Sex therapy and counselling help with the thoughts, feelings and relationship patterns that surround premature ejaculation (PE). This page explains when therapy can be a sensible first step, what sessions involve and how to find a registered professional. It is general information and not a medical assessment.
01
When therapy is the right first step
- Worry, shame or pressure is a large part of what you experience. See performance anxiety and PE.
- You feel that you last long enough, or the timing is within the normal range, but you are still preoccupied or distressed. This is described as subjective PE in the guidelines, and the International Society for Sexual Medicine (ISSM) advises psychological referral. See the types of PE.
- PE is straining your relationship or making it hard to talk to your partner.
- You would like support alongside other approaches.
If PE began suddenly, or you have pain or erection problems, see a doctor first or at the same time. See when to see a doctor.
02
What sessions involve
Sessions are conversations. A therapist will usually ask about your history, what you experience and how it affects you and your relationship. They may offer education, ways to reduce anxiety and pressure, communication exercises and, sometimes, practical exercises to try at home, such as the behavioural techniques. The ISSM guideline notes that the evidence for behavioural therapy is modest, so progress is judged together over time. The number of sessions varies and we cannot say how many you will need.
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Individual versus couples therapy
- Individual: useful when you want a private space to work on worry, confidence or past experiences, or when you do not have a partner at present.
- Couples: useful when the relationship is affected, or when you want to learn and practise together. It can reduce blame and help you both feel heard.
- Some men begin alone and bring their partner later, or the other way round. It is your choice.
Partners may also like our guide for partners.
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How to find a registered professional in South Africa
- In South Africa, psychologists and registered counsellors are registered with the Health Professions Council of South Africa (HPCSA). You can ask for the registration number and check it with the council.
- Ask whether they have experience with sexual difficulties, since not every therapist does.
- Ask about their approach, fees, session length and confidentiality before you begin.
- Be cautious about anyone who promises quick or guaranteed results.
Therapists use various titles, and not all titles are protected, so checking registration is worthwhile.
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How this fits with a naturopathic consultation
A naturopathic consultation can offer education, lifestyle guidance and non-medical support. It does not replace therapy, and our practitioner is not a psychologist or a counsellor. He can suggest when a therapist may help and can work alongside one if that suits you. See what to expect at a first consultation.
[DRAFT: George to confirm whether the clinic has referral partners for therapy, and what to say about them. Do not imply therapy is delivered in-house unless it is.]
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Questions to ask a therapist
- Are you registered, and with which council and category?
- Have you worked with premature ejaculation or other sexual difficulties?
- What would sessions involve, and how will we know whether it is helping?
- How many sessions might I need, and what do they cost?
- Can my partner join, and how do you handle this?
- How is my information kept private?
You can also read the overview of treatment options.