Premature Ejaculation

This is ejaculation occurring sooner than desired and persistent or recurrent ejaculation before, on or shortly after penetration.

Prevalence is 24% in 16–60-yr-old men.

Treatment

Semans ‘stop–start’ technique, Masters and Johnson squeeze technique. Pharmacological:

• SSRIs: dapoxetine 30 mg or setraline 50 mg or paroxetine 20 mg, once daily or about 3 hrs before IC; trial for 3–6 mths

Topical:

• lignocaine 2.5% + prilocaine 2.5% cream applied thinly to glans and distal shaft 10–20 min before IC; often counterproductive as reduces sexual pleasure