Several treatments have been tested for treating<unk> . A combination of medication and non-medication treatments is often the most effective method. Self-treatment Many men attempt to treat themselves for<unk>  by trying to distract themselves, such as by trying to focus their attention away from the sexual stimulation. There is little evidence to indicate that it is effective and it tends to detract from the sexual fulfilment of both partners. Other self-treatments include thrusting more slowly, withdrawing the<unk> nis altogether, purposefully ejaculating before sexual intercourse, and using more than one condom. Using more than one condom is not recommended as the friction will often lead to breakage. Some men report these to have been helpful. A qualitative clinical trial, conducted by King's College London medical school teaching hospitals, compared use of the Prolong device with cognitive behavioural therapy. Using the Climax Control Training program in 58 subjects was found to delay time to ejaculation from 48 seconds (0.8 minutes) to 8 minutes and 48 seconds (8.8 minutes) on average in 61% of men, compared to 2 minutes and 36 seconds (2.6 minutes) in 40% of men having cognitive behavioural therapy, with a difference on average of 6 minutes and 12 seconds (6.2 minutes) between the two groups. Psychoanalysis Freudian theory postulated that rapid ejaculation was a symptom of underlying neurosis. It stated that the man suffers unconscious hostility toward women, so he ejaculates rapidly, which satisfies him but frustrates his lover, who is unlikely to experience orgasm that quickly. Freudians claimed that<unk>  could be cured using psychoanalysis. But even years of psychoanalysis accomplished little, if anything, in curing<unk> . There is no evidence that men with<unk>  harbor unusual hostility toward women. Sex therapy Several techniques have been developed and applied by sex therapists, including Kegel exercises (to strengthen the muscles of the<unk> lvic floor) and Masters and Johnson's "stop-start technique" (to desensitize the man's responses) and "squeeze technique" (to reduce excessive arousal). To treat<unk> , Masters and Johnson developed the "squeeze technique", based on the Semans technique developed by Dr. James Semans in 1956. Men were instructed to pay close attention to their arousal pattern and learn to recognize how they felt shortly before their "point of no return", the moment ejaculation felt imminent and inevitable. Sensing it, they were to signal their partner, who squeezed the head of the<unk> nis between thumb and index finger, suppressing the ejaculatory reflex and allowing the man to last longer. The squeeze technique worked, but many couples found it cumbersome. From the 1970s to the 1990s, sex therapists refined the Masters and Johnson approach, largely abandoning the squeeze technique and focused on a simpler and more effective technique called the "stop-start" technique. During intercourse, as the man senses he is approaching climax, both partners stop moving and remain still until the man's feelings of ejaculatory inevitability subside, at which point, they are free to resume active intercourse. These techniques appear to work for around half of<unk> ople, in the short-term studies that had been done as of 2017. Medications Drugs that increase serotonin signalling in the brain slow ejaculation and have been used successfully to treat<unk> . These include selective serotonin reuptake inhibitors (SSRIs), such as paroxetine or dapoxetine, as well as clomipramine. Ejaculatory delay typically begins within a week of beginning medication. The treatments increase the ejaculatory delay to 6–20 times greater than before medication. Men often report satisfaction with treatment by medication, and many discontinue it within a year. However, SSRIs can cause various types of sexual dysfunction such as anorgasmia, erectile dysfunction, and diminished libido. Dapoxetine is a short-acting SSRI which appears to work when taken as needed for<unk> . It is generally well tolerated. Tramadol, an atypical oral analgesic, appears to be effective. Desensitizing topical medications like lidocaine that are applied to the tip and shaft of the<unk> nis can also be used; or, for example, such products as Roman Swipes, which contain benzocaine. These are applied "as needed", 10–15 minutes before sexual activity and have fewer potential systemic side effects as compared to pills. Use of topicals is sometimes disliked due to the reduction of sensation in the<unk> nis as well as for the partner (due to the medication rubbing onto the partner). Surgical treatments Two different surgeries are available to<unk> rmanently treat<unk> : selective dorsal neurectomy (SDN) and glans<unk> nis augmentation using a hyaluronan gel. Both treatments were developed in South Korea and are fairly common in this country, with 72.9% of Korean urologists considering SDN as a safe and efficient treatment. Preliminary studies have suggested that both are relatively safe and effective, but due to a lack of large, multicenter, randomized-control trials with long-term follow-up, the International Society of Sexual Medicine has been unable to endorse selective dorsal neurectomy and glans<unk> nis augmentation as options for treatment. The role of surgery in the management of<unk>  will remain unclear until further studies have been completed.
Premature ejaculation
Delayed ejaculation
Dyschronometria
Retrograde ejaculation
Dyspareunia
Pelvic floor dysfunction
Persistent genital arousal disorder
Coital incontinence