Introduction

The term “premature ejaculation” refers to ejaculating sooner than both the partner and the man would prefer during sex. PE occurs when the man has orgasms very quickly or orgasms without his control. It is also termed early ejaculation, rapid ejaculation, or premature climax. Men with PE have little or no warning before their orgasm, so they may be unable to delay it.

Premature ejaculation can be lifelong or acquired. According to the International Society for Sexual Medicine, ejaculation that always or nearly always occurs before or within about 1 minute of vaginal penetration from the first sexual experience is called a lifelong PE. Whereas a clinically significant reduction in time for ejaculation, often to about 3 minutes or less, is acquired PE.

Because PE is such a sensitive topic, many men feel uncomfortable visiting a doctor. This can lead to anxiety, depressive episodes and sexual dissatisfaction for the male and their partner.

PE can be frustrating and can impact relationships if sex is not enjoyable. Some home remedies, medications, and exercises may help delay ejaculation or help the man become more aware of their sensations and control them.

There is good news: PE is not a permanent condition. Depending on the reason behind the PE and how often it occurs, you may be able to cure it.

Treatments Available in Singapore:

Depending on the cause and whether the condition is acquired or lifelong, the treatment for premature ejaculation varies. Psychological therapy, behavioural therapy, medications, topical anaesthetics and counselling are some of the treatment options for PE. You may need to try several treatments or combinations of treatments before finding the one you’re most comfortable with. Although, in most cases, behavioural treatment and drug therapy in combination might be the most effective.

It is essential to address this issue immediately as PE can negatively affect sexual as well as mental well-being and relationships. The treatment of PE includes selective serotonin reuptake inhibitors (SSRIs) (such as dapoxetine), traditional local anaesthetics (such as lidocaine and prilocaine), and type 5 phosphodiesterase (PDE 5) inhibitors, tramadol and oxytocin, etc. Among the above treatments, only SSRIs are used for the treatment of PE, and others are used off-label.

Here are the eight best treatments available for PE in Singapore:

 

1.   Priligy (30 Mg): The only FDA- approved medication for Premature Ejaculation

This pill contains dapoxetine, which is specifically designed to treat PE. Dapoxetin is from a class of medicines known as selective serotonin uptake inhibitors (SSRIs). Studies have proved that 30 mg or 60 mg doses of dapoxetine result in a significant increase in ejaculation time and indicate greater control over ejaculation. The data also reported men experiencing more satisfaction and less ejaculation-related stress after Priligy treatment.

SSRIs boost a chemical known as Serotonin in our nerves, giving you more control over when to ejaculate. There are various types of SSRIs and multiple ways of dosing. The side effects are often limited to nausea and mild sedation.

The US FDA approves this medication for premature ejaculation, and it can be taken twice a day. In order for it to be completely effective, this pill needs to be taken 1 and 3 hours before sexual intercourse. This pill can definitely help you have more control over ejaculation and control it.

Here at Noah, a digital healthcare clinic available for men in Singapore, you can get the PE treatment you need from the comfort of home. You can see a licensed doctor, and have the prescribed PE medication discreetly delivered to your door within 4 hours at no additional cost.

The cost of Priligy at Noah is:

$65/box – 1 month

$55/box – 3 months

$50/box – 6 months

2.   Prolong Spray:

A local anaesthetic, Prolong spray contains lidocaine, which is highly effective in delaying ejaculation time. In PE, heightened sensitivity of the glance is implicated, which results in early ejaculation. When lidocaine containing spray is applied to the glans of the penis, it decreases the sprayed area’s sensitivity without overly numbing it.

Prolong spray increases the sensitivity threshold to bring slow and lasting control, thus enhancing the level of satisfaction. In a study conducted using topical lidocaine for the treatment of PE, both the men with PE and their partners reported improved levels of sexual satisfaction.

How to use Prolong spray?

Step 1: Hold the bottle 10 cm away, with the spray nozzle pointing towards the shaft of the penis.

Step 2: Press down the button fully to apply one spray on to the tip and shaft. Apply at least 15 minutes before sexual activity.

Step 3: Spread evenly for better absorption.

Step 4: After 15 minutes, you can wipe off any excess with fresh intimate wipes to prevent affecting your partner.

Noah Offers Prolong Spray at the cost of:

$45/bottle – 1 month

$39/bottle – 3 month

3.   Sertraline :

According to research, Sertraline can prolong IELT (intravaginal ejaculatory latency time) for people experiencing PE, and increase the sexual satisfaction of patients as well as their partners. Most studies of Sertraline for the treatment of PE involve a daily dose of 25 to 100mg.

Sertraline is commonly used for the treatment of depression and mental health conditions. As Sertraline is an SSRI, it can extend the time between erection and ejaculation. Studies report that it takes about four weeks of time for the treatment of Sertraline to work, and the side effects may involve an increased risk of gastrointestinal upset.

After consultation with your healthcare provider, they will let you know if you need Sertraline treatment or start you on Priligy treatment first. Sertraline is available at digital healthcare shops in Singapore.

4.   Sildenafil – 100mg (Viagra)

A lot of men suffering from PE also have Erectile Dysfunction. When getting an erection is challenging, maintaining and extending the time for the climax is nearly unattainable. Hence, while treating PE, the root cause of erectile dysfunction also needs to be treated. The good news is that Erectile dysfunction is highly treatable, and treatment is available here at Noah!

According to research, Sildenafil (Viagra) can also extend the time for ejaculation, improving the IELT at the dose of 50 Mg. Sildenafil comes from the class of PDE-5 inhibitors and can be more effective when used with a combination of SSRIs.

At Noah, Sildenafil is available at the cost of:

$50/box – 1 month

$40/box – 3 months

$35/box – 6 months

5.   Levitra – 20mg

Research says Levitra, a PDE-5 inhibitor, can have an inhibitory effect on seminal vesicles and may delay ejaculatory reflexes. A dose of this pill by prescription from your physician can provide you with sexual satisfaction and control over ejaculation.

At Noah, Levitra is available at the cost of:

$70/box – 1 month

$60/box – 3 months

$55/box – 6 months

6.   Cialis (Tadalafil) – 5 mg

Cialis is used as a daily medication for greater flexibility and spontaneity of sex in patients with erectile dysfunction. According to the mayo clinic, some medicines used to treat erectile dysfunction also might help premature ejaculation, and Cialis is one of them. According to a study, Tadalafil 5 mg daily can decrease premature ejaculation along with erectile dysfunction. Although Cialis can improve the IELT, more studies are needed as evidence for its benefits as a treatment of PE.

At Noah, Cialis is available at the cost of :

$210/box – 1 month

$200/box – 3 months

$195/box – 6 months

7.   Tramadol:

Tramadol is generally used as a pain reliever but also has shown efficacy for improving premature ejaculation when used occasionally or on a daily basis. According to research, 100 mg of tramadol can improve the sex life of patients significantly and provide greater satisfaction.

Tramadol is listed on the MOH (Ministry of Health of Singapore) website and is available in Singapore on a physician’s prescription only.

8.   Counselling:

This approach involves talking to your healthcare or mental healthcare provider and discussing your experiences and relationships. Talking about your problems can help you cope with mental stress and reduce performance anxiety. With the techniques and medications provided by Noah, most of the men will recover from PE. If not, your doctor may suggest counselling. Possibly, your doctor will recommend drug therapy in addition to mental therapy.

At Noah, you can skip all the pills and just go straight to sex therapy. Most men go for it to improve sexual performance or learn a new skill/technique to increase sexual pleasure.

The sexologist can then assess the root cause, whether physical, psychological or both. Sex therapy can help you identify your root issues and rediscover your strengths.

The Takeaway:

Treatment for PE majorly includes SSRIs such as Priligy, Sertraline and local anaesthetics such as Prolong spray (Lidocaine). Your doctor might suggest other treatment options after consultation.

Behaviour techniques, counselling, and exercises can benefit more if used in combination with medications. If you feel your PE is getting worse, it is best to see a doctor for a complete diagnosis. In some cases, there might be some underlying health condition causing it.

You can read more about PE, here.

References:

1. Dapoxetine: an evidence-based review of its effectiveness in treatment of premature ejaculation. (Link)
2. Topical lidocaine–prilocaine spray for the treatment of premature ejaculation: a proof of concept study. (Link)
3. Efficacy and safety of sertraline for the treatment of premature ejaculation (Link)
4. Sildenafil/Viagra in the treatment of premature ejaculation (Link)
5. New concepts in the diagnosis and treatment of premature ejaculation (Link)
6. Tramadol Use in Premature Ejaculation: Daily Versus Sporadic Treatment (Link)