Premature Ejaculation TreatmentDelay Creams and CondomsThe only way really effective method of controlling premature ejaculation is to retrain your body so that you respond much less quickly to sexual stimulation, which means you can maintain go for longer without having premature ejaculation.However, if you really need something that works pretty much instantly, something you can use as a stepping stone before trying the simple and effective but slightly longer term method above, then why not consider.... Premature Ejaculation Treatment With Delay Creams & Delay CondomsOne of the disappointing things about this condition is that in spite of the intense focus and effort being applied to coming up with treatments, it actually isn't possible to help every man who wants a cure with the treatment of choice: the long term solutions of exercises, training programs or therapy to delay ejaculation. It seems that for some men, psychotherapy, training programs, or a combination of the two, fail to work. This may be because they can't overcome profound early trauma or the consequences of years of negative sexual interactions, or it may be that the man doesn't have enough motivation to commit to the effective application of the treatment method. (Both psychotherapy and drug therapy do have limitations - mostly around cost and side-effects respectively; and in addition, despite what they claim, not all men want their premature ejaculation resolved, either because they don't care about it or they can't apply themselves to the possibly long-term nature of therapy; and in some cases a couple work around the man's premature ejaculation with other sexual activities which give them pleasure.) While there's no question that long-term therapy results in profound and continued improvement in a man's capacity to exercise self-control during intercourse, and is the desirable treatment, and is highly recommended by most therapists who have worked on the problem, there are sometimes good reasons why a quick solution like a premature ejaculation cream might be the best treatment. We have several issues to consider here: for one thing, how serious is this sexual problem? The truth is that it's not any kind of life-threatening condition; it usually isn't even a threat to a couple's relationship; sexual intercourse always remains possible, even though it may be brief; and in any event a wide range of other sexual behaviors can bring pleasure and satisfaction to both the man concerned and his partner. Second, it's possible that a man who's complaining of rapid ejaculation is simply searching for the Holy Grail of endless intercourse, or perhaps wants to achieve some standard of performance set by the cultural pressure to be a great lover or a "stud". So the question is: who determines what "rapid" actually means in this context? One of the objections to the oft-quoted "fact" that 50% or more of all men suffer from premature or rapid ejaculation is that a large proportion of these men are self reporting the condition: they may not in reality be any different to the population average (less than 5 minutes' intercourse, if you're wondering) if we actually knew what their staying power really was. Third, you have to ask whether premature ejaculation is a medical condition, or just the outcome of a particular lifestyle, or a real sexual dysfunction. How about considering it in the context of normal human variability, where things like weight and height vary from one extreme to another, with the majority of men in the middle? If you look at it in this way, how would you define the true prevalence of premature ejaculation, and how would you justify treatment? Indeed, why would one bother to treat it at all? Is it really a condition that is so distressing or stressful to either a man or his partner that it needs to be dealt with? In some ways these are rhetorical questions, but in other ways they are questions that need to be seriously considered by all men who want to last longer in bed (not to mention their partners). For some couples PE is a real issue; for others it hardly matters at all. We've already established that on another page of this site. But when we get into the question of pharmacological remedies, we have to bear in mind that the pharmaceutical industry may well have decided to accentuate the prevalence or seriousness of premature ejaculation simply because they have a financial interest in the treatment of such sexual dysfunctions. To what extent, therefore, it is desirable to intervene to allow couples to extend the duration of intercourse? These are all very good questions, and in the context of a man whose individual case appears to be highly resistant to any kind of therapeutic or behavioral program, they become even more relevant. I think we can say with certainty that a significant proportion of men with PE find the treatment methods of choice (i.e. the training program like the one on this site) ineffective. Some other treatment path is needed to extend the duration of sexual activity. For many in this situation premature ejaculation creams appear to be the perfect solution: they are quick-acting, can be applied almost "on demand", they can be used in a way that does not affect his partner's sensitivity, and if used carefully by the man concerned they will leave him with sufficient sensitivity to enjoy intercourse almost as much as he would without the cream. How do premature ejaculation creams work?They work by providing a local anesthetic effect on the sensitive tissues of the penis. This reduces the hypersensitivity of the man's glans, and decreases the number of nerve impulses which go to his brain, thereby slowing down the speed with which he approaches the point of ejaculatory inevitability. Creams for premature ejaculation usually contain a mild anesthetic such as benzocaine or lidocaine; although others are available as well, these are the two that are used most in premature ejaculation creams of this kind. (We'll look at herbal products lower down this page.) Such creams, used as a means to delay ejaculation, have been around since the 1950s, and when used correctly, they can be very successful. Unfortunately, if used incorrectly they can have some quite unfortunate side effects. First and foremost, if a man is not using a condom and his penis retains a coating of the anesthetic PE cream or lotion, it is going to be transferred to the inside of his partner's vagina, and she will most likely experience a degree of numbness or discomfort during sexual activity. While it's true that having both partners numbed out in this way might really extend the length of intercourse, there's obviously a downside -- which is the fact that there isn't much pleasure in it for either of them! So, the anesthetic cream or lotion has to be applied in a way that reduces the man's sensitivity, while he is left with enough feeling to enjoy sex, thereby halting or slowing down his premature ejaculation; at the same time, his partner's sensitivity should not be affected. There are two ways in which this can be done: first, the man can use a condom which contains the anesthetic coating in, hopefully, the correct concentration to slow him down without numbing him so much that he doesn't feel anything. The other is to apply a lotion or premature ejaculation cream directly to his penis. 1 Delay Condoms For Control Of Premature EjaculationWe recommend unreservedly a condom made by Durex called Performa or Performax. Reviews of this product on www.condomdepot.com are very interesting: if you read all the way through that page you will see that some of the men who tried them say they were so numb they couldn't feel anything, while others report that the product had no impact on their sensitivity or speed of ejaculation whatsoever! How on earth can we explain that? One possibility is how long the interval was between putting on the condom and beginning sex: it's conceivable that a man who was accustomed to ejaculating in less than two minutes would put the condom on immediately before sex and then engage in intercourse straight away; in such circumstances, he might still come very quickly because his penis had not been numbed. So the message here is that you actually have to experiment with these condoms to find out how they work best for you. When you open the packet, you'll find a small amount of benzocaine gel at the end of the condom, which melts in response to body heat. My suggestion would be to remove some of this gel the first time you try these condoms so that you get a sense of how much of the anaesthetizing PE lotion you actually need. The other issue, of course, is the size of the condom: some of the men in the reviews referred to above said that the condoms tore or broke, but this would only happen if they were using them incorrectly or because their penis was actually too big for the condom. If you are well-endowed, one possibility would be to find a brand and size of condom that suits you and then to transfer the anaesthetizing gel from the Performa condom into that condom so you can be sure it won't break. As with all condoms it may be necessary to use a certain amount of lubrication on the outside of the condom to help your partner fully enjoy sex but it's certainly an avenue worth exploring. 2 Premature Ejaculation Cream To Increase Staying Power & Last Longer During SexThe other alternative is to use a cream, lotion or spray containing the anesthetic that you apply directly to your penis. You have to wash some of these products off before intercourse to prevent them entering your partner and numbing her, others you just apply or spray onto your glans and don't need to wash off. In the former case, it's absolutely no use applying the PE cream and then trying to enjoy intercourse, because sure as anything, your partner is going to end up with an internal numbness that deprives her of any pleasure during sexual activity (at least, if she wants to feel you inside her!). Therefore, after extensive research we can tell you that there are only a few products we recommend. And they are as follows: i) Stud 100 delay cream You can read about this in the reviews here: Lovehoney.co.uk and on the following two pages of the Lovehoney site. Once again, it's worth reading all the reviews because by doing so you get a clear view of how the product works: you'll soon see it's absolutely essential to find the right number of times to spray the product on your glans and shaft, so that it delays you just enough to give you pleasurable intercourse without numbing you so completely that you don't feel a thing or even lose your erection. The product apparently advises between 3 and 8 sprays on the sensitive parts of your penis, so my suggestion is that you start with 3 and see how it works -- do not start with a higher number, thinking this will help you get better control......why not? Well, because some men are very sensitive to these products; if you're one of them, you might get a rather unpleasant stinging and burning sensation. Experimentation is everything. It also looks like this product has the advantage that if you spray it on about 10 minutes before intercourse you don't actually need to wash it off before you start making love, as the tissues of your sexual organs appear to absorb all the anesthetic. Certainly highly recommended, Stud 100 seems to have helped many men. In the USA you can buy it here (if the link doesn't work, just search for it on Amazon); in the UK you can buy it here. ii) V-RX CreamIf you are very sensitive to the benzocaine, and you want a milder premature ejaculation cream, one that may suit you is V-RX cream. This contains only 4% lidocaine which is about half of the quantity of anesthetic in the Stud 100 delay spray, so it's milder. Also, you apply it as a cream to the end of your penis about 10 minutes before you start making love, then you wash it off so it's not transferred to your partner (by the way, it's not suitable for use with condom because it contains oils). You have to be careful however when you're buying V-RX cream for premature ejaculation because the name is very similar to another product on the market called VIG-RX cream which is actually marketed as a "male enhancement product" and has nothing to do with delaying premature ejaculation. I'm not actually sure that this PE cream (V-RX) is available in the USA, but it certainly comes highly recommended and it gets rave reviews from the men who have tried it. It's very suitable for a couple who want the intimacy of sexual intercourse without using a condom, because, as I mentioned before you put it on your penis about 10 minutes before intercourse and then you wash it off so it's not transferred to your partner. After ten minutes, the anesthetic is absorbed into the tissues and has a slight numbing effect. It's certainly a very popular and very effective product, and I think you get even more control over how much dosage you actually apply to your penis than with Stud 100 spray. You can buy it here. Now, is there a product in the United States similar to V-RX cream? To start with, it's worth noting that there are many products supposed to control premature ejaculation on the market which go by suggestive names such as Vivaxa, Climinax, Deferol and so on. You'll find these promoted very heavily around the Internet -- on many different sites, including some which purport to be independent review sites but which are actually set up by the manufacturers of the product, and are therefore not, shall we say, entirely unbiased! (Really, who'd have thought it?) In our opinion there is no reason to believe any of these products work. We think you need to get a product that contains a genuine local anesthetic such as benzocaine or lidocaine or you'll be just as quick off the mark as before. But if you have an opinion to the contrary, please let us know (Email rod@end-premature-ejaculation-now.com) You could chase after the herbal products and herbal remedies for premature ejaculation that are widely advertised - see below for more information - but you may well be wasting your money and if you can find an anesthetic-based PE cream that works, then why go anywhere else? These products do have a long history, we know they work, and they are manufactured to high standards -- most importantly, we know men find them helpful. What we'd recommend if you want one of these creams in the United States, assuming V-RX isn't available there, is instead to use a lubricant that contains an anesthetic agent, because once again you can control how much you apply (although one possible disadvantage might be that your female partner becomes desensitized to some degree as well. Mind you, you can try the product and see what happens, perhaps using a condom if that helps). One such product is Durex's range of lubricants which you can see reviewed here on Amazon.com - if the link doesn't work, just search for delay cream on Amazon.com. 3 Herbal premature ejaculation creamsWhat if you find that you respond to benzocaine or similar anesthetics with an unpleasantly intense reaction? The answer might be a herbal product. However, you definitely need to avoid some of these to avoid because they can produce horrendous responses in the sensitive skin of the penis. To get an idea of what you might be dealing with read all the reviews of Indian God lotion and China Brush on Amazon. These are two products widely advertised for stopping premature ejaculation, but, in our opinion, you should probably avoid them at all costs. (If the links don't work, just search for the two product names on Amazon, then scroll down to the reviews.) We would really like to hear from anybody who finds a PE cream which is non-anesthetic based and works: in the meantime, after reading all the websites on the subject we cautiously recommend this delay cream: Extenda which claims to be herbal-based although the manufacturer doesn't say what's in it. At least the manufacturer's site does seem level-headed and based on common sense (if that means anything in this cut-throat competitive market place). You can buy it here: Extenda (and no doubt in many other places too). Please let us know if it works for you and - maybe more to the point - if it doesn't work for you, then we can adjust our recommendations for other men.... Email: (rod@end-premature-ejaculation-now.com) To reiterate, we are recommending this product because while we believe that benzocaine based ones are actually the product of choice for men who wish to use a premature ejaculation cream, we do recognize there are many men who will want, for one reason or another, to use a herbal cream, and for whom this might just possibly be a suitable option. 4 SS Herbal Cream for the treatment of premature ejaculation We know that premature ejaculation is by far and away the most common male sexual complaint, although as we have seen on this website, the prevalence is unclear, owing to the fact that it may be defined in many different ways. We know that SSRI treatment, topical anesthetics, and alpha blockers have enjoyed limited success, so it makes sense to investigate any traditional herbal remedies. Indeed, one of the motivations for the investigation reported below appears to have been the fact that although traditional therapies have been reported as achieving a success rate of around 90%, these results are often not replicable, and recidivism rates are high. in other words, while men may last longer in bed for a brief time, their tendency to quick ejaculation soon begins again. SS cream is a herbal remedy available in South Korea which had been used to treat premature ejaculation. It has been investigated by seven scientists and the departments of urology and biostatistics at the Yonsei University College of medicine in Seoul. SS cream is made from extracts of nine natural herbal products. When it is applied to rabbits, it inhibits nervous reflex responses in what appear to be a dose-dependent fashion. The object of the study was to establish if SS cream stops premature ejaculation, or at least delays ejaculation, in men in a similar way. These researchers started from the position that lack of control over ejaculation may have a neurological explanation. They studied sensory evoked nerve potential (SEP) and discovered that in men who reported themselves as having PE, the vibration threshold was lower than that of men without PE, the latency of SEP was reduced, and the amplitude of SEP was increased when compared to men who did not have premature ejaculation. In other words, men with PE seem to have heightened sensory response to stimulation of the penis: a fact which led these investigators to conclude that decreasing the hypersensitive penis might offer a successful method of treatment for PE. They conducted the research on 53 men between July 1997 and May 1998. These men had only lifelong (primary) PE, not acquired (secondary) PE. All of the men ejaculated in less than three minutes after penetration and they all reported sexual satisfaction as being less than 50%. The study excluded men who had psychological problems which might require psychiatric care or the administration of antidepressants. All the men had normal genitals and normal test results for hormone levels, liver and kidney function. SS cream comes in a variety of strengths. It was applied to the glans by a research assistant and then after one hour the vibratory threshold of the man's penis was checked using a biothesiometer. The 53 men completed penile biothesiometry twice during the period of screening, and three times after the application of SS cream to their penis. In the screening phase, the average ejaculatory latency period was 1.45 minutes, and the average sexual satisfaction rate reported by the participants and their sexual partners was 16.2%. The tests demonstrated that the mean vibration thresholds of the glans was significantly increased as the dose of SS cream was increased. What does this mean? These researchers argue that until the 1980s, the etiology of premature ejaculation was thought to be purely psychogenic, and by implication the lack of success of psychotherapy and behavior modification demonstrates an underlying physiological cause for premature ejaculation. They also observed that recent pharmacological treatment using neuroleptics, alpha blockers, tranquillizers of various kinds, and SSRI inhibitors have also had limited success and various side effects. They make the interesting observation that the use of topical spray containing lidocaine has been clinically effective in fewer than half the men on whom it has been tried, and it usually causes penile numbness which often causes erectile dysfunction. Broadly speaking, these conclusions are directly in line with my own observations. They also reinforce the observation that if topical anesthetic is used incorrectly, it can affect the sensitivity of the sexual partner's vagina. This lead the researchers to the observations that to be both effective and efficient, a premature ejaculation treatment should control the ejaculatory reflex, should be simple to apply, should have no effect upon the man's erection and orgasm, and should not interfere with sexual enjoyment of the partner. SS cream is made from natural components including euganol from Cryophilli flos, bufosteroid from Bufonis veneum, methyl leugenol from Asiasari radix, and sanshol from Zanthoxylli fructus, all of which are excellent local desensitizers and have in addition the ability to relax smooth muscle. The researchers claim that SS cream has almost no toxicity and there were no histological changes after long-term topical application on the glans penis of rabbits. We must hope the same is true for application to the glans penis in men! Certainly in rabbits the cream prolongs the ejaculatory latency period and reduces the amplitude of SEP stimulation. Human studies conducted by these researchers demonstrated that SS cream was effective in the treatment of premature ejaculation and extended the ejaculatory latency period to more than two minutes in 84% of men who used the cream. Now, this is very interesting because two minutes is a traditional measure of premature ejaculation, but for most women such a short period of intercourse is still completely inadequate. The researchers claimed that the SS cream completely restored a sense of physical well-being in men with premature ejaculation, although the satisfaction of their partners was not recorded. And while it is true that the vibratory threshold at the glans penis increased significantly in a dose-dependent measure after the application of SS cream, the only real measure of a satisfactory outcome in a study such as this is that both the man and his partner are much more satisfied with the level of control which the man has achieved over his ejaculatory reflex. In other words it isn't just a matter of measuring the sensitivity of the penis to artificially produced stimulation. Control of PE in the real world is about much more than that: it's about the length of time for which a man can thrust in his partner's vagina, and the pleasure which they both obtain from that thrusting. Neither of these factors appear to have been analyzed in any way in this study. Here's the best way to prevent premature ejaculation using natural methods. Finally it's worth mentioning that SS cream is not currently available in the United States or apparently in Europe, although it seems to be worthy of further investigation. http://www.nature.com/ijir/journal/v11/n5/pdf/3900431a.pdf
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