On 20/8, Dr. Tra Anh Duy, from Men’s Health, reported a patient who sought consultation for ejaculating less than a minute after penetration. The patient had been using lidocaine spray purchased over-the-counter for over 3 months. Recently, he experienced penile numbness, reduced arousal, and complaints from his wife about his lack of sensation during intercourse.
After an examination and an intravaginal ejaculatory latency time (IELT) test, the patient was diagnosed with moderate primary premature ejaculation. The doctor advised him to discontinue the spray and transition to behavioral therapy combined with oral medication. After 8 weeks, his ejaculation time improved to over 3 minutes, and he regained sensation.
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Dr. Duy counsels a patient. Photo: Lam Anh |
Dr. Duy counsels a patient. Photo: Lam Anh
According to Dr. Duy, among the various treatments for premature ejaculation, topical medications—primarily local anesthetics—are often sought as a quick and convenient solution. However, their actual effectiveness and safety remain questionable.
Topical premature ejaculation medications typically contain local anesthetics like lidocaine or prilocaine. These agents work by inhibiting nerve conduction at sensory receptors in the glans penis, reducing sensitivity and delaying ejaculation. They act quickly, needing only 10-15 minutes of application before intercourse, without affecting the central nervous system like oral medications. Other advantages include low cost and easy accessibility, making them suitable for those who cannot tolerate or have contraindications to oral medications.
However, topical medications can cause loss of pleasurable sensation if used in high doses or incorrectly, and can numb the partner if not washed off before intercourse. Their effect is purely symptomatic, not addressing the underlying cause. Some products from unreliable sources may contain harmful ingredients. A study by Atan et al. in Andrologia found that about 18% of men using topical premature ejaculation treatments reported reduced or mildly burning sensations after intercourse, especially if the medication wasn't washed off beforehand.
Besides lidocaine, many herbal products like cao sin su, a traditional remedy from Northwest Vietnam, are also promoted for prolonging intercourse. They often contain mildly anesthetic herbs or other highland plants, applied directly to the glans penis before intercourse. However, there are no international clinical studies proving their effectiveness or safety. Some cases have reported irritation, redness, reduced pleasure, and effects on the partner if not cleaned properly after use.
Recently, the doctor treated a 41-year-old man worried about erectile dysfunction after switching from oral medication to a topical cream bought online without clear labeling, resulting in redness and irritation. Tests ruled out genital ulcers. Results showed he didn't actually have premature ejaculation (averaging 3.5 minutes), but rather performance anxiety. His condition improved after counseling, exercises, and breath control, without medication.
The doctor advises caution when using herbal products with unclear ingredients, especially without scientific backing or medical approval. When using topical premature ejaculation treatments, choose certified products with clear ingredients. Start with a small dose to test for irritation. Wipe off the medication before intercourse to avoid numbing the partner. Avoid continuous use for over 3 months without improvement.
Consult a specialist when premature ejaculation affects your sex life and mental well-being for accurate diagnosis, assessment of underlying causes, and combined treatment if needed. Men shouldn't rely solely on topical medications but should actively seek professional urological advice for suitable, long-term, and safe treatment.
Le Phuong
