- Researchers say exercise such as running and yoga may be as effective as drugs to treat premature ejaculation.
- They say exercise can help curb the anxiety sometimes associated with the condition.
- Experts say a multi-faceted approach is the best way to treat the condition.
Going for a run may be the solution for some men who climax quickly during sex.
“[Premature ejaculation] is a common problem for penis owners,” Dr. Lee Phillips, a psychotherapist and certified sex and couples therapist, told Healthline. “Roughly 30 percent of my clients complain they are not satisfied with their ability to control orgasm.”
Treatment options are limited.
However, a new study suggests that non-medical interventions, such as running five days a week or attending yoga classes, can decrease the occurrence of premature ejaculation.
In some cases, researchers report, such interventions are just as effective as typical medication-based treatments for premature ejaculation, such as tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs).
The latter can have a variety of unwanted side effects, including erectile dysfunction.
Psychotherapy also has been widely utilized to address premature ejaculation, with or without being accompanied by medication.
“Sex therapy is excellent because we address the performance anxiety that takes place when all medical concerns have been ruled out,” Phillips told Healthline. “We look at this ‘new normal’ the person has developed and we work on breaking the habit by challenging anxious thinking and other somatic exercises to relax the body through grounding and meditation.”
Drug treatment limited for premature ejaculation
A multinational team of researchers led by Damiano Pizzol, PhD, a medical advisor based in Italy, conducted a literature review of 54 previously published studies on treatment of premature ejaculation.
The report, published in the journal Trends in Urology and Men’s Health, reported that only a single medication, the serotonin inhibitor dapoxetine, has been approved as a treatment for premature ejaculation in some countries.
However, dapoxetine has not been approved in the United States, where doctors instead often substitute off-label prescriptions of SSRI medications such Lexapro and Zoloft, which can reduce the anxiety associated with premature ejaculation.
How exercise may help
The researchers reported that past studies have found a variety of non-medical interventions that showed promising results for treating premature ejaculation.
These include exercises intended to tone the pubococcygeus muscle, known to be involved in ejaculation.
The researchers reported that moderate running for at least 30 minutes for five days a week for 30 days as well as engaging in yoga can be beneficial.
“These recent findings regarding the efficacy of physical activity on addressing premature ejaculation are promising, as they provide yet another option to addressing premature ejaculation,” Dr. James J. Elist, a urologist who specializes in penile corrective and enhancement surgery, told Healthline. “Some deal with acquired [premature ejaculation], others with lifelong [premature ejaculation]. Some due to stress, others due to relationship problems, and others due to physical health.”
“Given these varying causes, it’s important to have different options available,” Elist added. “Whether those are prescription options, numbing sprays, natural supplements such as mate endurance, or physical exercise, men should be aware of all options available to them when addressing an issue as frustrating as premature ejaculation.”
A multi-pronged approach
Pizzol told Healthline that the study pointed to the need for a multidisciplinary approach to treating premature ejaculation.
“Sex and sexuality are complex issues including anatomic, systemic, organic, psychologic and hormonal components, so the approach to sexual health should be holistic,” he said. “Also considering the relatively low effectiveness of existing drugs, it is important to deal with [premature ejaculation] as a couple and [as a] multifactorial problem.”
Running, for example, may improve symptoms because “physical exercise is a booster for the whole health and for all systems: endocrinological, metabolic, cardiac, vascular, mental health, [which are] all involved in sexual function,” Pizzol said.
“Another interesting finding is the yoga impact, highlighting the important role of mental condition in sexual health,” he added.
Some research suggested that treatment with erectile dysfunction medications could have the additional benefit of reducing occurrence of premature ejaculation.
“One explanation is that erectile dysfunction leads to a habit of ejaculating early that can be hard to break,” said Phillips. “The penis owners may feel rushed to orgasm quickly if they know their erection is not going to last long.”
Like premature ejaculation, erectile dysfunction is often rooted in performance anxiety and relationship problems, Philipps said. It can also be a symptom of another medical condition, such as type 2 diabetes.
Pizzol urged caution, however.
“Just a pill can not solve any disease,” he said. “Considering the multifactorial mechanism leading to [premature ejaculation], the approach should be global, considering the pharmacological treatment but looking at all aspects and all appropriate and possible adjuvant interventions.”
Dr. Sarah Melancon, a sociologist and sexologist who serves as the sexuality and relationships expert at SexToyCollective.com, told Healthline that “even when statistically significant, most [premature ejaculation] treatments are modest in practical terms.”
“The problem underlying most studies evaluating treatment outcomes for [premature ejaculation] is the difference between statistical significance, which is used to determine whether an intervention ‘worked,’ and couples’ real-life needs,” she said. “While an increase from 1 minutes to 2 or 3 minutes is statistically sizable, and partners are generally happy to experience improvement, 2 to 3 minutes is still not a satisfactory outcome for a majority.”
Melancon agreed that a multidisciplinary approach to premature ejaculation tends to be most effective.
“In my experience, combination treatment may include SSRI medication (if desired); mindfulness-style exercises to increase the patient’s awareness of their physical body; pelvic floor exercises to improve tone of pelvic muscles as well as build awareness of physical sensations in the pelvic region; the start-stop technique, ideally combined using a masturbation sleeve; [and a therapeutic relationship with a trusted counselor or therapist to help guide the process, answer questions, share concerns, and work through fears, worries, or anxieties that most men with [premature ejaculation] carry,” Melancon said.
“I always incorporate holistic practice into my work where I look at the whole individual and not just the symptoms,” added Phillips. “This includes having them engage in physical exercise and participate in pelvic floor exercises and kegel exercises.”
“When people feel healthy both mentally and physically, they feel sexually confident,” she said.
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