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Premature ejaculation

Ejaculatio praecox · Předčasná ejakulace

male only

What it is

Ejaculation that comes within about a minute of penetration and cannot be delayed, causing distress — the commonest male sexual complaint.

Symptoms & signs

  • Ejaculation within about a minute
  • unable to delay it
  • distress or avoidance of sex
  • lifelong or acquired

🚩 Get help if…

  • see a doctor soon Pain on ejaculation or blood in the semen
  • see a doctor soon Burning, discharge or pelvic pain
  • see a doctor soon Problem that started with a new medicine
  • see a doctor soon Also trouble getting erections

Where it strikes

Medical treatment

  • Behavioural techniques (stop–start, squeeze)
  • dapoxetine or daily SSRIs
  • topical anaesthetic spray (lidocaine–prilocaine)
  • treat erectile dysfunction or prostatitis if present
  • couple therapy

Natural & lifestyle

  • Pelvic-floor exercises
  • condoms to reduce sensation
  • less performance pressure

Emerging & experimental

  • Selective dorsal neurectomy (controversial)
  • hyaluronic acid injection of the glans

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Pelvic-floor training — small trials lengthen the time early / small studies
  • Acupuncture — a small trial helped early / small studies
  • Herbal 'delay' sprays and pills — some contain hidden anaesthetics or drugs anecdotal / traditional
  • Tramadol off-label — trials help, but it is addictive mixed evidence

ICD codes