Comparing Lifestyle Changes, Behavioural Therapy, and Medications

What We’ll Cover in This Post

In this article, we’ll discuss:

• Is there one “best” treatment for premature ejaculation?
• How healthcare professionals choose treatment
• Lifestyle changes that support better ejaculation control
• Behavioural techniques that may help
• Counselling and psychological therapy
• Medications used to treat premature ejaculation
• What if you also have erectile dysfunction?
• Which treatment works best for different men?
• How FlexiCare can help

“What’s the Best Treatment for Premature Ejaculation?”

After learning about premature ejaculation, most men ask the same question:

“So… what actually works?”

If you’ve searched online, you’ve probably found dozens of answers.

Some websites recommend herbs.

Others promote supplements.

Some advertise miracle pills.

The problem is that not all treatments have the same level of scientific evidence.

The good news is this:

There are effective treatments for premature ejaculation, but the best option depends on what’s causing the problem.

This is why healthcare professionals don’t recommend the same treatment for every man.

There Isn’t One Treatment That Works for Everyone

Premature ejaculation is not a single condition with a single cause.

As we discussed in our previous article:

Read more: Why Am I Ejaculating Too Quickly? Common Causes of Premature Ejaculation

Some men experience premature ejaculation because of:

• Performance anxiety
• Lifelong biological factors
• Erectile dysfunction
• Stress
• Relationship concerns
• Medical conditions

The treatment should match the cause.

Treatment Option 1: Lifestyle Changes

Lifestyle changes are usually the foundation of treatment.

Although they may not completely solve every case, they improve overall sexual health and may reduce factors contributing to premature ejaculation.

Examples include:

Regular exercise

Exercise supports:

• Cardiovascular health
• Blood circulation
• Mood
• Confidence

Several studies have shown that regular physical activity contributes to better sexual health.

Better sleep

Poor sleep affects:

• Stress hormones
• Mood
• Energy
• Overall wellbeing

Improving sleep may help men who notice that fatigue or stress worsens their symptoms.

Read more: Why Can’t I Sleep at Night Even When I’m Tired?

Limiting alcohol

Alcohol may reduce anxiety temporarily but can also affect erection quality and sexual performance.

Reducing excessive alcohol intake benefits overall sexual health.

Read more: Does Alcohol Affect Sexual Performance? What Men Should Know

Treatment Option 2: Behavioural Techniques

Behavioural techniques have been recommended for many years.

They help some men improve awareness and control over ejaculation.

Examples include:

Stop-start technique

This involves stopping stimulation before ejaculation and restarting once the urge has reduced.

With practice, many men become better at recognising the point just before ejaculation.

Squeeze technique

This method involves gently squeezing the head of the penis just before ejaculation to reduce arousal.

Although evidence is mixed, some men find it helpful.

Pelvic Floor Muscle Training

Among natural treatments, pelvic floor exercises have some of the strongest scientific evidence.

Research suggests they may improve ejaculation control in selected men when performed consistently.¹

Treatment Option 3: Counselling and Psychological Therapy

Not every case of premature ejaculation is purely physical.

For some men, anxiety is the biggest contributor.

This may include:

• Fear of disappointing a partner
• Previous negative sexual experiences
• Relationship stress
• Low confidence

In these situations, counselling or sex therapy may be beneficial.

Cognitive behavioural therapy (CBT) may also help some men reduce performance anxiety.

Treatment Option 4: Medication

Medication is an option for men whose symptoms remain troublesome despite lifestyle changes or behavioural techniques, or for those with more persistent premature ejaculation.

The decision to use medication should be based on an individual assessment by a qualified healthcare professional.

Common medication options include:

Selective Serotonin Reuptake Inhibitors (SSRIs)

Several SSRIs have been shown to delay ejaculation.

Examples include:

• Sertraline
• Paroxetine
• Fluoxetine

These medicines are typically prescribed off-label for premature ejaculation in many countries and should only be used under medical supervision.

They are not suitable for everyone, and the most appropriate choice depends on a man’s medical history and other medications.

Dapoxetine

Dapoxetine is a short-acting SSRI specifically developed for premature ejaculation and is approved for this indication in several countries.

It is taken before anticipated sexual activity rather than every day.

Availability varies depending on the country.

Topical Anaesthetic Creams or Sprays

These products reduce penile sensitivity and may help delay ejaculation.

To reduce the risk of transferring the medicine to a partner, they should always be used according to the manufacturer’s instructions or a healthcare professional’s advice.

What If You Also Have Erectile Dysfunction?

Many men experience both erectile dysfunction (ED) and premature ejaculation.

The two conditions are closely linked.

For example:

A man who worries about losing his erection may rush during sex, leading to premature ejaculation.

Conversely, repeated episodes of premature ejaculation may increase anxiety, making erections more difficult to maintain.

Treating erectile dysfunction may improve ejaculation control in selected men.

Research suggests that phosphodiesterase type 5 (PDE5) inhibitors, including tadalafil, may improve sexual confidence and satisfaction in men who have both conditions.

This is why a full assessment is important before choosing treatment.

Read more: Why You Get an Erection but Can’t Maintain It

What About Herbal Remedies?

Many herbal products are marketed as treatments for premature ejaculation.

Unfortunately, the scientific evidence supporting most of these products is limited.

Some unregulated products have also been found to contain hidden prescription medicines.

For this reason, reputable organisations recommend caution.

Which Treatment Works Best?

The answer depends on the individual.

For example:

If anxiety is the main cause

Behavioural therapy and counselling may be particularly helpful.

If erectile dysfunction is also present

Treating both conditions often produces better results than focusing on only one.

If symptoms have been present since early sexual experiences

Medication and behavioural techniques may both have a role.

If symptoms developed recently

Identifying and treating the underlying cause may lead to significant improvement.

Why Self-Treatment Doesn’t Always Work

Many men spend months trying different products without success.

This often happens because:

• The underlying cause hasn’t been identified.
• Treatments are chosen based on advertisements rather than evidence.
• Products promise unrealistic results.

A personalised approach is usually much more effective.

When Should You Seek Professional Advice?

You should consider seeking help if:

• Premature ejaculation is causing distress.
• It affects your relationship.
• Lifestyle changes haven’t helped.
• You also have erectile dysfunction.
• You’re unsure which treatment is appropriate.

How FlexiCare Can Help

At FlexiCare, we understand that every man’s situation is different.

Our pharmacists provide confidential consultations to help you:

• Understand the possible causes of your symptoms.
• Review evidence-based treatment options.
• Determine whether lifestyle changes, behavioural techniques, medication, or a combination of approaches may be appropriate.
• Receive personalised guidance in a private and supportive environment.

You can speak with a FlexiCare pharmacist by calling or sending a WhatsApp message to:

09057798028

Key Takeaways

If you’re looking for the best treatment for premature ejaculation, remember:

• There is no single treatment that works for every man.
• Lifestyle changes provide an important foundation.
• Behavioural techniques can improve control for many men.
• Medication is available when appropriate.
• Treating erectile dysfunction may also improve ejaculation control.
• The best treatment starts with understanding the cause.

Read More

Continue learning:

• Do I Really Have Premature Ejaculation?
• Why Am I Ejaculating Too Quickly? Common Causes of Premature Ejaculation
• Can Premature Ejaculation Be Cured? What the Evidence Says
• How to Last Longer Naturally: 10 Evidence-Based Ways to Improve Ejaculation Control
• Why You Get an Erection but Can’t Maintain It

References

1. Pastore AL, Palleschi G, Fuschi A, et al. Pelvic floor muscle rehabilitation for patients with lifelong premature ejaculation: A novel therapeutic approach. Therapeutic Advances in Urology. 2014;6(3):83–88.
2. American Urological Association (AUA) & Sexual Medicine Society of North America (SMSNA). Disorders of Ejaculation: AUA/SMSNA Guideline. Journal of Urology. 2020.
3. European Association of Urology. EAU Guidelines on Sexual and Reproductive Health – Male Sexual Dysfunction. 2025 Edition.
4. Althof SE, McMahon CG, Waldinger MD, et al. An Update of the International Society for Sexual Medicine’s Guidelines for the Diagnosis and Treatment of Premature Ejaculation. Journal of Sexual Medicine. 2014;11(6):1392–1422.
5. McMahon CG. Current and emerging treatment options for premature ejaculation. Nature Reviews Urology. 2012;9(2):79–88.