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.

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 inhibits premature 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 vibrate three 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 treatment for PE 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 PE, 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