Management Options for Premature Ejaculation and Delayed Ejaculation in Men

Sex Med Rev. 2020 Jul;8(3):473-485. doi: 10.1016/j.sxmr.2019.09.002. Epub 2019 Oct 23.


Introduction: Many men experience distressing issues regarding the timing of orgasm and ejaculation, such as premature ejaculation (PE) and delayed ejaculation (DE). Despite being highly prevalent, both PE and DE are poorly understood and present a management challenge for sexual medicine specialists.

Aim: To summarize existing data on the medical management of PE and DE.

Methods: A comprehensive literature review pertaining to the management of PE and DE was conducted using PubMed and for data published up until May 2019. Our focus was on double-blind, placebo-controlled trials and meta-analyses of such studies.

Main outcome measure: Peer-reviewed studies on treatment options for PE and DE were critically analyzed for results and methodological rigor.

Results: The peer-reviewed data on PE management continue to evolve. Psychotherapy, pharmacotherapy, and procedural interventions have all been associated with some degree of efficacy. A strong evidence base supports the off-label use of selective serotonin reuptake inhibitors and local anesthetics in PE given consistent increases in ejaculation latency time. Education and mental health assessments remain important components of PE management despite a dearth of peer-reviewed data on these interventions. Numerous treatment strategies have been evaluated for DE; limited data support psychotherapy, pharmacotherapy, and/or penile vibratory stimulation as management options.

Conclusion: A number of management options for PE or DE exist but none has been formally approved by the US Food and Drug Administration. New and novel treatments would be of great value in managing issues regarding the timing of ejaculation/orgasm. Martin-Tuite P, Shindel AW. Management Options for Premature Ejaculation and Delayed Ejaculation in Men. Sex Med Rev 2020; 8:473-485.

Keywords: Anorgasmia; Delayed Ejaculation; Pharmacotherapy of Delayed Ejaculation; Pharmacotherapy of Premature Ejaculation; Premature Ejaculation; Sexual Dysfunction.

Publication types

  • Review

MeSH terms

  • Ejaculation*
  • Humans
  • Male
  • Premature Ejaculation / epidemiology
  • Premature Ejaculation / physiopathology
  • Premature Ejaculation / therapy*
  • Selective Serotonin Reuptake Inhibitors / therapeutic use
  • Sexual Dysfunction, Physiological / epidemiology
  • Sexual Dysfunction, Physiological / physiopathology
  • Sexual Dysfunction, Physiological / therapy


  • Serotonin Uptake Inhibitors