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How to Last Longer in Bed: Options for Premature Ejaculation
By Your Health Magazine Health Information Team
To last longer in bed, start with the stop-start technique, try a condom to reduce sensation, and address performance pressure with open communication. If early ejaculation happens regularly and causes distress, effective treatment options include counseling, topical numbing products and prescription medications. The best approach often combines behavioral practice with treatment for any contributing medical or emotional issue.
When Early Ejaculation Becomes a Health Concern
Occasionally ejaculating sooner than intended is common, especially during a new relationship, after a period without sex or when feeling particularly excited or anxious. There is also no single “normal” amount of time that intercourse should last.
Premature ejaculation is more likely when ejaculation repeatedly occurs before or soon after penetration, the person has difficulty delaying it, and the experience causes frustration, distress or relationship problems. It may be lifelong, beginning with a person’s earliest sexual experiences, or acquired after a period of satisfactory control. The MedlinePlus overview of premature ejaculation explains how clinicians evaluate and treat the condition.
Practical Techniques to Help You Last Longer
Use the stop-start method
- Begin sexual stimulation and pay attention to your arousal level.
- Stop stimulation just before reaching the point where ejaculation feels unavoidable.
- Wait until the urge decreases, then resume stimulation.
- Repeat the cycle several times before allowing ejaculation.
This can be practiced alone or with a partner. The goal is not to suppress arousal completely but to recognize the sensations that occur before ejaculation and regain control before crossing the “point of no return.”
Try the squeeze technique
When ejaculation feels close, stop stimulation and gently squeeze the area where the head of the penis meets the shaft for several seconds. Resume after the urge has decreased. Stop if squeezing causes pain or discomfort.
Use a condom
A standard or thicker condom may decrease penile sensitivity enough to delay ejaculation. Some condoms contain benzocaine or lidocaine, but these can cause excessive numbness or irritation. Read the product label, and do not use a numbing product if you or your partner has reacted to its ingredients.
Reduce performance pressure
Rushing, monitoring the clock and worrying about satisfying a partner can increase tension. Slower breathing, pauses and a broader focus on touch, oral sex or other forms of intimacy may make sex more enjoyable while reducing pressure on penetration time. A qualified sex therapist can help when anxiety, shame, past sexual experiences or relationship conflict contribute to the problem.
Pelvic Floor Training
Pelvic floor muscles participate in erection and ejaculation. Learning to contract and relax them may improve awareness and control for some people. To identify the muscles, briefly notice what you use to stop urine flow or prevent passing gas. Do not routinely exercise by repeatedly interrupting urination, because that can interfere with normal bladder emptying.
Practice gentle contractions while breathing normally, followed by complete relaxation. Avoid tightening the abdomen, buttocks and thighs. People who have pelvic pain, urinary symptoms or difficulty relaxing these muscles may benefit from a pelvic floor physical therapist rather than doing more forceful exercises. You can also learn about the ischiocavernosus muscle and its role in sexual health.
Medical Options to Treat Early Ejaculation
| Option | How it may help | Important considerations |
|---|---|---|
| Topical anesthetics | Lidocaine, prilocaine or benzocaine can temporarily reduce penile sensation. | May cause numbness, irritation or reduced pleasure in either partner. |
| Prescription antidepressants | Certain SSRIs and clomipramine may delay ejaculation. | Use for premature ejaculation is generally off-label in the United States and requires medical supervision. |
| ED medications | May help when erection difficulties contribute to rushing or loss of control. | They are not a universal treatment for premature ejaculation and may be unsafe with certain heart medications. |
| Counseling or sex therapy | Addresses anxiety, relationship stress and unhelpful sexual patterns. | May be used alone or with behavioral and medical treatment. |
Topical numbing products
Products containing lidocaine, prilocaine or benzocaine can delay ejaculation by lowering sensitivity. Choose a product specifically labeled for genital use and follow its directions exactly. Using too much or leaving it on longer than directed can cause excessive numbness, irritation and difficulty maintaining an erection.
Remove or wash off the product as directed before penetration, or use a condom, to reduce transfer to a partner. Stop using it if either partner develops burning, itching, swelling or a rash. A DailyMed label for a lidocaine genital desensitizer illustrates the warnings and directions that should be checked before using this type of product.
Prescription medications
No prescription pill is FDA-approved specifically for premature ejaculation in the United States. However, clinicians sometimes prescribe certain antidepressants off-label because delayed orgasm is a known effect. Options may include selective serotonin reuptake inhibitors such as paroxetine, sertraline or fluoxetine, as well as clomipramine.
Possible adverse effects include nausea, sweating, sleep changes, reduced sexual desire and erection or orgasm difficulties. These drugs may also interact with other medicines. They should not be started, combined, discontinued or changed without guidance from the prescribing clinician. The American Urological Association guideline on ejaculation disorders supports SSRIs, selected on-demand medications where available, and topical anesthetics as leading medication options.
Tramadol can delay ejaculation, but it is an opioid with risks that include dependence, sedation and dangerous drug interactions. It is not a routine first choice and should only be considered by a clinician after safer first-line options have been reviewed.
Address erection problems at the same time
Some people rush during sex because they worry that their erection will fade. In that situation, evaluating and treating erectile dysfunction may improve confidence and ejaculatory control. Medications used for erectile dysfunction should generally be reserved for people who also have erection difficulties rather than used as a do-it-yourself premature ejaculation treatment. Learn more from the MedlinePlus guide to erectile dysfunction.
When to Seek Care
Contact a primary care clinician or urologist if early ejaculation is persistent, causes significant distress or does not improve with basic behavioral techniques. Evaluation is particularly important when the problem begins suddenly or occurs with:
- Difficulty getting or maintaining an erection
- Penile or pelvic pain
- Urinary symptoms, prostate symptoms or blood in the semen
- A recent medication change
- Symptoms of anxiety, depression or relationship distress
- Difficulty conceiving because ejaculation occurs before penetration
A clinician can review sexual and medical history, medications and possible contributing conditions. A urologist may address physical or erection-related concerns, while a licensed sex therapist or mental health professional can help with performance anxiety and relationship factors. Treatment is individualized, and improvement may require trying more than one appropriate strategy.
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