Finish too Soon? Best Techniques to Help Men Last Longer in Bed! According to a Urologist

Summary

Dr. Rena Malik explains that premature ejaculation (PE) is common and may involve physical, psychological, and emotional factors. She defines it as ejaculating sooner than a person or their partner would like, causing distress. The clinical timing criteria she gives are within one minute for lifelong PE or within three minutes for newly developed PE after penetrative sex begins.

PE can also affect self-esteem, anxiety, mood, and relationships.

Strategies and treatment options

• Identify possible contributing factors: These may include testosterone abnormalities, increased penile sensitivity, stress, performance anxiety, depression, or relationship and communication difficulties. A clinician can help assess what may be relevant.
• Practice the stop–start method: Pause stimulation when close to ejaculation, resume when arousal decreases, and repeat before allowing ejaculation. The technique can also be practiced during masturbation to learn personal arousal patterns.
• Consider the squeeze technique: When nearing ejaculation, press the head of the penis to reduce arousal. Malik notes that practicing this with a partner may take communication and patience.
• Assess pelvic-floor tension before doing Kegels: Pelvic-floor exercises may help some people, but Malik cautions that men with an already tight pelvic floor may worsen symptoms by doing more strengthening exercises. Relaxation work may be more appropriate for them.
• Try diaphragmatic breathing: Malik describes deep abdominal breathing as a low-risk technique and cites research suggesting it may increase time to ejaculation. The specific improvement she mentions—900%—is a claim she attributes to research, not a guaranteed result.
• Consider body-awareness training: She discusses high-intensity interval training (HIIT), citing a study in which seven minutes a day for two weeks was associated with increased time to ejaculation.
• Discuss desensitizing creams or sprays with a clinician or pharmacist: Products containing lidocaine or prilocaine may reduce sensitivity and are generally applied 10–15 minutes before sex. Using too much can reduce sensation, and product transferred to a partner may also numb them.
• Talk with a doctor about medication options: Malik says SSRIs are sometimes prescribed off-label to delay ejaculation. Dapoxetine may be taken as needed in some countries but is not available in the United States. She also mentions alpha-blockers and tramadol as options with potential side effects that require medical guidance.
• Address erectile dysfunction if present: Malik notes that erectile dysfunction and PE can occur together, and treating erectile dysfunction may help. She mentions sildenafil and tadalafil as medications a clinician may consider.
• Consider sex therapy: A specialized sex therapist may help with anxiety, thoughts about sex, and communication. Malik says combining psychological support with physical approaches or medication may be useful for some people.
• Be consistent and allow time: Many approaches may take several weeks or months of regular practice before significant improvement is noticeable.

Presenters and sources mentioned

• Dr. Rena Malik, urologist and pelvic surgeon
• Eric Lackey, physical therapist, referenced in a prior video about pelvic-floor relaxation exercises