How to last longer in bed

The ways to last longer in bed with the best evidence are numbing sprays or creams used before sex and daily SSRI antidepressants prescribed off-label, with stop-start practice and pelvic floor exercises as drug-free options. The American Urological Association (AUA) recommends the medicines as first-line treatment for premature ejaculation and says combining them with behavioral techniques may work better than either alone.

Before you treat anything, it helps to know what is typical. In a stopwatch study of 500 couples in five countries, the median time from penetration to ejaculation was 5.4 minutes, ranging from under a minute to 44 minutes. The AUA notes that up to 30% of men say they ejaculate too early, but fewer than 5% meet the clinical definition. This guide covers each option, what it did in trials, and when a prescription makes sense.

What counts as premature ejaculation

The AUA’s 2020 guideline, written with the Sexual Medicine Society of North America, defines lifelong premature ejaculation as poor control, bother, and ejaculation within about 2 minutes of penetration that has been present since your first sexual experiences. Acquired premature ejaculation is a marked drop from your usual time, with the same loss of control and bother. The International Society for Sexual Medicine uses about 1 minute for lifelong and about 3 minutes for acquired.

Bother matters as much as the clock. If neither you nor your partner is distressed, there is nothing to treat. If you are, the guideline asks clinicians to take a medical, relationship and sexual history and do a brief exam, and to consider referral to a mental health professional who works on sexual problems. Being circumcised or not makes no difference to timing, according to the same guideline.

The options at a glance

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Stop-start and squeeze techniques

The stop-start technique, first described by Semans, works like this: you or your partner stimulate the penis until you feel the urge to ejaculate, then stop until the feeling passes, and repeat a few times before allowing ejaculation. With the squeeze technique, from Masters and Johnson, your partner squeezes the head of the penis until the urge fades. Both aim to teach you to recognize the build-up of arousal so you can control it.

A 2015 systematic review of 10 randomized trials with 521 men found that two trials comparing these techniques (with sensate focus, a touch-based exercise) against a waitlist reported 7 to 9 minutes longer to ejaculation. Two other waitlist trials, of a web-based program and a stimulation device, found no difference. Three trials found that adding behavioral training to a drug gave a small extra gain of 0.5 to 1 minute, plus better satisfaction and control. The authors rated the overall evidence as limited, and no harms were reported.

Kegel exercises for premature ejaculation

The pelvic floor muscles help push out semen, and training them may give you more control. To find them, MedlinePlus suggests stopping your urine midstream once: for men, they are the same muscles you would tighten to stop passing gas. Don’t make a habit of exercising while you urinate. Its general routine is to tighten for a count of 10, relax for a count of 10, and repeat 10 times, 3 to 5 times a day.

The evidence is promising but thin. In a 2014 Italian study, 40 men with lifelong premature ejaculation who lasted 1 minute or less did 12 weeks of pelvic floor muscle rehabilitation; 33 of them (82.5%) gained control, and their average time rose from 39.8 seconds to 146.2 seconds. There was no comparison group. A 2026 review of five randomized trials with 236 men found pelvic floor training alone produced smaller gains than dapoxetine or combined treatment. Expect it to help most as part of a plan, not on its own.

Numbing sprays, creams and condoms

Topical numbing is the oldest drug treatment for premature ejaculation, and the AUA lists it as first-line. In the US, over-the-counter “male genital desensitizers” are allowed under an FDA monograph (21 CFR part 348) with two ingredients: benzocaine at 3% to 7.5% in a water-soluble base, or lidocaine in a metered spray of about 10 mg per spray. The required directions for lidocaine sprays are 3 to 10 sprays on the head and shaft of the penis before sex, washed off afterwards. Stop if you or your partner get a rash, burning or itching.

What the trials measured:

• Lidocaine-prilocaine spray. In a 2007 trial of 54 men, average time to ejaculation rose by 3.8 minutes on the spray against 0.7 minutes on placebo. Mild to moderate numbness affected 3 men (12%) on the spray. No lidocaine-prilocaine spray is FDA-approved in the US.
• Umbrella review. A 2025 analysis of 65 randomized trials rated topical anesthetics and paroxetine as the only treatments with moderate to high certainty evidence, though topical anesthetics had the highest rate of side effects relative to placebo.
• Premature ejaculation condoms. The FDA has cleared condoms with benzocaine, such as Durex Condom with Benzocaine (510(k) K211152, 2022). In a 2025 randomized study of 273 men, benzocaine condoms, a lidocaine spray and a lidocaine-prilocaine cream all lengthened time to ejaculation; the spray did most and the condoms least, but the condoms had the fewest side effects. Ordinary condoms didn’t change timing in the 500-couple stopwatch study.

Premature ejaculation pills: off-label SSRIs

Boxed warning first. Sertraline and paroxetine carry a boxed warning: antidepressants increased suicidal thoughts and behaviors in children, teens and young adults in short-term studies. Anyone starting one should watch for mood changes. These drugs can also lower sex drive, cause erection problems, interact with other medicines and cause withdrawal symptoms if stopped suddenly.

No drug is FDA-approved for premature ejaculation in the US, so every pill prescribed for it is off-label. The AUA recommends daily SSRIs, or on-demand clomipramine, as first-line medicines. They work because delayed ejaculation is a known side effect: in Zoloft’s own trials for depression and anxiety, 8% of men on sertraline reported ejaculation failure, against 1% on placebo. In a 2004 analysis of 43 antidepressant studies with 1,514 men, daily paroxetine produced the strongest delay of the drugs studied, and a 2025 review put paroxetine’s average gain over placebo at 5.64 minutes. Dapoxetine, a short-acting SSRI sold for premature ejaculation in other countries, has no FDA approval, and an openFDA search for it returns no US application.

A clinician sets the drug, dose and schedule. Don’t stop an SSRI suddenly; ask how to taper.

If erections are part of the problem

The AUA lists erectile dysfunction among the possible causes of acquired premature ejaculation, and Zoloft’s label shows SSRIs can cause erection problems too (4% of men against 1% on placebo). The guideline says comorbid erectile dysfunction should be treated under its ED guideline, and ED pills such as sildenafil and tadalafil are FDA-approved for erections, not for premature ejaculation. If you have both, see our guide to the four FDA-approved ED pills.

What doesn’t have good evidence

• Supplements and herbal products. The AUA says there is insufficient evidence for alternative therapies, and the herbal trials it reviewed were small and flawed.
• Surgery and penile filler injections. The AUA calls these experimental, to be done only in an approved clinical trial, because of a risk of permanent loss of sensation.
• Erection injections. The guideline says injecting drugs into the penis doesn’t treat premature ejaculation and raises the risk of priapism in men without ED. See Trimix injections for that treatment’s real use.

Getting treatment online

Licensed telehealth providers can prescribe sertraline or paroxetine off-label for premature ejaculation after an online review; neither is a controlled substance. As of October 2026, sertraline for premature ejaculation started at $27 a month at Rex MD, including clinical care. Our premature ejaculation treatment page covers the drugs and warnings, and the ED provider rankings compare online clinics on price and care.

The bottom line

If you last a few minutes and feel fine about it, you are in the normal range. If you consistently finish within a minute or two and it bothers you, the best-tested options are numbing sprays or creams before sex and a daily SSRI prescribed off-label, with stop-start and pelvic floor training added for better results. Benzocaine condoms are an easy start with modest effect. Talk to a clinician before using an SSRI, read its boxed warning, and treat any erection problem alongside. More on the ED hub.