The risks and benefits of all of the below treatment options should be discussed between the caregiver and the patient, as patient and partner satisfaction is the primary goal in the treatment of PE. It should be noted that there are no FDA approved prescription medicine in the US for treating PE. The FDA compliant available treatment indicated for delaying PE are over-the-counter (OTC) products and are called desensitizing agents such as EjectDelay® containing benzocaine 7.5%.
1. Desensitization treatments: these are aimed at reducing the sensitivity of the penis immediately before sexual relations.
A. Using condoms: the use of a single condom may reduce sensitivity enough to make a difference in ejaculatory control for some men. Using multiple condoms, however, reduces sensitivity, potentially to the point where the sensation during relations is less than satisfactory for men.
B. Using desensitization ointments: local anesthetics like lidocaine/prilocaine and benzocaine gels such as EjectDelay® can be applied to the undersurface of the head of the penis (the glans). Benzocaine and lidocaine/prilocaine have different water solubility and response time. Benzocaine is less water soluble and hence stays a longer time on the skin of the penis, resulting is potentially better response and ejaculatory control. It is also applied as early as 15 min before intercourse, whereas lidocaine/prilocaine are generally applied 30 minutes before sex. Desensitization ointments are best applied and then washed off 5-10 minutes before sexual relations, otherwise they will cause a numbing effect for the partner also. Some men use these gels underneath a condom.
C. Masturbating prior to intercourse: many men with PE, even those with primary (life-long) PE, have much better ejaculatory control if they have sexual relations a second time within a short period of time after the initial encounter. Some men use masturbation in the hours before anticipated intimacy as a means to improve ejaculatory control.
Do not use EjectDelay® if you are allergic to benzocaine. Discuss your general health status with your doctor to ensure that you are healthy enough to engage in sexual activity. If you experience discomfort during sex, seek immediate medical help. EjectDelay® should not be used with other PE treatments. EjectDelay® should not be used with any topical product containing lidocaine. EjectDelay® does not protect against sexually transmitted diseases, including HIV. Read the potential side effects before using EjectDelay®.