Premature ejaculation in Taichung: self-check, types and treatment

In short

• Treatment: four routes: behavioural and pelvic floor training, a numbing medicine on the skin (topical anaesthetic), an oral prescription medicine, and an injection into the glans (the head of the penis) to reduce sensitivity. Most people start with the first two, often combined.
• The key question: always, or only in the last year or two? If it started recently, the guidelines advise treating the cause first; then long-term medicine is often not needed.
• First visit: one visit is enough. If suitable, you get a prescription at the same visit. Bring your current medicines (packets or a photo). You do not need a stopwatch or your partner.
• Cost: this is self-paid. Costs are explained at the consultation. You can also ask about costs on LINE before you come.

One-minute self-check

The doctor asks these five questions at every first consultation. The first answer scores 1 point, the second 2, up to 5. The total is 5 to 25.

1. When you want to delay ejaculation, can you control it?

(1) Yes  (2) Mostly  (3) About half the time  (4) Mostly not  (5) Not at all

2. After penetration, about how long until you ejaculate? A rough guess is enough.

(1) More than 5 minutes  (2) 3–5 minutes  (3) 1–3 minutes  (4) About 1 minute  (5) Just before or at penetration

3. How often does this happen?

(1) Almost never  (2) Occasionally  (3) About half the time  (4) Most of the time  (5) Almost every time

4. How heavy is the emotional burden?

(1) I do not really mind  (2) A little  (3) It clearly bothers me  (4) I often feel upset  (5) It affects me a lot

5. Have you changed what you do because of it? For example, avoiding sex, having sex less often, or not daring to start.

(1) No  (2) Occasionally  (3) At times  (4) Often  (5) Almost always

• 5–9 points: little effect on your life now, and no hurry. If it still worries you, read the “subjective” type below.
• 10–16 points: it is already affecting you. The first step is finding your type: “always” and “started recently” need completely different first steps.
• 17–25 points: control, frequency and burden are all clearly affected. Do not buy topical products of unknown content online; the clinic has treated local burns caused by them. Book an assessment: your type and related problems (erections, urinary symptoms) can be checked at one visit.

This clinic based these questions on the three elements used by the International Society for Sexual Medicine (ISSM): time, control and distress. It is not a validated scale, and the score is not a diagnosis. A doctor decides your type and treatment in person.

How short is “premature”? Three things together

According to data in the American Urological Association and Sexual Medicine Society of North America (AUA/SMSNA) guideline, the median time from penetration to ejaculation is 5 to 6 minutes (range 6 seconds to 52 minutes). Only 2.5–6% of men take less than 2 minutes, and 0.5–3% less than 1 minute. The time falls slightly with age, but premature ejaculation does not become more common. A 2009 study of 474 men in five countries found medians from 4.4 minutes (Turkey) to 10.0 minutes (UK), with no significant effect of circumcision or condoms (Waldinger 2009).

But time is only one condition. The ISSM unified definition (2014) needs all three:

1. A short intravaginal ejaculation latency time (IELT): since the first sexual experience, ejaculation almost always within about 1 minute after penetration; or a clear drop from normal to about 3 minutes or less.
2. Unable to delay ejaculation almost every time. The key is no control, not a short time.
3. Negative personal effects: distress, frustration, stress, or avoiding intimacy.

If the time is short but neither partner is bothered, it is not treated as a disease. If the time is normal but you feel anxious and avoid sex, what needs attention may not be ejaculation itself. Your own time estimate is enough. For the lifelong type, the AUA/SMSNA use a cut-off of about 2 minutes, not 1, so you will see both numbers online.

When did it start? Four types, four first steps

This is the first thing the doctor asks. Figures show how common each type is among men in general (two large surveys cited by the European Association of Urology, EAU: Serefoglu 2011, Turkey; Gao 2013, Anhui, China).

• Lifelong (always, since the first sexual experience; about 2.3–3.2%, the least common). The cause is unclear; studies suggest a low ejaculation-reflex threshold or higher local sensitivity, but data are limited. The focus is control and sensitivity, without many tests.
• Acquired (normal before, faster in the last year or two; about 3.9–4.8%). Something has changed: look for the cause (next section). Medicine alone only suppresses the symptom until you stop.
• Variable (sometimes fast, sometimes not, with no fixed pattern; about 8.5–11.4%, the most common). The EAU sees this as normal variation; behavioural techniques may help.
• Subjective (the time is actually in the usual range, but you are not satisfied and avoid sex; about 5.1–6.4%). The doctor talks with you first, and may suggest psychological counselling.

The last two types together are more common than the first two. A low score is still a reason to come. Send us your score, when it started and your current medicines on LINE.

If it started recently: what to check first

A later change is often a sign of something else. The clinic checks, in order:

• Erections becoming less stable. Worry about losing the erection makes you speed up, and it becomes a habit. Both are assessed together, and the erection is usually treated first. See erectile dysfunction and low-intensity shockwave therapy.
• Prostate or urinary tract inflammation, especially with aching in the perineum (between the scrotum and the anus), discomfort after long sitting, or waiting before urine starts. A urine test comes first. See chronic pelvic pain syndrome and the urinary symptom self-check (Chinese).
• Thyroid and hormones, if you also feel tired, have fewer morning erections or less interest in sex. See the testosterone self-check.
• New or changed medicines. Bring the packets or photos.
• Sleep, alcohol, routine and relationship stress, the easiest to change.

When the cause is treated, long-term medicine is often not needed. So most of the first visit is spent on this, not on choosing a medicine.

Pelvic floor muscle training

The last stage of the ejaculation reflex depends on rhythmic contractions of two pelvic floor muscles (the bulbospongiosus and ischiocavernosus). These muscles can be trained. Of the four routes, this one has the lowest risk. You can do it at home, with no equipment, starting tonight.

The AUA/SMSNA advise telling patients that combining behavioural methods with medicine may be more effective than either alone (moderate recommendation, grade B). A 2025 meta-analysis of 8 randomised trials (656 people) found that in lifelong cases, adding non-drug treatment (including pelvic floor training, not magnetic stimulation) to a short-acting oral medicine was better than the medicine alone (moderate certainty). Trials of training alone are few, small and mostly single-centre. So it is a good start, but not advised as the only route.

Find the right muscle: the feeling is between “holding in wind” and “stopping urine halfway”. Put a hand on your lower abdomen: if it tightens clearly, or you hold your breath, you are using the wrong muscles. Keep the thighs and buttocks relaxed. The doctor can check this at the same visit.

How: squeeze for 3 seconds, relax for 3 seconds; 3 sets of 10, three times a day. Most studies observe for 8 to 12 weeks. If there is no progress, come back; do not extend or increase it on your own.

With perineal pain, discomfort after sitting, or waiting before urine starts, the pelvic floor may be too tight rather than weak, and strengthening can make symptoms worse. See pelvic floor tone assessment (Chinese).

The four routes compared

The order depends on your type, and routes are often combined. Side effects and contraindications are under “Risks and limits”.

The EAU also strongly recommends that if premature ejaculation comes with erectile dysfunction, another sexual problem or a genital or urinary infection (for example prostatitis), that problem is treated first.

The first visit

1. Questions to find your type (this takes the most time).
2. Related problems: erection stability, urinary symptoms, and your current medicines (bring the packets or photos).
3. Physical examination, with pelvic floor tone if needed. A prostate examination (finger exam through the anus) is usually not done; it may be suggested only with perineal discomfort or urinary symptoms, with the reason explained first. You can say no to any test.
4. Tests if needed: urine test, a check of sexually transmitted infection risk, or thyroid and hormone tests.
5. The plan: the order of treatment, with the limits and risks of each. If suitable, you get a prescription at the same visit.

Glans injection: if you meet the conditions above and booked in advance, it can be done at the first visit after assessment (not for the acquired type, where the first visit looks for the cause). After the injection, avoid sex and masturbation for 7 days, and do not shave the area during that time. The visit takes about 1–2 hours, so you can travel home the same day.

Privacy: registration and waiting use private rooms and separate routes, so you never explain your visit in a public area. You can also write it on LINE first.

Frequently asked questions

Risks and limits

Effects differ from person to person. No treatment suits everyone, and none can promise a result. The oral and topical medicines are prescription-only, after an in-person assessment. Do not buy them yourself or pass them to others.

Oral dapoxetine: may cause nausea, dizziness and headache; a few people have a drop in blood pressure on standing, or fainting. Do not combine with alcohol. It must not be combined, or needs a limited dose, with serotonin medicines such as antidepressants, and with some antifungal, antiviral and antibiotic medicines. Use with caution with erection medicines (PDE5 inhibitors); people using these for erectile dysfunction should not use it. Heart disease, moderate to severe liver impairment and some other conditions are contraindications or need individual assessment. Following its approved product information, it must not be combined with products containing L-tryptophan or St John’s wort, and you must wait 14 days after stopping them. Bring the packaging of any herbal medicines or supplements you take.

Topical anaesthetics: may cause local burning, stinging and too much numbness, and can affect erection. The medicine can pass to a partner through contact. Not suitable if you are allergic to local anaesthetics, or have inflammation or broken skin in the area.

Glans hyaluronic acid injection: an invasive procedure and an off-label use, done after a numbing cream. It may cause bleeding, infection, lumps (nodules), an uneven surface, or an appearance that is not as expected. Rarely, a local blood vessel can be blocked. The evidence is limited (see the guideline positions above).

Behavioural and pelvic floor training: low risk, but needs time. The EAU rates the evidence for behavioural therapy as weak and inconsistent. Pelvic floor trials are small and mostly single-centre.

Magnetic stimulation chair: outside its approved use for ejaculation control, and still being studied. You may feel mild numbness or tingling in the lower abdomen; a few people have aching for 1–2 days. Come back if you have pain that does not go away, blood in the urine or difficulty urinating. Following its approved instructions, it is not recommended for older people, children, or people with a fever, epilepsy or suspected epilepsy, signs of injury to the brain or neck, a heart pacemaker, a drug infusion pump, a hearing aid, a skull implant or any metal implant; a doctor’s approval is needed first. Do not wear metal items during treatment, as they can cause serious skin burns. Full list: magnetic chair contraindications (Chinese).

Full indications, use, interactions and contraindications follow the Chinese product information approved by the Ministry of Health and Welfare, and the doctor’s assessment. Patients under 18 should come with a legal guardian.

Related pages

• Erectile dysfunction and low-intensity shockwave therapy
• The first visit for erection problems
• Male menopause and testosterone self-check
• Glans hyaluronic acid injection: conditions and visits (Chinese)
• Pelvic floor magnetic stimulation chair (Chinese)
• Circumcision

Appointments and access

Consultations are conducted in Mandarin, and can also be conducted in English.

Three things are enough to start: when it started, your self-check score, and the medicines you take now.

昭安泌尿科診所 (Morning Urology Clinic)
No. 98, Boguan 2nd St., West District, Taichung City 403, Taiwan（403 臺中市西區博館二街98號）
Consulting hours: Monday to Saturday (closed Sunday). Online booking is open 24 hours.

This page was produced by 昭安泌尿科診所 (Morning Urology Clinic). Medical content last updated: October 2026 (same as the Traditional Chinese version). English version published: 5 November 2026. Medically reviewed by Dr. Chao-An Chen, urologist.

Sources: EAU Guidelines on Sexual and Reproductive Health 2026: Disorders of Ejaculation / Disorders of Ejaculation: An AUA/SMSNA Guideline / ISSM unified definition, 2014 / ISSM guidelines, 2014 / Waldinger 2009 / Serefoglu 2011 / Gao 2013 / Nieves Martín 2025 / Morris & Krieger 2013 / Morales 2009 / Wang 2026 / NCT07627438 / Dapoxetine product information approved in Taiwan (2 July 2024) and the approved Chinese instructions for the pelvic floor magnetic stimulation device (December 2022).

This page provides general medical information and does not replace an individual diagnosis or treatment plan.