Premature Ejaculation Treatment Guide
Available treatment options
When it comes to medical intervention, we have excellent options. The only licensed oral prescription medication specifically for PE in the UK is Priligy (dapoxetine). It belongs to a class of drugs called selective serotonin reuptake inhibitors (SSRIs).
While SSRIs are typically used for depression, Priligy is a short-acting variant that alters the chemical signals in the brain to delay the ejaculatory reflex. I typically recommend this as a first-line medical treatment for men who want a reliable, on-demand solution.
A crucial insight from my clinic: Priligy works best when taken one to three hours before sex, but you must take it with a very large, full glass of water.
This simple step drastically reduces the risk of sudden blood pressure drops and dizziness, which is the most common reason men abandon the medication.
What to expect from treatment
Setting realistic expectations is vital. Patients often expect a magic switch on day one, but the reality is more nuanced. I always warn my patients about "first-dose anxiety." The first time you use a treatment like Priligy, you may be so anxious about whether the medication will work that your adrenaline overrides the drug's delaying effect.
Do not be discouraged if the first attempt isn't perfect. It is usually on the second or third try, once you trust the medication is in your system, that we see the real, significant improvement in duration.
Most of my patients report a two- to three-fold increase in their baseline time once they find their rhythm.
Self-care and prevention
Medication is highly effective, but it works best when combined with behavioural techniques. You have likely heard of the "stop-start" technique, but implementing it with a partner can feel disruptive and awkward.
Instead, I advise my patients to practice the "ballooning" technique during solo masturbation. This involves bringing yourself right to the edge of climax and then completely stopping until the arousal subsides, repeating this several times.
Practicing this alone removes the performance pressure of a partner and helps you safely map out your physical sensations. Over time, this actively rewires your brain's response to arousal, teaching your nervous system how to tolerate higher levels of stimulation without triggering the ejaculatory reflex.
