Premature ejaculation (PE) is the most common sexual dysfunction in men. Since heightened sensitivity of the glans is implicated in PE, it seems reasonable that reducing this sensitivity could have a delaying effect on intravaginal ejaculation latency time (IVELT) without adversely affecting the sensation of ejaculation. We have developed a local anesthetic combination, in a metered-dose aerosol delivery system, that delivers lidocaine and prilocaine in base form without organic solvents. The drug can be easily removed prior to vaginal penetration, circumventing the need for a condom that most patients find undesirable. Herein, we report on a prospective open-label pilot study investigating the safety and efficacy of this novel delivery system for topical local anesthetic to the glans penis aimed at prolonging the IVELT in patients who self-reported having PE. This was an open-label prospective pilot study. The lidocaine–prilocaine (LP) aerosol delivered 7.5 mg lidocaine and 2.5 mg prilocaine, both in base form, per actuation. A total of 14 men who had been referred to urology clinics with the problem of PE were recruited. Consent was obtained from both subjects and their partners. Couples were asked to time their IVELT without treatment on one encounter, and then on five subsequent encounters were asked to apply the spray to the glans penis, leave on for 10–15 min, wipe off carefully before intercourse. The IVELT was timed with a stopwatch and then both partners were asked to rate their individual satisfaction relative to baseline without treatment. They were also asked to document any adverse events or comments. In all, 11 patients completed the study. The average IVELT increased from 1 min:24 s to 11 min:21 s (P=0.008) representing an average eight-fold increase. No subjects experienced a decrease in IVELT. The average satisfaction score for both subjects and partners was 1.0; on a scale where −1 was worse, 0 the same, +1 better and +2 much better. Topical LP spray, applied to the glans penis 15 min before intercourse, prolongs ejaculation time significantly and improves sexual satisfaction in both men with PE and their partners. The glandular numbness, noticed in only two cases, did not adversely affect the quality of the orgasm. Occasionally, a patient reported difficulty maintaining an erection while waiting the required 15 min between application of the spray and the initiation of intercourse.
This is a preview of subscription content, access via your institution
Subscribe to this journal
Receive 8 print issues and online access
$259.00 per year
only $32.38 per issue
Rent or buy this article
Get just this article for as long as you need it
Prices may be subject to local taxes which are calculated during checkout
Laumann EO, Paik A, Rosen C . Sexual dysfunction in the United States: prevalence and predictors. JAMA 1999; 281: 537–545.
Vickers MA . The forgotten dysfunction: a pharmacological approach to premature ejaculation. In Morales A. (ed). Erectile Dysfunction. Issues in Current Pharmacology. Martin Dunitz: London, 1998, pp 253–267.
DeAmicus LA et al. Clinical follow-up of couples treated for sexual dysfunction. Arch Sex Behav 1985; 14: 467–473.
Rosen C, Lane RM, Menza M . Effect of SSRIs on sexual function: a critical review. J Clin Psychopharmacol 1999; 19: 67–72.
Choi HK et al. Clinical study of SS-cream in patients with lifelolong premature ejaculation. Urology 2000; 55: 257–261.
Berkovich M, Keresteci AG, Koren G . Efficacy of prilocaine–lidocaine cream in the treatment of premature ejaculation. J Urol 1995; 154: 1360–1361.
Fischer Santos BO, deDues Vieira LA, Fischer R . Neurotomy: a new technique for the treatment of premature ejaculation. Int J Impotence Res 2001; 13(Suppl 1) 11.
Henry R . Prilocaine and hydrofluorocarbon aerosol preparations. US patent no.: 5,858,331 12 January 1999.
Reading A, Weist W . An analysis of self-reported sexual behavior in a sample of normal males. Arch Sex Behav 1984; 13: 69–74.
Frank E, Anderson C, Rubenstein D . Frequency of sexual dysfunction in ‘normal’ couples. N Eng J Med 1978; 299: 1111.
Masters W, Johnston V . Human Sexual Inadequacy. J. A. Churchill: London, 1970.
Guyton AC . Textbook of Medical Physiology. W.B. Saunders: Philadelphia, 1991.
Shilon M, Paz G, Homonnai Z . The use of phenoxybenzamine treatment in premature ejaculation. Fertil Steril 1984; 42: 659.
Greenberg H . Inhibition of ejaculation by chlorpromazine. J Nerv Ment Dis 1971; 152: 364–366.
Girgis S, El-Haggar S, El-Hermouzy S . A double-blind trial of clomipramine in premature ejaculation. Andrologia 1982; 14: 364–369.
Xin Z et al. Penile sensitivity in patients with primary premature ejaculation. J Urol 1996; 156: 979–981.
Xin Z et al. Somatosensory evoked potentials in patients with primary premature ejaculation. J Urol 1997; 158: 451–455.
Vignoli G . Premature ejaculation: new electrophysiologic approach. Urology 1978; 11: 81–82.
Colpi G et al. Evoked sacral potentials in subjects with true premature ejaculation. Andrologia 1986; 18: 583–588.
Rights and permissions
About this article
Cite this article
Henry, R., Morales, A. Topical lidocaine–prilocaine spray for the treatment of premature ejaculation: a proof of concept study. Int J Impot Res 15, 277–281 (2003). https://doi.org/10.1038/sj.ijir.3901011
- local anesthetic
- premature ejaculation
This article is cited by
Prilocaine/lidocaine spray for the treatment of premature ejaculation: a dose- and time-finding study for clinical practice use
International Journal of Impotence Research (2023)
A bibliometric analysis of international publication trends in premature ejaculation research (2008–2018)
International Journal of Impotence Research (2021)
Tramadol for the management of premature ejaculation: a timely systematic review
International Journal of Impotence Research (2015)
Current therapeutic strategies for premature ejaculation and future perspectives
Asian Journal of Andrology (2011)
Ejaculatory disorders: pathophysiology and management
Nature Clinical Practice Urology (2008)