Phone consult with a Specialist GP to discuss premature ejaculation (PE), anywhere in Australia. A private-fee consult. The consult uses the validated PEDT diagnostic tool, discusses your situation, and goes through the full evidence-based treatment toolkit on the call.
PE is the most common male sexual dysfunction worldwide and is treatable. Same-day phone consults usually available, 7 days a week.
Specialist GP phone consult for premature ejaculation — $59, private fee. The consult uses the validated PEDT diagnostic tool, works through the lifelong-vs-acquired distinction, and goes through the full evidence-based treatment toolkit on the call.
PE is the most common male sexual dysfunction worldwide and is treatable. Three evidence-based pathways: behavioural strategies (start-stop, squeeze, pelvic floor training), topical desensitiser preparations, and oral therapy options. Treatment is matched to the cause and your situation — many men do best on a combination.
What PE is. Premature ejaculation means ejaculating with minimal stimulation, sooner than wanted, and being unable to control it — with distress as part of the picture. The clinical definition uses three core criteria from the International Society for Sexual Medicine (ISSM): ejaculation usually within 1 minute (lifelong PE) or a clinically significant reduction from baseline (acquired PE); inability to delay; and negative personal impact such as frustration, avoidance of intimacy, or relationship distress.
Lifelong vs acquired — the critical distinction. Lifelong (primary) PE has been present from the first sexual experiences and reflects neurobiological factors, including genetic variation in serotonin signalling. It is typically managed with daily oral therapy. Acquired (secondary) PE develops after a period of normal ejaculatory control and is more commonly linked to performance anxiety, relationship distress, erectile dysfunction (often producing rushed ejaculation as a workaround), prostatitis, hyperthyroidism, or substance use. Treating the underlying cause often resolves acquired PE. The Specialist GP works through which category fits your situation, as this shapes the whole treatment plan.
How PE is diagnosed. Diagnosis is clinical and based on a focused history. The consult applies the validated PEDT (Premature Ejaculation Diagnostic Tool) — a 5-question self-rated scale — to confirm and quantify severity. No blood tests or imaging are routinely needed for typical presentations; investigations follow only where the history points to an underlying cause.
Treatment options. Three pathways with established evidence: behavioural strategies (start-stop, squeeze technique, pelvic floor training); topical desensitiser preparations applied to the glans before sex to reduce sensitivity; and oral therapy options including on-demand items taken before sex or daily SSRI-class items used off-label with strong PE-specific evidence. The Specialist GP arranges the right combination on the call. Many men do best on a combined approach.
Realistic timelines. Topical desensitisers work the same day. On-demand oral therapy works for that occasion. Daily therapy builds up over 2 to 4 weeks and typically plateaus by 12 weeks. Behavioural strategies show effect after several weeks of consistent practice. Combined approaches typically produce meaningful improvement within 4 to 8 weeks. Follow-up consults are arranged at the right cadence to review progress and fine-tune the plan.
Confidentiality. The consult is confidential. We do not notify your regular GP, partner, employer, or insurer by default. A summary letter to your regular GP can be sent with your explicit consent if you want continuity. See our fees page for all Clinic365 service costs.
Frequently asked questions
A Specialist GP with over 10 years of clinical experience treating men with PE. The Clinic365 sexual-health practice sees PE day-to-day and is comfortable with the full multi-modal treatment toolkit — behavioural, topical, and oral. Consults are available Australia-wide via phone telehealth from the East Melbourne clinic. The in-person pathway is available for Melbourne residents who prefer face-to-face care; an in-clinic option is at our East Melbourne clinic.
Diagnosis is clinical and uses three core criteria from the International Society for Sexual Medicine (ISSM): ejaculation usually under 1 minute for lifelong PE (or a clinically significant reduction for acquired PE); inability to delay ejaculation; and negative personal consequences. The consult uses the validated PEDT (Premature Ejaculation Diagnostic Tool) — a 5-question self-rated scale — to confirm and quantify severity. The PEDT is widely used in Australian primary care.
Lifelong (primary) PE has been present from the first sexual experiences and reflects neurobiological factors, including genetic variation in serotonin signalling — typically managed with a daily oral approach. Acquired (secondary) PE develops after a period of normal ejaculatory control and is more commonly linked to performance anxiety, relationship distress, erectile dysfunction, prostatitis, hyperthyroidism, or substance use. Treating the underlying cause often resolves acquired PE. Getting this distinction right at the first consult avoids trial-and-error on the wrong approach.
Two oral pathways with established evidence. (1) An on-demand option taken 1 to 3 hours before sex — short half-life designed for as-needed use; side effects can include nausea, dizziness, and headache, particularly at first. (2) Daily SSRI-class options used off-label for PE, with strong PE-specific evidence; they build up over 2 to 4 weeks and work continuously rather than as-needed. The Specialist GP works through which fits your situation on the call.
Three techniques have evidence. Start-stop: pause stimulation before ejaculation, wait until the urge subsides, then resume. Squeeze technique: firm pressure to the glans-shaft junction when ejaculation feels imminent. Pelvic floor training: targeted exercises (similar to Kegels) have moderate evidence for delaying ejaculation. Behavioural strategies work most consistently when practised over weeks and often work best combined with oral or topical treatment. Many men under-use them because they sound too simple — but the evidence is there.
Some antidepressants used for depression or anxiety commonly cause sexual side effects in men — delayed ejaculation, reduced libido, sometimes erectile dysfunction. This is most pronounced with SSRI-class items. Paradoxically, that side-effect profile is also what makes daily SSRIs useful as off-label PE treatment. The Specialist GP works through whether your current antidepressant is helping your PE, whether dose adjustment would help, or whether switching is the right next step — coordinating with your usual treating clinician where appropriate.
Most PE is managed in primary care. Referral to a USANZ urologist is appropriate for treatment-resistant PE (no response after several weeks of oral and behavioural treatment), suspected underlying urological pathology (prostatitis, anatomical concerns), PE coexisting with erectile dysfunction not improving with first-line treatment, or where you simply want specialist input. The Specialist GP arranges referral to a local USANZ urologist near you on the consult where needed.
PE is bidirectionally linked with performance anxiety, depression, and relationship distress. Treating PE often improves these; treating these often improves PE. Where mental-health factors are driving PE (or PE is driving anxiety or relationship distress), the consult covers Australian mental-health pathways including GP Mental Health Treatment Plans (partially Medicare-funded sessions) and ASSERT-registered sex therapists. The Mental Health Plan and referral can be arranged at the same PE consult where useful.
Yes — and often should be, because PE and ED commonly coexist. ED can produce rushed ejaculation as a workaround, so treating the ED often improves the PE. The Specialist GP works through the combined picture on the consult and arranges treatment for both where appropriate. See our telehealth ED treatment page for the ED pathway specifically.
Topical desensiser preparations work the same day from first application. On-demand oral therapy works for that occasion. Daily oral therapy builds up over 2 to 4 weeks and typically plateaus by 12 weeks. Behavioural strategies show effect after several weeks of consistent practice. For most men, a multi-modal approach combining two treatments produces meaningful improvement within 4 to 8 weeks. Follow-up consults are arranged to review progress and fine-tune the plan.
