There are several ways to approach premature ejaculation (PE), and they work in different ways. This page compares them in plain language so that you can see where each fits. It is general information and not a medical assessment. Medicines are decided with a doctor.
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How treatment is chosen
The right approach depends on the type of PE, any underlying cause, your preferences and your partner, if you have one. The European Association of Urology (EAU) guidelines advise treating an underlying cause first in acquired PE, and describe medicine as first-line treatment for lifelong PE. The International Society for Sexual Medicine (ISSM) notes that behavioural therapy has modest evidence. Many men use more than one approach. See the types of PE.
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Behavioural techniques
Methods such as the start-stop and squeeze techniques aim to help you notice and control arousal. They cost nothing to try, but the evidence is modest and benefits can fade without continued practice. Read more about behavioural techniques.
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Pelvic floor work
Exercises for the muscles of the pelvic floor are sometimes suggested to help with control. Research is still growing, mostly from small studies. Read more about pelvic floor exercises.
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Medicines (prescribed by a doctor)
Some medicines, including some taken by mouth and some creams or sprays applied to the skin, are used for PE, and the guidelines include them. They are a matter for a doctor, who can consider suitability, side effects and other conditions or medicines. This clinic does not prescribe medicines. Read how medicines are used.
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Psychological and sex therapy
Counselling and sex therapy can address worry, relationship factors and communication, and may be combined with other approaches. Read more about sex therapy and counselling.
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Natural and naturopathic approaches
Many men ask about herbs, supplements and lifestyle changes. Research on most of these in PE is still developing, and “natural” does not mean risk free. Read what the evidence says about natural approaches.
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Delay sprays and condoms
Numbing sprays and creams, and condoms designed to reduce sensation, work by reducing sensitivity. Read more about delay sprays and condoms.
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Comparison table
| Approach | How it works | Evidence (general guide) | Who decides |
|---|---|---|---|
| Behavioural techniques | Learning to notice and control arousal | Modest | You, with guidance |
| Pelvic floor work | Training the pelvic floor muscles | Limited | You, with guidance |
| Medicines | Act on the body to delay ejaculation | Stronger, according to the guidelines | A doctor |
| Psychological and sex therapy | Addresses worry, habits and communication | Modest | You and a therapist |
| Natural approaches | Herbs, supplements and lifestyle | Limited | You, with advice from a doctor or pharmacist |
| Delay sprays and condoms | Reduce sensitivity | Some support in the guidelines | You, and a pharmacist or doctor for products |
The evidence column is a broad guide drawn from the ISSM and EAU guidelines. It is not a ranking for any one man, and it can change as research develops.
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What this clinic offers and what it refers on
Our practitioner is a naturopath. He offers education, lifestyle guidance and non-medical support, and he refers you to a doctor when a medical check or a medicine is needed. He does not prescribe medicines or diagnose medical causes. Learn more on the practitioner profile.
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Next steps
- If you are unsure whether you have PE, try the private self-check.
- Read when to see a doctor and what can and cannot be promised.
- To talk to us, see what to expect at a first consultation.