Delay Sprays and Creams for Premature Ejaculation: How They Work, Side Effects and Risks
Delay sprays and creams are topical anaesthetic products that reduce glans sensitivity; controlled studies have reported a longer time to ejaculation than with placebo. How the effect varies between people and products, side effects, transfer to a partner, who should avoid them and the risks of unlicensed “herbal” products are covered here.
A man who is distressed by not being able to last in intimacy may come across “delay spray” advertisements at the pharmacy or online and ask: “Do these products really work, can they cause harm, and will they pass to my partner?” Out of embarrassment, many people try a product on their own before asking a doctor, and sometimes buy one from an unregulated source.
Delay sprays and creams are products containing substances from the topical anaesthetic group, intended to reduce the sensitivity of the head of the penis (glans) temporarily. This article covers a short definition of premature ejaculation, how the products work, the evidence, general principles of use, side effects, transfer to a partner, who should not use them, how they relate to other treatments and the risks of unlicensed “herbal” products.
What is premature ejaculation, and when is it a problem?
Premature ejaculation means being unable to delay ejaculation as much as one wishes, with distress for the man or his partner. The lifelong form has been present since the first sexual experiences, while the acquired form appears after a period of problem-free sexual life. International definitions of the lifelong form take ejaculation within about one minute of penetration as a criterion; however, time alone does not make the diagnosis, and loss of control and distress are also required.
This distinction matters, because in the acquired form causes such as erectile problems, prostate inflammation, thyroid disease, anxiety or relationship difficulties are looked for. Our related article covers myths and facts about premature ejaculation in detail.
How do delay sprays and creams work?
These products are not drugs that directly “delay” ejaculation. Topical anaesthetics applied to the glans skin temporarily reduce the response of nerve endings on the skin surface to stimulation; when sensitivity falls, it may take longer to reach the level of stimulation that triggers the ejaculatory reflex.
For them to be useful, the product has to be applied at the right time and in the right amount, and any excess has to be wiped or washed off when required, because too much product reduces sensitivity more than intended and can pass to the partner. The details of timing and amount differ between products and are set “according to the product leaflet and the doctor's advice.”
How effective are they? What does the evidence say?
In controlled studies, sprays and creams containing topical anaesthetics have produced a clear increase in time to ejaculation compared with placebo. However, the absolute time varies with the study and the product; in some men the increase is marked, in others limited. For this reason, quoting a single figure such as “it lengthens by this much” would not be accurate.
Satisfaction and discontinuation rates also differ: even when the time lengthens, some men and couples stop the product because of genital numbness, loss of spontaneity or the effort involved. Evidence is stronger for the short-term gain in time; it is limited for long-term outcomes, couple satisfaction and differences between products.
How and when are they used?
Use differs between products; the site of application, timing, amount and when to wipe off must be determined “according to the product leaflet and the doctor's advice.” No general time or amount is given here; the principles below only outline a framework:
- Following the leaflet: The product should not be used beyond the stated amount and frequency; the idea that “more is more effective” increases the risk of numbness and loss of erection.
- Removing the excess: Wiping or washing off excess product as the leaflet advises helps reduce both excessive numbness and transfer to the partner.
- First use: Trying a new product before an important occasion, after consulting a doctor or pharmacist, helps show any allergic reaction.
- Condom compatibility: Some products can affect the strength of latex condoms; compatibility is stated in the leaflet, and if it is not, the pharmacist should be asked.
Erection quality should also be monitored throughout use; if erections weaken, a doctor should be consulted.
What are the possible side effects, and can it pass to the partner?
Side effects are mostly related to the area of application:
- Genital numbness: Sensitivity falling more than intended can reduce the pleasure of intercourse.
- Reduced erection quality: Erections may weaken, especially with excess application.
- Burning and irritation: Burning, redness or itching may occur on the glans and mucous membrane.
- Allergic skin reaction: A sensitivity may develop, showing as redness, blisters or swelling.
Transfer to the partner is possible. If the product reaches the partner's genital mucosa through contact, the partner too may experience numbness, burning, irritation or an allergic reaction. Wiping or washing off excess product and using a condom compatible with the product can reduce this risk; however, the method of application is set by the product leaflet. Because mouth contact can cause numbness in the mouth, the leaflet should also be followed on this point. If the partner is pregnant or breastfeeding, a doctor should be consulted before use.
Who should not use them, or should take care?
In the following situations, it is better to consult a doctor or pharmacist than to start the product on your own:
- History of allergy: People who have previously reacted to topical anaesthetics or other components of the product should not use it.
- Genital skin problems: With an open wound, crack, infection, balanitis or marked irritation, the product may increase irritation.
- Erectile problems: In men whose erections are already weak, reducing sensitivity may make things worse; erections should be assessed first.
- Pregnancy, breastfeeding or allergy in the partner: The partner's situation affects the choice of product.
Where do they fit among other options, and what should expectations be?
Sprays and creams are only one option in the treatment of premature ejaculation. Behavioural and sex therapy techniques, pelvic floor work, some medicines from the antidepressant group and combinations of these methods are also used; which suits whom depends on the person, accompanying problems and preference. Our related article covers current treatment methods in detail; glans filler and surgical (SDN) options are covered in separate articles.
Expectations need to be kept honest: these products only reduce sensitivity; they do not treat anxiety, relationship problems, prostate inflammation, a thyroid disorder or premature ejaculation linked to erectile problems. If an erectile problem accompanies the picture, it should be assessed first, because in a man who rushes to avoid losing his erection, the main problem may be the erection. If too much product is applied, the opposite picture, such as a marked loss of pleasure, can also occur.
Why are “herbal” delay products bought online risky?
Many delay sprays, creams and pills sold on social media and websites as “natural,” “herbal” or “instant-acting” are unlicensed. Such products may contain active substances that are not written on the label; because the contents and amounts are unknown, side effects cannot be predicted. This risk is covered in detail in our article on herbal sexual enhancement products.
Obtaining a licensed product through a pharmacy or a doctor means the contents and instructions for use have been checked. Products with no ingredients list, warnings or leaflet on the packaging, or with exaggerated claims, should not be used. If a side effect occurs with such a product, stop using it and see a doctor, taking the packaging with you.
When should a doctor be consulted?
A urology and andrology assessment is advised in the following situations:
- Premature ejaculation has been present since the first intercourse or appeared later, and it distresses you or your partner
- An erectile problem, burning on urination, groin or perineal pain or reduced sexual desire accompanies it
- Marked burning, swelling, redness, blisters or a rash develops after a spray or cream; for serious allergy signs such as shortness of breath or swelling of the face or tongue, call 112 without delay
- There is not enough benefit despite using a product, or erection quality worsens
- An unlicensed product or one with unknown contents has been used
- The partner has numbness or irritation, or is pregnant or breastfeeding
Delay sprays and creams are topical anaesthetic products that temporarily reduce glans sensitivity; controlled studies have reported a longer time to ejaculation than with placebo, but the effect varies between people and products and does not remove the underlying cause. Because of problems such as genital numbness, weaker erections and transfer to the partner, products should be used according to the leaflet and the doctor's advice, and unlicensed products should be avoided. Assoc. Prof. Zülfü Sertkaya practises in urology and andrology in Istanbul; assessment and treatment planning for premature ejaculation are carried out with individual assessment and confidentiality.