Premature Ejaculation Home Remedies

Remember back when PE used to mean gym class? Now that more and more physical education programs are being dropped in schools, it won’t be long before PE will only refer to premature ejaculation! The nongym PE is actually the most common male sexual dysfunction (erectile dysfunction, or ED, runs a close second). 

The primary method of treating it is delaying ejaculation by decreasing stimulation and sexual function. Some of the most commonly used drugs for PE are either numbing topical agents (a.k.a. anesthetics, such as lidocaine or over-the-counter sprays) or a class of antidepressants known as SSRIs (selective serotonin reuptake inhibitors), which cause delayed ejaculation as a side effect. So it makes sense that supplements that work for PE either have anesthetic or antidepressant properties.

What is Premature Ejaculation?

Premature ejaculation is ejaculation with minimal stimulation and earlier than desired, usually before or soon after penetration. The man has little or no voluntary control over it, and the situation usually (but not always) causes distress, sometimes to the point where sexual intimacy is avoided altogether. Unlike erec-tile dysfunction, PE is not age-related and the drugs that work for ED generally don’t work for PE. Unfortunately, most men with PE never seek help; I’m hoping this section will change that.

The causes of PE are unknown. Experts have speculated that it’s due to anxiety, a hypersensitive penis, or even a neurotransmitter/chemical imbalance, but there’s little data to support these theories.

Most men know they have a problem, but for those who are unsure, there are questionnaires online, such as the Premature Ejaculation Diagnostic Tool. The higher the score, the likelier the problem is PE.

Premature Ejaculation Home Remedies

1. Topical anesthetic (desensitization) creams/sprays dosage varies

As mentioned earlier, these products work by blunting exterior sensations. Really the only topical supplement product that’s been studied and has decent evidence so far is Severance Secret-Cream (also known as SS-cream), a combination of nine herbs that is produced by a Korean company (Cheil Jedan Corporation). You apply 0.2 grams (200 milligrams) to the head of the penis 30 to 60 minutes before sexual activity and wash it off immediately after sex. The problem is, it’s hard to get outside of Korea, but you can contact the company or look for it on Amazon (it’s hit and miss there). It had very impressive (almost difficult to believe) results in one double-blind trial. The average ejaculatory time went from 1.4 minutes to 10.9 minutes, and the cream was 27 times more effective than the placebo in terms of increasing sexual satisfaction! 

Twenty percent of the SS-cream users reported mild localized irritation, including burning and pain (the partners didn’t report any side effects), and some participants complained about the color and odor. Although the European Association of Urology now recommends SS-cream in its clinical treatment guidelines, I doubt this cream will be widely available outside of Korea anytime soon (my colleagues in Korea have not heard of any push to bring it to the United States or other areas). One thing you can always count on though in the supplement field is copycats (companies that copy the original formula or even sell anesthetic sprays).

The nine herbs in this product are:

  • Ginseng Radix Alba
  • Angelicae Gigantic Radix
  • Cistanchis Herba
  • Zanthoxylli Fructus
  • Torlidis Semen
  • Asiasari Radix
  • Caryophylli Flos
  • Cinnamomi Cortex
  • Bufonis V eneum

2. (tie) St. John’s wort 300 to 450 milligrams a day

Note: Both of the silver medalists here (St. John’s wort and 5- HTP) have not been heavily researched; rather, they have similar mechanisms of action to some of the most commonly used prescription drugs for PE. I’m breaking my research rules here because of my experience with patients and doctors around the world who have used these successfully for PE.

Both St. John’s wort and 5-HTP (opposite) increase serotonin, much the same way that selective serotonin reuptake inhibitor antidepressants, or SSRIs, do (see the Depression section). Researchers are still trying to figure out exactly how St. John’s wort works, but it seems to block serotonin uptake (meaning the chemical hangs around longer) and alter levels of multiple brain neurotransmitters, including dopamine, norepinephrine, and GABA (gamma-aminobutyric acid).

Increased levels of serotonin inhibit the ejaculatory reflex, and delayed ejaculation is one of the common side effects of antidepressants, which is why doctors frequently prescribe them for PE. While there is preliminary research showing it may help some men with PE, I’d like to see more evidence. One of the active ingredients in St. John’s wort, a compound called hyperforin, has been getting some research, but it’s still only in the lab; in other words, it hasn’t been tested for PE in real people.

St. John’s wort has been effective for depression at doses of 500 to 1,200 milligrams per day (in two or three divided doses) over 4 to 12 weeks. (Always look for an extract that is standardized to contain 0.3 percent hypericin.) But clinical trials for PE will use a dosage that is much lower (probably one-third to one-half of what has been used for depression).

Just keep in mind that St. John’s wort can reduce the efficacy of almost half of all prescription drugs in the United States, including birth control pills. (That might slow down the excitement process right there!)

And never take St. John’s wort if you’re already on a prescription antidepressant, including SSRIs, tricyclics, or monoamine oxidase (MAO) inhibitors. You should also avoid it if you’re taking immunosuppressants, antiretrovirals, blood thinners (like warfarin), or chemo- therapy drugs. Side effects of high dosages of St. John’s wort include insomnia, vivid dreams, anxiety, dizziness, and sun sensitivity.

Is it worth the risk? I think some of the potential drug interaction concerns are overblown, but that’s something to ask your physician about. Since the number one prescription treatment for PE is SSRI-type drugs and because St. John’s wort works like these drugs, it’s easy to recommend this supplement for PE. If it’s not effective after 1 or 2 weeks, try something else.

2. (tie) 5-HTP 50 to 300 milligrams a day

While St. John’s wort keeps serotonin from being reabsorbed by cells, 5-HTP essentially helps cells create more serotonin (either way you end up with more of it). 

Again, there are no studies with PE yet, but it has a mechanism of action that’s similar to conventional drugs for PE. As with St. John’s wort, the letters and comments I’ve received over the years in terms of efficacy of 5-HTP have been encouraging. Most studies of this supplement for depression used 200 to 300 milligrams, but you can start as low as 50 milligrams. 

Keep in mind, higher doses (above 300 milligrams) are not better; they can cause nightmares, vivid dreams, and dizziness (nausea, diarrhea, and drowsiness have also been reported). Talk with your doctor about what dosage might be good for you. Most important, do not combine 5-HTP with any other medications that also impact serotonin levels, such as anti-depressants, without first speaking with your doctor. I believe it can increase the risk of serotonin syndrome (which can cause diarrhea, fever, seizures, and even death) and possibly deplete other neurotransmitters.

3. L-citrulline 1,500 milligrams a day

Again, my recommendation here is based on experience, not a major clinical trial. This is a potential exception to the rule that what works for ED generally won’t work for PE (ED drugs usually don’t have any anesthetic effect or impact on the ejaculatory reflex). L-citrulline improves erectile function and hardness in some men (see the Erectile Dysfunction section) by increasing levels of nitric oxide in the blood, which helps improve bloodflow.

There is recent evidence in the prescription drug world that low nitric oxide levels may increase the risk of PE by increasing sensitivity or stimulating the ejaculatory reflex. Therefore, despite a lack of published evidence with L-citrulline so far, I had to make it my third choice. Nothing else has a better benefit-to-risk ratio when it comes to PE (after my first two choices, of course).

Keep in mind that ED supplements (and drugs) seem to improve confidence, the perception of ejaculatory control, and overall sexual satisfaction, while reducing anxiety and the amount of time needed to get a second erection. Some studies have observed a better result for PE when combining an ED pill with an antidepressant.

What Are Useless For Treating Premature Ejaculation?

Panax ginseng

This product needs more research. There are some compounds in the ginseng plant (specific ginsenosides) that might hold some promise, though, so I’m keeping my eye on it. It is an ingredient in SS-cream (my #1 pick on this page), but only as a small percentage.

Maca

There’s simply no evidence to suggest maca can help individuals with PE.

Folic acid

There’s some preliminary evidence that large doses of this B vitamin (1 milligram or more) can help reduce PE because folic acid can enhance brain neurotransmitters (the primary conventional drugs used for PE impact brain chemicals), but the evidence is weak and the safety of taking so much is questionable. Plus, there is a concern that using mega-doses of folic acid over long periods can enhance the growth of male cancers, like prostate cancer.

Other Natural Cures For Premature Ejaculation

This is one health issue where lifestyle has a minimal impact (so I’ll save you the “heart-healthy” spiel). Similarly, research has not found a relationship between PE and obesity, but you can never go wrong by making healthy changes to your lifestyle!

Refine your technique

Here are a few ways to avoid premature ejaculation (a sex therapist or urologist who specializes in sexual dysfunction can give you more tips).

  • The stop-start method is just like it sounds. It involves taking periodic breaks from sexual activity to essentially train the penis to hold off. For example, you or your partner stimulates the penis until you’re close to orgasm, then stop for a bit. Repeating this over time has helped some men with PE overcome the quick urge or need to ejaculate.
  • The squeeze technique has several versions, but it mainly involves squeezing the head of the penis with your thumb and forefinger when the sensation of ejaculation begins. Focus the pressure on the urethra, which is the tube running along the underside of the penis. This method pushes blood out of the penis and temporarily reduces sexual tension and the ejaculatory response.
  • Masturbating before intercourse is a common technique used by younger men. (You can call this the There’s Something about Mary technique, for all you moviephiles out there.)
  • Kegel exercises tighten the pubococcygeal muscles of the pelvic floor. These muscles get activated when you cut off the flow of urine midstream. You can strengthen them by doing exactly that (starting and stopping several times when you urinate), but people may start to wonder why you’re taking so long in the bathroom! You can easily mimic the same sensations anywhere without anyone knowing what you’re doing. Performing several sets of 10 throughout the day can strengthen the muscles and improve ejaculatory control. In the same vein, core exercises (like plank moves or exercises on a stability ball) strengthen the pelvic floor, too.
  • The most sensitive nerve endings of the vagina are in the first third of the vaginal entrance, so small, shallow movements can help you last longer than simply thrusting vigorously, and this might satisfy your partner as well.
  • Sensate techniques involve setting aside time to slowly explore, touch, and kiss each other without an immediate need for intercourse or even genital touching. It helps you both get comfortable with each other, with the ultimate goal of also treating PE. Other methods include masturbating in front of each other and using massage oils and lubricants.

Get poked

In a large Turkish study, researchers compared acupuncture to the PE prescription drug paroxetine. It didn’t perform as well as the drug, but it did work significantly better than a placebo. In this study, patients received acupuncture twice a week for 4 weeks. There’s also some promising preliminary clinical research regarding combining yoga with prescription medication for PE.

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