From the Guidelines
EMLA cream can be used off-label to treat premature ejaculation by reducing penile sensitivity, but its use should be approached with caution due to potential side effects and the need for proper application and removal techniques. The most recent and highest quality study on this topic, published in 2022 in The Journal of Urology, suggests that topical anesthetics such as lidocaine and prilocaine are moderately effective in delaying ejaculation 1. EMLA cream, which contains 2.5% lidocaine and 2.5% prilocaine, can be applied topically to the glans penis and frenulum 20-30 minutes before sexual activity to decrease sensitivity and potentially extend the time before ejaculation. However, it is essential to cover the cream with a condom or thoroughly wash it off before sexual contact to prevent numbing of the partner, as noted in the 2022 study 1.
Some key points to consider when using EMLA cream for premature ejaculation include:
- Applying a small amount (about a pea-sized portion) to the affected area 20-30 minutes before sexual activity
- Wiping or washing off the cream before intercourse to prevent transfer to the partner
- Potential side effects, such as temporary loss of sensitivity, mild irritation, or allergic reactions
- The need for a comprehensive approach that may include behavioral techniques and communication with partners
- Consulting a healthcare provider before using EMLA cream for this purpose to ensure proper usage and to discuss potentially more effective treatment options, as the 2004 study also highlights the importance of proper usage and potential limitations of topical anesthetics 1.
Overall, while EMLA cream may be a useful off-label treatment for premature ejaculation, its use should be carefully considered and approached with caution to minimize potential side effects and ensure effective treatment.
From the Research
EMLA Cream for Premature Ejaculation
- EMLA cream, a topical anaesthetic, is used to treat premature ejaculation (PE) by reducing the sensitivity of the penis 2, 3.
- The cream contains a eutectic mixture of lidocaine and prilocaine, which helps to delay ejaculation 3, 4.
- Studies have shown that topical anaesthetics, including EMLA cream, are effective in treating PE, with significant improvements in intravaginal ejaculatory latency time (IELT) and patient-reported outcomes 2, 5, 4.
- However, the use of EMLA cream for PE is not without side effects, and patients should be aware of the potential risks and benefits 6, 5.
Mechanism of Action
- The exact mechanism of action of EMLA cream in treating PE is not fully understood, but it is thought to involve the reduction of sensory input from the penis, allowing for greater control over ejaculation 2, 3.
- The cream works by blocking the transmission of nerve signals, reducing the sensitivity of the penis and delaying ejaculation 3, 4.
Efficacy and Safety
- Studies have shown that EMLA cream is effective in treating PE, with significant improvements in IELT and patient-reported outcomes 2, 5, 4.
- The safety profile of EMLA cream is generally good, with few reported side effects 6, 5.
- However, patients should be aware of the potential risks and benefits of using EMLA cream for PE, and should discuss their treatment options with a healthcare professional 6, 5.
Comparison with Other Treatments
- EMLA cream is one of several treatment options available for PE, including selective serotonin reuptake inhibitors (SSRIs), phosphodiesterase type 5 inhibitors (PDE5Is), and behavioural therapies 2, 6, 5.
- The choice of treatment will depend on the individual patient's needs and preferences, as well as the severity of their PE 6, 5.