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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Yes, usually. A doctor can diagnose premature ejaculation in a private conversation and prescribe treatment; tests are rarely needed, and an examination is arranged if a physical cause is suspected.
- What it is: ejaculating sooner than you or your partner wish, with little control, in a way that causes distress. In lifelong PE it happens within about a minute of penetration.
- How common: about 1 in 5 men aged 18 to 59 report it, and 30 to 40 in 100 have it at some point. It is the most common sexual problem in men.
- What works: techniques such as stop-start, numbing sprays, and tablets such as dapoxetine taken 1 to 3 hours before sex. Many men do best with a combination.
- Emergency: call 112 for a painful erection lasting more than 3 to 4 hours, or chest pain during or after sex.
Premature ejaculation is not an emergency. Do not book a video appointment if you have a painful erection that has lasted more than 3 to 4 hours, chest pain or pressure during or after sex, or sudden swelling of the lips, mouth, throat or tongue or difficulty breathing after a new medicine. Call 112 or go to an emergency department.
Can an online doctor treat premature ejaculation?
Yes, usually. Premature ejaculation is diagnosed mainly from what you describe, and routine tests are not needed, so a private video consultation suits it well. The doctor asks how long it has been happening and in which situations, checks for the causes that need treating first, such as erection problems, an infection or anxiety, explains the techniques that work, and prescribes dapoxetine, a numbing spray or cream, a daily tablet or an erection medicine when it suits you. When something points to a physical cause, such as pain or discharge when you ejaculate or pee, the doctor arranges an examination or tests.
How an online consultation helps with premature ejaculation
- Talked through in private: Many men put off asking for years. It is common, and doctors talk about it every day.
- Causes checked: Erection problems, an infection, a thyroid problem or anxiety can cause it, and treating them helps.
- Techniques that work: Stop-start and squeeze techniques, and simple changes that help many men last longer.
- The right medicine: On-demand tablets, numbing sprays, daily tablets or erection medicines, after checks that they are safe for you.
What the doctor checks in an online consultation for premature ejaculation
The doctor asks about the problem, your health and your medicines. European guidelines include a physical examination in the first assessment, mainly to find erection or prostate problems; the doctor arranges one when your story points to a physical cause. The doctor asks about:
- How long: whether it has happened since your first sexual experiences, or started after a time without problems.
- How soon: roughly how soon after penetration you ejaculate, and how much control you have.
- When it happens: with every partner and situation, or only some, and during masturbation.
- Erections: whether getting or keeping an erection is difficult, which changes the treatment.
- Infection signs: pain when you ejaculate or pee, discharge, blood in your semen or pee, or a high temperature.
- Your health: thyroid symptoms, anxiety, low mood, stress and your relationship.
- Your medicines and alcohol: antidepressants, migraine and heart medicines, recreational drugs and alcohol.
- Your heart: heart conditions, fainting or dizziness, and blood pressure, before some medicines.
It helps to think beforehand about when the problem started, what you have tried and what you would like to change. Your partner is welcome to join if you both want.
What is premature ejaculation?
Premature ejaculation (PE), also called early ejaculation, is when a man ejaculates sooner than he or his partner wishes during sex, with little or no control over it, in a way that causes distress, frustration or avoiding sex. It is the most common sexual problem in men: about 1 in 5 men aged 18 to 59 report it, and 30 to 40 in 100 have it at some point.
Swipe sideways to compare →
| Type | What it means |
|---|---|
| Lifelong | Since the first sexual experiences, ejaculating always or nearly always within about a minute of penetration |
| Acquired | A new, bothersome shortening of the time, often to about 3 minutes or less, after a time without problems |
| Variable | Coming early only sometimes; a normal variation, not a medical problem |
| Subjective | Feeling that you come too soon, although the time is normal or longer |
How long is normal?
There is a wide range. In a study of nearly 500 men in five countries, including the UK, Spain and the Netherlands, in which couples timed sex with a stopwatch over 4 weeks, the median time from penetration to ejaculation was 5.4 minutes. 14 in 100 men took under 3 minutes 20 seconds, and 26 in 100 over 10 minutes.
How do I know I have premature ejaculation?
Three things together: ejaculating within about a minute of penetration, or a new drop to about 3 minutes or less; being unable to delay it on all or nearly all occasions; and it bothering you or your partner, or making you avoid sex. Coming early now and then, with a new partner or after a long break, is normal.
What are the main causes of premature ejaculation?
Often there is no single cause, especially in lifelong PE. Brain chemistry, a sensitive penis and genes are thought to play a part. Things that can cause or worsen it include:
- Anxiety about performance, stress, depression and relationship problems.
- Erection problems, which often come together with PE.
- An inflamed or infected prostate or urethra.
- An overactive or underactive thyroid.
- Recreational drugs, and poor sleep.
Acquired PE, which starts after a time without problems, more often has a cause that can be treated, so the doctor looks for one first.
Can an STI cause premature ejaculation?
An infection of the prostate or the urethra can contribute, and treating it comes first. Pain when you ejaculate or pee, discharge, or a high temperature need tests. See urethritis and STIs.
How to delay ejaculation and last longer
Techniques that teach control, such as the stop-start and squeeze techniques, help many men, especially with practice and a partner’s support. Simple changes help too: masturbating an hour or two before sex, using a thicker condom, and positions that let you pause.
The stop-start technique
- During masturbation or sex, notice the build-up towards the point where ejaculation can no longer be stopped.
- Stop stimulation just before that point, without squeezing, and wait for the urge to pass.
- Start again, and repeat several times before allowing yourself to ejaculate.
- Practise regularly: control improves with practice.
The squeeze technique
Just before the point of no return, you or your partner firmly squeeze the head of the penis for 10 to 20 seconds, until the urge passes, then carry on. Like stop-start, it takes practice.
Other things that help
- masturbating an hour or two before sex
- a thicker condom, which reduces sensation
- positions where your partner is on top, so they can move away as you get close
- distraction during sex, such as focusing your thoughts elsewhere for a moment
- talking openly with your partner, which lowers the pressure
Alcohol can delay orgasm, but it is not a treatment, and having sex less often tends to make the problem worse.
Which premature ejaculation treatment might the doctor recommend?
Treatment depends on whether the PE is lifelong or acquired, whether there is a cause to treat, and what you prefer. This is the framework the doctors use:
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| What you have | Likely first step | Suitable for online care? | When in-person care is needed |
|---|---|---|---|
| Lifelong PE | Dapoxetine before sex or a numbing spray, with techniques | Yes | Not usually needed |
| PE that started recently | Looking for a cause, then treatment and techniques | Yes | For tests, if a cause is suspected |
| PE with erection problems | Treating the erection problems first | Yes | Not usually needed |
| PE with pain, discharge or a high temperature | Tests for an infection, and treatment | Partly | For urine or swab tests |
| PE with anxiety, low mood or relationship strain | Talking therapy or psychosexual counselling, with medicine if needed | Partly | For counselling, often with your partner |
| No improvement with first treatments | A daily tablet, a combination, or a specialist | Partly | A urologist or sexual medicine specialist |
Want to last longer? A doctor can talk it through in private and plan treatment in one consultation.
See available times →Treatment options for premature ejaculation
European urology guidelines recommend treating erection problems or an infection first, then dapoxetine or a numbing spray for lifelong PE, and a daily tablet as the next step. Combining medicine with techniques or counselling often works better than either alone.
Dapoxetine
A tablet from the same family as some antidepressants (SSRIs), made for premature ejaculation and taken on demand, 1 to 3 hours before sex, no more than once a day. It is approved for PE in many countries. Side effects include feeling sick, diarrhoea, headache and dizziness, and fainting is rare. In trials, up to 1 in 10 men stopped it because of side effects, more often at the higher strength. The doctor checks your blood pressure, heart and other medicines before prescribing it.
Numbing sprays and creams
A spray or cream containing lidocaine and prilocaine, local anaesthetics, reduces sensitivity of the penis. The spray is approved for lifelong PE in Europe. Use a condom, or wash the penis before sex, so your partner does not go numb.
Daily tablets
Some antidepressants, such as paroxetine, sertraline, fluoxetine and clomipramine, delay ejaculation when taken every day, and the effect often lasts for years. They are used off-label for PE, after a discussion of risks and benefits. Side effects such as tiredness, drowsiness, feeling sick, a dry mouth and sweating are often mild and usually settle within 2 to 3 weeks.
Erection medicines
Sildenafil or tadalafil help when PE comes with erection problems, and can also help some men without them, alone or with another treatment. The doctor checks your heart health and medicines first. See erectile dysfunction.
Counselling and psychosexual therapy
Talking therapy, ideally with your partner, helps with anxiety and relationship strain, and teaches techniques such as stop-start and squeeze. It is especially useful for acquired PE, alongside medicine.
What is not prescribed online
Tramadol, an opioid painkiller, is sometimes used by specialists for PE, but it is a controlled medicine and is never prescribed online. Surgery to reduce sensation is not recommended.
A prescription is never issued without a consultation. If the doctor prescribes, use the prescription at a pharmacy near you.
What is the best treatment for premature ejaculation?
There is no single best treatment for everyone. For lifelong PE, dapoxetine before sex or a numbing spray are the first choices; a daily tablet is the next step. When PE has started recently, treating the cause, such as erection problems, an infection or anxiety, comes first. Many men do best with medicine plus techniques or counselling.
Can premature ejaculation be cured?
Many men gain good control with techniques and treatment, and acquired PE often improves once its cause is treated. Lifelong PE may need ongoing treatment, taken when you need it. There is not enough evidence that herbal remedies or supplements work.
Special situations
Premature ejaculation and erection problems
They often go together, and treating erection problems first can solve both. See erectile dysfunction.
A new partner, or after a long break
Coming early now and then, especially with a new partner or after a long time without sex, is a normal variation, not premature ejaculation.
Delayed ejaculation and other problems
Some men have the opposite problem, delayed ejaculation, or little or no semen because it goes backwards into the bladder (retrograde ejaculation). Both are different conditions, and the doctor can help with them too.
Anxiety and low mood
Worry about sex can make PE worse, and PE can make worry worse. Help for anxiety or low mood is part of treatment: see anxiety and depression.
When premature ejaculation is treated online, and when you need in-person care
Treated online: diagnosing premature ejaculation, techniques, dapoxetine, numbing sprays and creams, daily tablets, erection medicines, and help with anxiety and low mood.
In-person care: urine or swab tests when an infection is suspected, psychosexual counselling, and a urologist or sexual medicine specialist when first treatments have not helped.
When to get in-person care
Call 112 or go to an emergency department now for:
- a painful erection that has lasted more than 3 to 4 hours
- chest pain or pressure during or after sex
- sudden swelling of the lips, mouth, throat or tongue, or difficulty breathing, after a new medicine
Get medical advice the same day for:
- pain when you ejaculate or pee, with a high temperature
- being unable to pee
- fainting, or feeling very dizzy, after taking a new medicine
How Mobi Doctor works
- Book a time that suits you: daily 7am–11pm CEST. You can see a doctor over video, usually within 15 minutes. No subscription, and the exact price is shown before you pay.
- Speak to a licensed doctor in private: say how long it has been happening, in which situations, and whether erections are a problem too.
- Leave with a plan: the techniques to practise, what to take and when, and which signs mean you should be seen in person. If the doctor prescribes, use the prescription at a pharmacy near you.
No sign-up needed
Not sure it’s premature ejaculation? Tick every symptom you have to see each condition page that mentions it. It finds the right page, not a diagnosis: a doctor gives you that on a video call.
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Similar symptoms, different condition? Erectile Dysfunction can start the same way. Compare them, or look up any other symptom in the full symptom checker.
Frequently asked questions about premature ejaculation
What is premature ejaculation?
Ejaculating sooner than you or your partner wish during sex, with little control, in a way that causes distress. In lifelong PE it happens within about a minute of penetration.
How do I know I have premature ejaculation?
Premature ejaculation means coming within about a minute of penetration, or a new drop to about 3 minutes or less, being unable to delay it nearly every time, and it bothering you or your partner. Coming early now and then is normal.
What are the main causes of premature ejaculation?
Often there is no single cause of premature ejaculation. Performance anxiety, stress, depression, relationship problems, erection problems, an inflamed prostate or urethra, thyroid problems and recreational drugs can all play a part.
Is it premature ejaculation or erectile dysfunction?
They often go together, which is why a doctor asks about both. Premature ejaculation means coming sooner than you want with little control, usually with a normal erection; erectile dysfunction means difficulty getting or keeping an erection firm enough for sex. Some men with erection problems rush to finish before the erection fades, which looks like premature ejaculation but is driven by the erection problem, so treating that comes first. Coming early now and then is normal and is neither.
How do you delay ejaculation?
To delay ejaculation, the stop-start and squeeze techniques teach control with practice. Masturbating an hour or two before sex, a thicker condom and positions that let you pause help too. Medicine can add more control.
What can I do myself about premature ejaculation?
Practise the stop-start technique: stimulate until you are close, stop until the urge fades, and repeat three or four times before finishing; or use the squeeze technique, pressing the head of the penis firmly for a few seconds at the same point. Masturbating an hour or two before sex, a thicker condom, slower positions that let you pause, and slow breathing to lower anxiety all help, and talking openly with your partner takes away the pressure that keeps premature ejaculation going.
What is the best treatment for premature ejaculation?
For lifelong PE, dapoxetine before sex or a numbing spray are the first choices, then a daily tablet. When PE is recent, treating the cause comes first. Combinations often work best.
How long should a man last in bed?
There is a wide range. In a stopwatch study of nearly 500 men in five countries, the median time from penetration to ejaculation was 5.4 minutes.
Does dapoxetine work?
It delays ejaculation for many men with premature ejaculation. It is taken 1 to 3 hours before sex, no more than once a day, after a doctor checks your heart, blood pressure and medicines.
Do delay sprays work?
A spray containing the local anaesthetics lidocaine and prilocaine is approved for lifelong premature ejaculation in Europe. Use a condom or wash before sex so your partner does not go numb.
Can an STI cause premature ejaculation?
An STI does not usually cause premature ejaculation, but an infection or inflammation of the prostate or urethra can contribute to it, especially when the problem is new, and treating the infection comes first. Pain when you pee or ejaculate, discharge, or a high temperature need tests for infection, and premature ejaculation that started alongside these often settles once they are treated.
Can premature ejaculation be cured?
Many men gain good control with techniques and treatment, and acquired PE often improves once its cause is treated. Lifelong PE may need ongoing treatment when you need it.
Can premature ejaculation be prevented?
Lifelong premature ejaculation cannot be prevented, because it is partly down to brain chemistry and genes, but it can be controlled with practice and treatment. Acquired premature ejaculation often can be: keep erections healthy by not smoking, staying active and managing weight, blood pressure and diabetes; treat anxiety, stress and low mood early; limit alcohol and recreational drugs; get prostate or urinary symptoms checked; and keep sex regular, since long gaps make coming quickly more likely.
Is premature ejaculation common?
Yes. Premature ejaculation is the most common sexual problem in men: about 1 in 5 men aged 18 to 59 report it, and 30 to 40 in 100 have it at some point in their lives. Many men never mention it to a doctor, which is a pity, because the techniques, sprays and tablets that help are simple to arrange, and a private video consultation suits it well.
Can an online doctor treat premature ejaculation?
Yes, usually. Premature ejaculation is diagnosed mainly from what you describe, so a private video consultation suits it, and the doctor can prescribe treatment when it is right for you. An examination is arranged if a physical cause is suspected.
- Ejaculation problems, NHS, National Health Service (UK), reviewed 9 February 2023.
- Sexual and reproductive health: disorders of ejaculation, European Association of Urology (EAU) guidelines, accessed 15 October 2026.
- An evidence-based unified definition of lifelong and acquired premature ejaculation, Serefoglu EC, McMahon CG, Waldinger MD, et al. International Society for Sexual Medicine. Sexual Medicine, 2014.
- A multinational population survey of intravaginal ejaculation latency time, Waldinger MD, Quinn P, Dilleen M, et al. Journal of Sexual Medicine, 2005.
- Premature ejaculation, Cleveland Clinic (US), reviewed 27 September 2023.
- Premature ejaculation, British Association of Urological Surgeons (BAUS), accessed 15 October 2026.
- Priapism, NHS, National Health Service (UK), reviewed 5 December 2023.
- Prostatitis, NHS, National Health Service (UK), reviewed 19 February 2024.
- Heart attack: symptoms, NHS, National Health Service (UK), reviewed 31 March 2026.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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