How to stop premature ejaculation: every treatment compared

Premature ejaculation treatment ranges from techniques you practise alone or with a partner to medicines from a GP or pharmacist. The 2026 European Association of Urology (EAU) guidelines, the BNF, the NHS and BAUS (the British Association of Urological Surgeons) cover the options, and don't always agree.

If you want to know how to stop premature ejaculation, the starting point is the type, because the guidelines treat lifelong and acquired premature ejaculation differently. Our guide to premature ejaculation explains the types and causes.

What is the best treatment for premature ejaculation?

The best treatment for premature ejaculation depends on its type. For lifelong premature ejaculation, present since your first sexual experience, the EAU recommends medicine first, either dapoxetine or a lidocaine and prilocaine spray. For acquired premature ejaculation, which starts later, the first step is treating the cause, such as erection problems, prostatitis, anxiety or an overactive thyroid.

For early ejaculation that comes and goes, the ISSM says men should be educated and reassured, and the EAU sees it as a normal variation. The BNF recommends non-drug treatment, such as counselling, education and behavioural techniques, when premature ejaculation causes few problems or you'd rather not take medicine, and says these techniques can be used alongside medicine too.

Premature ejaculation treatments compared

	What it involves.	What the evidence says.	How to get it in the UK.	Things to know.
Stop-start and squeeze	Stopping, or squeezing the head of the penis, before the point of ejaculation; practised alone first	Limited: two trials found 7 to 9 minutes more than a waiting list (2015 review); the EAU calls the evidence weak and inconsistent	Can be tried on your own; a psychosexual therapist can teach them	The NHS says they take lots of practice
Pelvic floor exercises	Regular squeeze-and-lift exercises for the muscles used in ejaculation	BAUS calls them effective; a 2026 review of five trials found less effect than dapoxetine or combined treatment	Can be tried on your own; a physiotherapist can teach them	A 2018 study used a 12-week programme of physiotherapy, electrical stimulation and biofeedback
Counselling or sex therapy	Talking therapy, alone or as a couple, which teaches techniques and looks at relationship issues	Lacks empirical support on its own; better results with medicine than medicine alone (EAU)	Ask your GP; NHS sex therapy varies by area; or privately	Sex therapists should belong to COSRT or the Institute of Psychosexual Medicine (NHS)
Thick condoms	Wearing a thicker condom during sex	Effective, particularly with a local anaesthetic (NHS); one 2022 study of 100 men found longer times but less comfort	Free from sexual health clinics and some GP surgeries and pharmacies, or bought	BAUS says condoms containing the local anaesthetic benzocaine have proved useful in some men
Lidocaine and prilocaine spray	A local anaesthetic medicine licensed for lifelong premature ejaculation	First-line for lifelong premature ejaculation (EAU, strong recommendation)	Pharmacy medicine: from a pharmacist without a prescription	Can pass to a partner; avoid if planning to conceive; can damage polyurethane condoms (BNF)
Dapoxetine (Priligy)	A short-acting SSRI tablet licensed to be taken when needed	First-line for lifelong premature ejaculation (EAU, strong recommendation)	Prescription only; local NHS areas decide whether to prescribe it on the NHS	Blood pressure on standing is checked first; side effects include headaches, dizziness and feeling sick
Daily antidepressants	SSRIs such as paroxetine, sertraline or fluoxetine, or clomipramine, used off-label	Second-line (EAU); full effect usually after 1 to 2 weeks (NHS)	Prescription only	Don't stop them suddenly; avoid if trying for a baby (EAU)
Sildenafil and similar medicines	PDE5 inhibitors, mainly used for erection problems	Recommended alone or combined for men without erection problems (EAU), though sildenafil did not significantly improve time to ejaculation; exact role uncertain (BAUS)	Prescription, or sildenafil from a pharmacy after a discussion with the pharmacist	Not usually prescribed with nitrates (NHS)
Tramadol	A painkiller, used off-label	Third-line, with caution (EAU); BAUS does not recommend it	Prescription only (a controlled drug)	Risk of addiction; should not be combined with an SSRI (ISSM)

Only dapoxetine and the lidocaine and prilocaine spray are approved for premature ejaculation; other medicines are used off-label (EAU, BNF). This is general information from the sources listed below: check any medicine with a GP or pharmacist.

How to stop premature ejaculation without medicine

You can try to stop premature ejaculation without medicine using the stop-start and squeeze techniques, pelvic floor exercises, a thicker condom and counselling. The evidence for these is weaker than for the licensed medicines, and the BNF recommends non-drug treatment when premature ejaculation causes few problems or you'd rather not take medicine.

Stop-start and squeeze techniques

In the squeeze technique, the NHS explains, you masturbate, stop before the point of ejaculation and squeeze the head of your penis for 10 to 20 seconds, then wait 30 seconds before starting again. The stop-go (stop-start) technique is the same without the squeeze. Once you feel more confident, you can try it during sex.

A 2015 systematic review of 10 randomised trials (521 men) found limited evidence: two trials of squeeze, stop-start and sensate focus found 7 to 9 minutes more time to ejaculation than a waiting list, two other trials found no difference, and no side effects were reported, though safety data were limited. The techniques are explained step by step, along with edging, in stop-start, squeeze and edging.

Pelvic floor exercises

BAUS lists pelvic floor (Kegel) exercises among the behavioural strategies it calls effective, as a way to strengthen the muscles used in ejaculation. A 2026 review of five randomised trials (236 men) found exercise programmes alone had a smaller effect on the time to ejaculation than dapoxetine or combined treatments. A routine is in pelvic floor exercises for men.

Condoms

The NHS suggests using a thick condom, and says condoms are effective, particularly when combined with a local anaesthetic. In a 2022 study of 100 men with premature ejaculation in China, thicker condoms lengthened the time to ejaculation, though the men found them less comfortable. BAUS says condoms containing the local anaesthetic benzocaine have proved useful in some men. The NHS says you can get condoms free from sexual health clinics and some GP surgeries and pharmacies.

Masturbating first, and positions

The NHS also says it can sometimes help to masturbate an hour or two before sex, and to have your partner on top so they can pull away when you're close to ejaculating. BAUS says masturbating first may benefit younger men in particular.

Counselling and sex therapy

In psychosexual counselling, the NHS says, a therapist helps you, and a partner if you have one, explore relationship issues and learn techniques such as squeeze and stop-go. The EAU guidelines say psychosexual treatment alone lacks empirical support, but that combining it with medicine gives better results than medicine alone. NHS sex therapy varies widely by area, the NHS says.

Are there pills for premature ejaculation?

Yes. Dapoxetine (Priligy) is the one tablet licensed for premature ejaculation in the UK, and doctors also prescribe daily antidepressants off-label. Sildenafil and tramadol are used in some cases. All these premature ejaculation pills have side effects, and all except sildenafil from a pharmacist need a prescription.

Dapoxetine (Priligy)

Dapoxetine is a short-acting SSRI (a type of antidepressant) licensed to be taken when needed, not every day. The EAU guidelines recommend it first-line for lifelong premature ejaculation; in trials, it increased the time to ejaculation 2.5 to 3 times overall, depending on the dose.

It's prescription-only. The BNF says it's for men with poor control over ejaculation, a history of premature ejaculation over the past 6 months, marked distress or relationship difficulty because of it, and a time to ejaculation of less than two minutes, and it isn't recommended for men aged 65 and over. Local NHS areas can choose whether to prescribe it on the NHS, and the NHS says your response is reviewed after 4 weeks (or 6 doses) and every 6 months after that.

The NHS says dapoxetine isn't suitable for some men with heart, kidney or liver problems and can interact with other medicines, such as other antidepressants; common side effects include headaches, dizziness and feeling sick. The BNF says your blood pressure should be tested for a drop on standing before you start, and that you should keep well hydrated and sit or lie down until warning signs such as feeling sick, dizzy or sweaty pass. More in dapoxetine (Priligy) explained.

Daily antidepressants (off-label)

SSRI antidepressants such as paroxetine, sertraline and fluoxetine, and another antidepressant called clomipramine, also delay ejaculation, and doctors use them for premature ejaculation off-label. The EAU guidelines recommend them as a second-line option. The NHS says some men notice an improvement a few days after starting, but you'll usually need to take them for 1 to 2 weeks before you notice the full effects.

A 2021 Cochrane review of 31 trials (8,254 men), seven of them testing dapoxetine, found that SSRIs probably improve men's own rating of their symptoms and their satisfaction with sex compared with a placebo, and probably cause more side effects. The NHS lists feeling sick, being sick, diarrhoea and excessive sweating, usually mild and improving after 2 to 3 weeks. The EAU says not to stop daily SSRIs suddenly, to avoid them when trying for a baby, and recommends caution for young people aged 18 or under and for men with depression, particularly with suicidal thoughts.

Sildenafil and similar medicines

Sildenafil (Viagra) and similar medicines, called PDE5 inhibitors, treat erection problems. The NHS says research has found they may also help with premature ejaculation, and the EAU guidelines recommend them, alone or with other treatments, for men with premature ejaculation who don't have erection problems. The EAU also says that in the sildenafil studies it reviews the time to ejaculation was not significantly improved, though confidence, the sense of control and satisfaction increased. BAUS says their exact role is uncertain, but that they can improve confidence and reduce anxiety by producing better erections when poor erections are a problem. See does Viagra make you last longer?

Tramadol

Tramadol is a prescription painkiller and a controlled drug. The EAU guidelines treat it as a third-line option, to be used with caution because its long-term safety, including addiction, is uncertain. BAUS says its role is unclear and does not recommend it for premature ejaculation, and the ISSM says it should not be combined with an SSRI because of the risk of serotonin syndrome, which can be fatal.

What about the licensed lidocaine and prilocaine spray?

A spray combining the local anaesthetics lidocaine and prilocaine is licensed for lifelong (primary) premature ejaculation; the BNF lists it under the brand name Fortacin as a pharmacy medicine, so you can get it from a pharmacist without a prescription. The 2026 EAU guidelines recommend it, alongside dapoxetine, as a first-line treatment for lifelong premature ejaculation.

In longer-term studies cited by the EAU, the time to ejaculation increased up to 6.3-fold over three months. The EAU reports a low incidence of side effects in men and their partners, including genital hypoaesthesia, meaning reduced feeling in the genitals (4.5% of men and 1.0% of female partners), erection problems (4.4%) and a burning feeling in the vulva or vagina (3.9%). The BNF lists sexual dysfunction among the common or very common side effects, and says side effects reported in female partners include vaginal thrush and pain when peeing.

BAUS advises washing the area or using a condom so the anaesthetic doesn't pass to your partner. The BNF notes that polyurethane condoms have been damaged by the spray, and gives the manufacturer's advice to avoid it if you're planning to conceive. More in lidocaine and benzocaine: what they are and their safety.

Can premature ejaculation be cured?

The research doesn't promise a permanent cure for premature ejaculation. The EAU guidelines say the long-term results of both medicines and psychosexual treatments are unknown, and BAUS says improvements with the behavioural techniques are seen in 50 to 60% of men, but are not always maintained in the long term.

A 2018 study of pelvic floor rehabilitation looked back at 154 men with lifelong premature ejaculation, and its authors believe it has the longest follow-up reported for any treatment of premature ejaculation. Of the 122 who completed the 12-week programme of physiotherapy, electrical stimulation and biofeedback, 111 gained control of ejaculation, and among the 95 followed up for three years, 64% still had satisfactory control at two years and 56% at three. It had no control group. Dapoxetine is often stopped, too. The EAU guidelines report that 90% of men have stopped dapoxetine two years after starting it; the reasons given included cost (29.9%), disappointment that it wasn't a cure along with having to take it each time (25%), side effects (11.6%) and feeling it didn't work well enough (9.8%).

So if you've read how someone cured their premature ejaculation naturally, treat it as one person's experience: the studies show improvement for many men, and the problem coming back for some.

Is it safe to buy premature ejaculation pills online?

The MHRA advises buying only from UK-registered pharmacies, including online pharmacies showing the official green cross logo. In a 2019 case, the MHRA named dapoxetine among the active ingredients of unlicensed medicines sold illegally online, and warned that unlicensed medicines may have dangerous side effects, including an increased risk of heart attacks.

The MHRA also advises avoiding buying medicines from social media, messaging apps or unknown websites. For an online pharmacy based in Great Britain, you can check its registration on the General Pharmaceutical Council (GPhC) website.

What other treatments are being studied?

The EAU guidelines say several other treatments need more evidence or more safety data first. Filler injections into the head of the penis (hyaluronic acid) may cause serious complications, and surgery to cut nerves in the penis is irreversible. Acupuncture, yoga and electrical nerve stimulation also need more evidence.

When should you see a GP?

See a GP if premature ejaculation keeps happening and it's a problem for you; the NHS says they'll discuss it with you and may examine you or refer you to a specialist. BAUS says most men can be managed by their GP without seeing a urologist.

A sexual health clinic is another option: the NHS says they're free and confidential, and you can find one with the NHS sexual health clinic finder.

If you take sildenafil, the NHS says to call 999 if you think you're having anaphylaxis (a serious allergic reaction), a heart attack or a seizure, and to call NHS 111 for other serious side effects, such as a painful erection lasting longer than 4 hours. For the wider picture, see how to last longer in bed: what the evidence says.