oversensitivity of the penis 
• nerves damaged by multiple sclerosis 

Premature ejaculation is more common in men under the age of 35 compared to older men and is commonly found in men who are going through a new relationship, a new experience or stressful situations in their relationship.

About Priligy

Priligy contains the active ingredient dapoxetine, which temporarily boosts the serotonin levels in your body. It will not cure premature ejaculation, but it will help men who can’t control their ejaculation naturally. 

One Priligy tablet should be taken 1-3 hours before sexual activity and its effects will wear off 1-2 hours afterwards. 

The starting dose for Priligy is 30mg, however, this can be increased to 60mg if needed. The higher dose may increase your risk of side effects. Priligy is not intended for continuous daily use.

Patient information leaflet:

https://www.medicines.org.uk/emc/files/pil.1269.pdf

About EMLA cream

EMLA cream lowers the sensitivity on the skin of the penis, helping to delay ejaculation. The two main ingredients in EMLA cream are lidocaine and prilocaine which are local anaesthetics. 

A small amount of EMLA cream should be applied directly to the penis head 15-20 minutes prior to sex. After your penis becomes numb, clean off any surplus cream before having sex to avoid causing a numbing effect on your partner. 

EMLA cream is not licensed to treat premature ejaculation, however, it has been regularly prescribed for this purpose and is a licensed anaesthetic for procedures involving the genitals. Please read our information on Unlicensed treatments before choosing this treatment.

Patient information leaflet:

https://www.medicines.org.uk/emc/files/pil.7994.pdf

Due to this being an unlicensed treatment, the directions in the patient information leaflet for EMLA cream are not entirely relevant, however, warnings and side effects may still be applicable.

Alternative treatments

There are other ways to treat premature ejaculation such as:

• Thicker condoms with a numbing gel on the inner side
• The Masters and Johnson's “Start-stop” technique
• Creams from sex shops that can lower the sensitivity of the penis
• Visiting a psychological counsellor who can help if your premature ejaculation is caused by distress, anxiety or relationship problems. 

Side Effects

Priligy:

Very common side effects (affects more than 10% of the population):

• Headaches
• Nausea
• Dizziness

If any of these symptoms occur then users are advised to keep hydrated and sit/lie down until they go away. Some Priligy users have also reported other side effects such as mood swings, anxiety and abnormal dreams. 

For a full list of side effects, please read the patient information leaflet.

https://www.medicines.org.uk/emc/files/pil.1269.pdf

EMLA cream:

There should not be any major side effects from EMLA cream, however, the numbing sensation from the cream can lower your sexual pleasure. If the cream is left on the skin too long, then a burning/itchy sensation and a red rash may develop.

https://www.medicines.org.uk/emc/files/pil.7994.pdf

 Unlicensed Treatments

Usually, medicines prescribed by your doctor or bought over the counter are licensed for use by the Medicines and Healthcare products Regulatory Agency. The licence specifies the conditions and patients for which the medicine should be used, and how it should be given. Patient information leaflets supplied with medicines reflect the licensed uses. 

The EMLA cream treatment we offer for Premature Ejaculation is used off-label. This means that although EMLA cream is a licensed medication, the manufacturer of the drug didn’t intend for it to be used for this particular treatment and they accept no responsibility for any adverse events. Instead, our online doctors take on this responsibility. We will only prescribe medicines beyond their licence when there is research and experience to back up their use.

As a result, the instructions in the patient information leaflet (PIL) provided by the manufacturer will not be entirely relevant to your circumstances, however any warnings of potential side effects and drug interactions are still applicable.