Concerns About Long-Term Use of Topical Anesthetics for Premature Ejaculation

Injury

Hello, Dr.
Lin.
I would like to ask about my condition of premature ejaculation.
I have been using a topical anesthetic cream prescribed by my doctor for this issue, but I am concerned about the long-term effects on my penis.
Additionally, I feel that the anesthetic cream is not very effective, as I still experience ejaculation within five minutes.
Should I consider taking medication instead? Would Western medicine be better, or should I continue with traditional Chinese medicine? I have been taking Chinese medicine, but I haven't seen significant results, so I am considering switching to Western medication to see if it can help.
Are there any side effects associated with Western medications? Also, given my age, am I eligible to take Cialis? Are there any harmful side effects? If prescribed by a hospital, what is the cost of Cialis?
I apply the anesthetic cream from the middle of the penis to the glans.
Is this correct? How much should I apply each time? Thank you.
Furthermore, I also have issues with achieving a firm erection.
The combination of premature ejaculation and erectile difficulties is quite distressing for me.
My daily routine is normal, and I receive adequate sexual stimulation, yet I still face problems with maintaining an erection and hardness.
While this may not be classified as erectile dysfunction, it is still troubling.
Do you have any solutions for these issues? Although I am not yet married, I would like to address these problems before marriage.
Thank you for your assistance!

yi wen, 20~29 year old female. Ask Date: 2007/04/27

Dr. Lin Hexing reply Urology

Hello, regarding the treatment of premature ejaculation, there is currently strong evidence from evidence-based medicine supporting the use of topical anesthetic creams and selective serotonin reuptake inhibitors (SSRIs) as effective options.
Additionally, the combination of medications like Viagra (sildenafil) or Cialis (tadalafil) can also help increase the duration.
Furthermore, in South Korea, a product called SS-CLEAM, made from nine plant extracts, has shown in clinical trials to extend the average ejaculation time from 1.37 minutes to 10.92 minutes, providing another simple and convenient option; however, it is not yet available in Taiwan.
The application of topical anesthetic cream should focus primarily on the glans penis.
The price of Cialis varies by provider, but a typical 20 mL unit is priced around 500 TWD.

Reply Date: 2007/04/27

More Info

When it comes to the long-term use of topical anesthetics for premature ejaculation (PE), there are several important considerations to keep in mind. Topical anesthetics, such as lidocaine or prilocaine, are often prescribed to help delay ejaculation by numbing the penis. While they can be effective for some individuals, their long-term use may raise concerns regarding potential side effects and effectiveness.

Potential Risks of Long-Term Use
1. Skin Irritation and Sensitivity: Prolonged use of topical anesthetics can lead to skin irritation, redness, or allergic reactions. The skin on the penis is sensitive, and repeated application may cause discomfort or a decrease in sensitivity over time.

2. Desensitization: Over time, the body may become accustomed to the anesthetic, leading to reduced effectiveness. This means that while the anesthetic may initially help with PE, its efficacy could diminish with continued use.

3. Impact on Sexual Experience: While the goal of using these anesthetics is to prolong sexual activity, they may also reduce overall sexual pleasure for both partners. If the anesthetic numbs the penis too much, it could lead to a less satisfying experience.

Alternative Treatments
Given your concerns about the effectiveness of topical anesthetics, it may be worth exploring other treatment options for PE. These can include:
1. Oral Medications: There are several oral medications that can help with PE. Selective serotonin reuptake inhibitors (SSRIs), such as paroxetine or sertraline, are often prescribed off-label for this purpose. They can help delay ejaculation but may have side effects, including nausea, fatigue, or changes in libido.

2. Behavioral Techniques: Techniques such as the "stop-start" method or the "squeeze" technique can be effective in managing PE. These methods involve training the body to recognize the point of no return and learning to control ejaculation.

3. Counseling or Therapy: Sometimes, psychological factors contribute to PE. Speaking with a therapist or counselor can help address any underlying issues, such as anxiety or relationship concerns.

Concerns About Erectile Dysfunction
You mentioned experiencing issues with achieving and maintaining an erection. This can be related to various factors, including psychological stress, anxiety, or even the use of topical anesthetics. It is essential to address both PE and erectile dysfunction (ED) simultaneously, as they can be interconnected.

1. Viagra (Sildenafil): This medication is commonly prescribed for ED and can help improve blood flow to the penis, aiding in achieving and maintaining an erection. However, it is crucial to consult with a healthcare provider to determine if it is appropriate for you, especially considering your age and overall health.

2. Lifestyle Changes: Regular exercise, a balanced diet, and avoiding excessive alcohol or tobacco use can significantly improve sexual health. Stress management techniques, such as mindfulness or yoga, can also be beneficial.

Consultation with a Healthcare Provider
Before making any changes to your treatment plan, it is vital to consult with a healthcare provider. They can evaluate your specific situation, discuss the potential benefits and risks of various treatments, and help you find the most suitable approach for managing both PE and ED.

Conclusion
In summary, while topical anesthetics can be helpful for premature ejaculation, long-term use may lead to diminishing returns and potential side effects. Exploring alternative treatments, including oral medications and behavioral techniques, may provide a more effective and sustainable solution. Additionally, addressing any erectile dysfunction concerns is crucial for overall sexual health. Always consult with a healthcare professional before starting or changing any treatment regimen.

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