The current European Association of Urology (EAU) guidelines for the management of PE have suggested the use of pharmacotherapy as first-line treatment. This includes either the short-acting dapoxetine or other off-label antidepressants such as daily selective serotonin reuptake inhibitors (SSRIs).

Tramadol and topical local anesthetics might be used as weak alternatives to SSRIs. Phosphodiesterase-5 inhibitors should be used only in men with concomitant ED.

Behavioural therapy should also be used with pharmacotherapy. There are two types of behavioural therapy: psychotherapy and physical techniques.

Psychotherapy uses counselling to identify and correct any interpersonal problems which may be contributing to PE.

Physical therapies includes a variety of exercises to increase slowly the degree of genital stimulation over time, which allows the male to gain control over his ejaculation. This includes ‘stop-start’, ‘squeeze ’, sensate focuses, and pelvic floor muscle rehabilitation.