Alternative Medicine for Premature Ejaculation Is Not the Best Option

During a 48-year career as a health/medical/sexuality journalist, I’ve written a great deal about the many benefits of acupuncture, herbal medicine, and other complementary healing arts. Recently, English investigators reviewed the research on alternative treatments for treatment of premature ejaculation (PE). Alas, most helped men last only a minute or two longer, and did not teach them reliable ejaculatory control.

Meanwhile, the behavioral retraining program developed by sex therapists teaches around 90 percent of men to last as long as they’d like. It’s low cost and causes no side effects. It also enhances sex for women—not because men last longer, but because the program encourages men to embrace the sexual style most women prefer.

Men’s #1 Sex Problem

Men’s best-known sex problem is erectile dysfunction. But few men develop it until well into their forties. Meanwhile, according to a landmark University of Chicago study, throughout the lifespan, PE ranks as men’s leading sex problem. The myth is that PE affects only young men. Actually, in every age group, the Chicago researchers found that one-quarter to one-third of men admit having it. Other studies worldwide largely agree, estimating PE prevalence at 20 to 30 percent of men.

The Study

The British researchers combed medical databases and found 10 studies of alternative therapies for PE:

• Two assessed acupuncture.
• Five considered Chinese herbal medicines.
• One tested Indian (Ayurvedic) herbal medicines.
• And two studied the oddly named topical ointment, Severance Secret (SS), which contains Chinese herbs and toad venom, which is toxic if ingested, but reasonably safe, though possibly caustic, when applied to the skin.

Compared with placebo treatment, men using Ayurvedic herbs, Chinese herbs, or acupuncture lasted less than one minute longer. With Chinese herbs plus SSRI antidepressants, men lasted an extra two minutes, not all that different from SSRIs alone. The topical herbal/venom cream gave men an extra eight minutes, though some reported painful penis irritation.

The alternative therapies are not cheap. I found SS cream on the Internet—$89 plus shipping. (Its label warns: Contains Caustic Ingredients.) And men must use these treatments long-term, which means recurring expense and possible side effects. The alternative therapies also require the additional time and expense of periodic visits to practitioners.

Topical Anesthetics: Problematic

In the U.S., the three main approaches to treating PE include topical anesthetic creams, low-dose SSRIs, and the sex therapy program.

Topical anesthetics, also known as “delay” creams, are similar to anesthetic sunburn products. They were developed in the belief that PE sufferers have extra-sensitive penises. The anesthetic reduces this super-sensitivity, allowing men to last longer. However, Korean researchers assessed the penile sensitivity of men with and without PE and found no differences. So delay creams are based on a faulty premise.

PE anesthetics are available over the counter, but the products I found on the Internet are not cheap—$17 to $50. They numb the penis, which interferes with men’s erotic pleasure. They must be applied within around 15 minutes of intercourse, which may interrupt lovemaking. And their taste may deter fellatio.

Low-Dose SSRIs: Problematic

When men mention PE to doctors, most are quick to prescribe low-dose SSRIs antidepressant medications (Prozac, Zoloft, Paxil, etc.). PE sufferers show no higher rate of depression than the general population. But SSRIs have a side effect, delayed—and sometimes completely inhibited—ejaculation. So doctors prescribe SSRIs not for their therapeutic effect, but to elicit this side effect.

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Most studies show that SSRIs do, indeed, delay ejaculation a minute or two. But many men dream of sex that lasts “all night long.” An extra few minutes is a far cry from that. And like the alternative therapies, using SSRIs requires regular doctor visits, the expense of the drug, and possible side effects.

Some sex therapists work with doctors who prescribe SSRIs to the small proportion of men who don’t gain sufficient benefit from the sex therapy program alone. But in my opinion, SSRIs should be a last resort.

The Most Cost-Effective Treatment

The most cost-effective option is the sex therapy program developed in the 1960s by pioneering sex researchers William Masters, M.D., and Virginia Johnson, and refined since then by other sex researchers and therapists.

It’s based on the fact that men have excitable nervous systems, due in large part to high blood levels of the male sex hormone, testosterone. As a result, men are physiologically primed to climax more quickly than women, who have lower levels of the female version of testosterone. Anxiety makes the male nervous system even more excitable and ready to ejaculate—including men’s worries about ejaculating too quickly.

In addition, many men get much of their sex education from pornography, which is fixated on the penis—fellatio and intercourse. But if most erotic touch focuses only on the penis, ejaculation often happens quickly.

The key to curing PE is for men to jettison porn-style lovemaking and transition to a sexual style that’s deeply relaxing, one that involves deep breathing and at least 20 minutes of slow, sensual, whole-body massage before genital play:

• Before sex, take a hot bath or shower. Both relax the nervous system.
• Breathe deeply throughout sex. Also relaxing.
• Before any penis fondling or attempted intercourse, engage in at least 20 minutes of leisurely, playful, mutual whole-body massage from head to toe. Whole-body massage spreads erotic excitement around the body, which takes pressure off the penis. And many studies show that it’s the sexual style most women prefer. (If you make love to music, 20 minutes is five or six typical songs.)
• Learn to recognize the run-up to your point of no return, the moment when ejaculation feels inevitable. When you feel yourself approaching it, stop all movement, breathe deeply, and double down on whole-body massage. The urge to ejaculate usually subsides. If it does, feel free to resume genital play. If not and you ejaculate before you’d like, don’t despair. Think about what went wrong and recommit to the steps above.
• Limit alcohol before sex, so you can focus on the program.

There are two approaches to the sex therapy program—self-help and professional therapy. Either way, once men learn reliable ejaculatory control, they pay no more—no ongoing expenditures for practitioner visits, drugs, or other products. The program works for men who are single or coupled. It causes no side effects. And it enhances women’s sexual pleasure, because most women say they prefer sex based on leisurely, playful, mutual whole-body massage.

If the self-help approach doesn’t provide sufficient relief, a short course of professional sex therapy almost always does, though a small proportion of men need SSRIs as well. To find a sex therapist near you, visit the Psychology Today Therapy Directory.

Alternative therapies help treat a broad array of medical complaints, and often work when mainstream medical treatments provide little or no benefit. But the recent review shows that they don’t help men last significantly longer, nor do they help men learn ejaculatory control. If you have premature ejaculation, your best bet is the sex-therapy approach. For more about learning ejaculatory control, see the PE chapter in my recent book, Sizzling Sex for Life.