One method of attempting to prolong the time prior to ejaculation is to employ mental diversionary tactics—that is, filling your mind with thoughts other than ejaculating in order to prevent doing so. Baseball, work, counting backwards, etc., are examples of such thoughts. Unfortunately, these “deerotization” techniques are rarely effective and diminish the pleasure of sexual activity and intimacy.
A more successful means of preventing P.E. is the stop-start method originated by Dr. Semans. This technique requires you to develop an enhanced awareness of the feelings and sensations surrounding the time leading up to ejaculation; by achieving such familiarity, you can learn to accurately predict when ejaculation will occur and how to gain control before the “point of no return.” Recognizing imminent ejaculation and responding by slowing the pace of pelvic thrusting as well as varying the angle and depth of vaginal penetration may allow time for the feeling to dissipate. If slowing the tempo is not sufficient to prevent the occurrence of premature ejaculation, you may need to stop thrusting completely while maintaining penetration in order for the urgency to go away. Once the sensation to ejaculate subsides, pelvic thrusting may be resumed.
Another option is the squeeze technique originated by Masters and Johnson. As ejaculation approaches, the penis is withdrawn from the vagina and the head of the penis is squeezed until the feeling of ejaculation passes, after which intercourse is resumed. The male or his partner may apply the squeeze.
Decreasing penile sensitivity can be helpful in the management of P.E. There are various means of accomplishing this, including the use of extra thick condoms, topical creams that desensitize the penis, and increasing the frequency of ejaculation, since P.E. tends to be more pronounced after prolonged periods of sexual abstinence. By masturbating prior to engaging in sexual intercourse, the ejaculatory latency period can be increased.
Local anesthetics including
Lidocaine (2.5%) or Lidocaine and Prilocaine (EMLA cream) applied 20-30 minutes prior to intercourse will diminish the sensitivity of the penis.