Premature ejaculation (PE) is a very common condition, but often experienced in silence due to embarrassment. Its impact on self-confidence and couple life can be profound, generating performance anxiety, frustration, and relational tension. If you’re looking for a premature ejaculation treatment in London, it’s important to know that effective solutions exist. This dysfunction, defined as the inability to control ejaculation, is not a simple “timing issue”, but a medical condition requiring a specialist approach.
Prof. Fabio Castiglione, an internationally renowned urologist and andrologist, offers cutting-edge, personalized treatment pathways. At his London clinic, he has developed a multidisciplinary approach to address the problem at its root and restore patients to serene, fulfilling intimacy.
Premature ejaculation treatment in London: Causes and Risk Factors—Why It Happens
Premature ejaculation is a complex condition, rarely attributable to a single cause. More often, it results from an interaction of organic, psychological, and behavioral factors. Identifying the origin of the problem is essential to defining the most effective therapy.
Organic Causes:
- Glans Hypersensitivity: A heightened neurological sensitivity at the penile glans can lower the excitation threshold needed to trigger the ejaculatory reflex.
- Hormonal Factors: Imbalances in hormones such as serotonin, dopamine, or thyroid hormones can influence ejaculatory control.
- Inflammation: Prostatitis (prostate inflammation) or urethritis can irritate the nerves involved in ejaculation.
- Erectile Dysfunction: Paradoxically, fear of losing an erection can lead to hurried, uncontrolled ejaculation.
- Genetic Factors: A family predisposition seems to play a role in some cases of primary PE.
Psychological and Relational Causes:
- Performance Anxiety: Obsessive worry about not satisfying one’s partner is a chief driver of premature ejaculation.
- Stress and Depression: General psychological conditions can alter the neurotransmitters that regulate mood and sexual control.
- Early Sexual Experiences: Initial experiences that were rushed or took place in anxiety-provoking contexts can create a difficult-to-change “imprinting.”
- Relationship Issues: Unresolved tensions, lack of communication, or conflicts can also manifest in the intimate sphere.
Habits and Lifestyle:
- Alcohol and Substance Use: Abuse of alcohol or certain drugs can impair neurological control.
- Smoking: Cigarette smoking damages circulation and can negatively affect overall sexual function.
- Sedentary Lifestyle: A lack of physical activity can contribute to poor general health, including sexual health.
Frequently Asked Questions (FAQ)
Addressing premature ejaculation raises many doubts. Here are answers to some of the most common questions patients ask during consultations in London.
What is the best treatment for premature ejaculation in the UK?
There is no single “best” treatment for everyone. The most honest and scientifically accurate answer is: the best treatment is the personalized one. In the UK, and especially at centers of excellence like Prof. Castiglione’s Erectile Dysfunction Clinic London, the winning approach is an integrated one. This means combining different strategies based on the diagnosis:
- On-demand pharmacological therapies for rapid control.
- Behavioral and physiotherapy interventions for long-term control.
- Regenerative therapies such as shockwaves in selected cases.
- Psychological and sexological support to tackle underlying causes. The gold standard is a treatment plan that unites multiple methods, monitored by a specialist.
Looking for a definitive premature ejaculation treatment in London? Call Prof. Castiglione’s clinic now at +447830398165 for a private consultation.
How much does treating premature ejaculation in London cost?
The cost of a premature ejaculation treatment in London varies greatly depending on the nature and duration of the therapeutic pathway. An initial specialist consultation with an andrologist can cost from £250–£350. Diagnostic tests (hormonal panels, penile Doppler ultrasound) may add further costs. Comprehensive treatment plans, including cycles of physiotherapy, shockwave therapy, or counseling, can range from £1,500 to over £4,000. It’s important to view this as an investment in your health and well-being. Many private insurers (such as Bupa, AXA PPP) may cover part of the costs for visits and tests.
Why does my partner ejaculate prematurely?
This is a question many partners ask, often feeling unjustly responsible. It’s crucial to understand that premature ejaculation is nobody’s “fault.” The causes, as we’ve seen, are multifactorial: biological, psychological, or a mix of both. The most important thing is to approach the topic with empathy, openness, and without judgment, encouraging your partner to seek specialist help. Couples therapy is often a key component of successful treatment.
Overview of Available Therapies in 2025
Sexual medicine has made great strides. Today, a modern approach to premature ejaculation treatment includes a range of effective options that go well beyond simply prescribing a drug.
On-Demand Medications (Dapoxetine, Low-Dose SSRIs)
Selective serotonin reuptake inhibitors (SSRIs) are drugs that, by increasing serotonin levels in the brain, help delay ejaculation.
- Dapoxetine: The first drug specifically approved for PE. Taken on-demand, 1–3 hours before intercourse, it offers good control with generally mild side effects.
- Low-dose SSRIs (e.g., Sertraline): Used “off-label” at doses lower than for depression, they can be taken daily or as needed to improve ejaculatory control.
Next-Generation Desensitizing Sprays and Topicals
These products (sprays or creams) contain mild local anesthetics (such as lidocaine and prilocaine). Applied to the glans 10–15 minutes before intercourse, they reduce hypersensitivity without compromising pleasure. Newer formulations are designed not to be absorbed by the partner.
Exercises and Biofeedback (Kegel, Start-Stop, Squeeze)
These are essential behavioral techniques to regain bodily control.
- Kegel Exercises: Involve contracting and relaxing the pubococcygeus muscle, fundamental for ejaculatory control. A specialized physiotherapist can teach correct execution.
- Start-Stop Technique: During masturbation or intercourse, stop as soon as orgasm is imminent, wait for the sensation to subside, then resume.
- Squeeze Technique: Similar to the above, but when stopping, squeeze the base or tip of the glans with your fingers for a few seconds to reduce urgency.
Low-Intensity Shockwaves and Pshocks as a Regenerative Option
This is one of the most innovative frontiers. Although shockwaves (LI-ESWT) are primarily used for erectile dysfunction, recent studies and Prof. Castiglione’s clinical experience suggest a potential role even in selected PE cases, especially when associated with chronic prostatitis or a vascular component.
The Pshocks protocol, devised by Prof. Castiglione, synergistically combines shockwaves with PRP (Platelet-Rich Plasma) to stimulate tissue regeneration and improve penile neurological and vascular health. This option can be considered for patients unresponsive to conventional therapies.
Psychological Therapy (CBT, Mindfulness, Couples Sex-Therapy)
Psychological intervention is crucial, especially when anxiety and stress are primary culprits.
- Cognitive-Behavioral Therapy (CBT): Helps identify and modify negative thoughts and dysfunctional behaviors related to sex.
- Mindfulness: Teaches focus on the present moment and bodily sensations, reducing performance anxiety.
- Couples Sex-Therapy: Involves both partners to improve communication, reduce pressure, and rediscover intimacy.
Surgical Options (Rare Cases)
Surgery for premature ejaculation is rare and reserved for very specific cases, such as frenuloplasty for a short frenulum causing hypersensitivity and pain. Circumcision is sometimes proposed, but its efficacy is not universally proven and must be carefully discussed with a specialist. Selective dorsal neurectomy is almost entirely abandoned due to high risk of permanent complications.
The solution exists. For your premature ejaculation treatment in London, trust Prof. Castiglione’s expertise. Start your journey today: call +447830398165 for a private consultation.
Prof. Castiglione’s Services: A Unique Approach in London
At the Erectile Dysfunction Clinic London, Prof. Fabio Castiglione offers a diagnostic and therapeutic pathway of excellence, based on a holistic, personalized model.
Multidisciplinary Evaluation Protocol
Every pathway begins with an accurate diagnosis, going beyond a simple symptom description.
- Comprehensive Medical History: Detailed discussion of the patient’s—and the couple’s—sexual, medical, and psychological history.
- Measurement of Intravaginal Ejaculatory Latency Time (IELT): The patient records the time between penetration and ejaculation.
- Validated Questionnaires (e.g., PEDT): Use of scientific tools to quantify problem severity and perceived distress.
- Hormonal and Biochemical Tests: To rule out organic causes like thyroid issues or low testosterone.
- Penile-Scrotal Ultrasound and Doppler: To assess inflammation (prostatitis) or other anatomical anomalies.
Personalized Treatment Plans and Monitoring
Based on results, Prof. Castiglione crafts a bespoke treatment plan that may include:
- A combination of on-demand medications.
- A pelvic floor physiotherapy program with specialists from his team.
- In-house sexological counseling.
- Innovative protocols such as Pshocks in selected cases.
Patients receive quarterly follow‑ups to evaluate progress, adjust therapy, and provide ongoing support. This approach ensures treatment adapts to the patient’s evolving condition.
Indicative Costs and Insurance Coverage (NHS/Bupa/Private)
Prof. Castiglione operates privately, ensuring minimal waiting times and utmost discretion. His services are covered by major UK private health insurers, such as Bupa, AXA, Cigna, and WPA. It’s always advisable to check your policy details. For uninsured patients, the clinic provides clear, detailed quotes for each treatment phase. Although Prof. Castiglione also serves as a Consultant at King’s College Hospital (NHS), the innovative therapies and integrated pathways described are primarily available at his private practice.
Practical Tips to Improve Control
Alongside medical therapies, some lifestyle changes can make a big difference:
- Diet: A balanced diet rich in zinc (oysters, red meat, seeds) and magnesium (leafy greens, nuts) supports sexual health.
- Sleep: Getting 7–8 hours per night is vital for hormonal balance and stress management*.
- Alcohol: Reduce alcohol intake, especially before sexual activity*.
- Exercise: Aerobic activities (running, swimming) boost circulation and mood, while yoga can enhance body awareness*.
Conclusion: Regain Control of Your Intimacy
Premature ejaculation is not a life sentence, but a medical condition that can and should be treated. Embarrassment and misinformation are the real enemies. In London, there are concrete, scientifically sound, and cutting‑edge solutions to address the problem definitively. Prof. Fabio Castiglione’s holistic approach, integrating the best pharmaceutical, physiotherapeutic, regenerative, and psychological treatments, represents the most effective path to rediscovering control, confidence, and the pleasure of a fulfilling sex life. Don’t let premature ejaculation control your life. The first—and most important—step is to seek help from a qualified specialist.