Medically reviewed by Assoc. Prof. Dr. Tuncay Taş
Premature ejaculation is the most common male sexual dysfunction worldwide. Dr. Tuncay Tas offers a comprehensive, personalised approach — combining medical, behavioural and minimally invasive surgical options — to help men regain control and confidence. All consultations are handled with complete discretion.
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Premature ejaculation (PE) is defined as ejaculation that occurs sooner than desired — typically within one to two minutes of penetration — causing distress to one or both partners. It is estimated to affect 20–30% of men at some point in their lives, making it the most prevalent male sexual complaint.
PE is classified into two main types:
Both forms are treatable. A thorough evaluation by a specialist is the first step to identifying the underlying cause and selecting the most effective treatment strategy.
Causes may include neurobiological factors, penile hypersensitivity, psychological components, relationship dynamics, or an underlying condition such as erectile dysfunction.
Dr. Tas evaluates each patient individually and designs a treatment plan combining the most effective options for their specific case.
The Most Widely Prescribed Approach for PE
Oral medications are often the first treatment recommended for premature ejaculation, particularly for lifelong PE with a neurobiological basis.
SSRIs are the most commonly used class of medication for PE. They work by delaying ejaculation through their effect on serotonin pathways in the brain. Options include:
For men with both PE and erectile dysfunction, phosphodiesterase-5 inhibitors (such as sildenafil or tadalafil) may be prescribed alongside SSRIs. This combination can be particularly effective when anxiety about erection quality contributes to early ejaculation.
Reducing Penile Sensitivity to Delay Ejaculation
Topical agents reduce hypersensitivity of the glans penis, which is a key contributing factor in many cases of PE.
Applied 20–30 minutes before intercourse, these formulations temporarily reduce penile sensitivity without affecting erection quality when used correctly. The EMLA cream and Fortacin spray are among the most widely studied options.
Correct application technique is important to avoid transferring the agent to the partner. Dr. Tas discusses proper use in detail during consultation.
Retraining Ejaculatory Control Through Structured Techniques
Behavioural techniques aim to increase a man's awareness of arousal levels and improve voluntary control over ejaculation. They are particularly effective for acquired PE and when psychological factors are present.
The patient (alone or with a partner) pauses stimulation just before the point of ejaculatory inevitability, waits for the sensation to subside, then resumes. Repeated regularly, this builds greater awareness and control.
At the point of near-ejaculation, gentle pressure is applied to the glans penis for several seconds to reduce arousal. Over time, this technique trains the ejaculatory reflex.
When anxiety, performance pressure or relationship issues contribute to PE, working with a psychosexual therapist — either alone or with a partner — can produce significant and lasting improvement, especially when combined with medical treatment.
A Minimally Invasive Surgical Option for Lifelong PE
For patients with lifelong PE caused by penile hypersensitivity who have not responded adequately to medical and behavioural treatments, selective dorsal neurectomy (SDN) is a surgical option that can produce significant, lasting improvement.
SDN involves the selective cutting of some of the dorsal nerve branches of the penis, reducing excessive sensory input to the ejaculatory centre. The procedure is performed under local or spinal anaesthesia and typically takes 30–60 minutes.
Patient selection is critical. Dr. Tas conducts a thorough pre-operative assessment including neurological evaluation to ensure SDN is appropriate for each individual patient.
Istanbul has become a destination of choice for men seeking discreet, effective treatment for sexual health conditions. A combination of clinical expertise, modern facilities and cost advantage makes it a compelling option for international patients.
Many men prefer to seek treatment for sexual health conditions away from their home country, where privacy concerns or limited specialist access are a barrier. Istanbul provides world-class andrology care in an environment specifically designed for international patients.
Dr. Tas works with each patient to build an individualised treatment plan — starting from the least invasive option and progressing only when needed. Most patients achieve meaningful improvement without surgery.
In many cases, yes. Acquired PE often resolves completely with appropriate medical or behavioural treatment. Lifelong PE can be significantly improved — sometimes to the point that patients no longer experience it as a problem — using a combination of oral therapy, topical agents and behavioural techniques.
For patients with severe lifelong PE due to penile hypersensitivity who have not responded to other treatments, surgical options such as selective dorsal neurectomy can produce long-lasting improvement.
On-demand treatments (dapoxetine, topical agents) take effect within 1–3 hours of application and can be noticed from the very first use. Daily SSRI therapy typically requires 1–2 weeks of consistent use before a clear effect is seen.
Behavioural techniques require practice over several weeks but can produce lasting improvements in ejaculatory control without ongoing medication.
Surgical treatment results are usually apparent within 4–6 weeks of recovery.
Absolutely. All enquiries, consultations and medical records are handled with strict confidentiality. Many of our international patients specifically choose to seek treatment abroad for this reason. Our team understands the sensitive nature of sexual health conditions and ensures complete discretion at every stage.
Yes. Many patients who travel for PE treatment also discuss related concerns such as erectile dysfunction, penile enhancement or testosterone management. Dr. Tas offers a complete men's health assessment and can address multiple concerns within the same consultation or visit.
Combining procedures where clinically appropriate can reduce the number of trips required and allows for a more integrated treatment plan.
Speak confidentially with our international patient team — no commitment required.
Medically reviewed by Assoc. Prof. Dr. Tuncay Taş