What this page covers. Premature Ejaculation Treatment Online from Clinic365 is a $59 phone consult with Dr Ed Skinner — a Specialist GP with over 10 years of experience treating men with PE, running a focused sexual-health practice that sees PE day-to-day rather than as an occasional consult. PE is the most common male sexual dysfunction worldwide and substantially under-diagnosed in Australia because most men do not raise it with their regular GP. It is treatable. The consult applies the validated PEDT diagnostic framework, then discusses the full evidence-based toolkit: oral therapy, topical desensitiser preparations, and behavioural strategies (start-stop, squeeze, pelvic floor training). This page covers how PE is diagnosed, the critical lifelong-vs-acquired distinction, oral and topical treatment options, behavioural strategies, the mental-health intersection, antidepressant-related sexual side effects, when in-person urology referral is needed, substance-use review, realistic treatment timelines, and confidentiality. For in-person care in Melbourne, see our PE Treatment Melbourne page.
About Dr Ed Skinner. Dr Ed Skinner is the Specialist GP at Clinic365 (MBBS, FRACGP, AHPRA-registered MED0001674680). With over 10 years of clinical experience treating men with PE, Dr Skinner has consulted with several thousand Australian men for PE specifically and runs a focused sexual-health practice covering men's and women's sexual-health items day-to-day. The volume of PE-specific consults matters for several reasons: familiarity with the validated PEDT diagnostic tool and the ISSM definition criteria, comfort with the full multi-modal treatment toolkit (rather than defaulting to a single approach), and judgement about when first-line treatment is enough vs when urology, psychosexual therapy, or pelvic floor physiotherapy referral should be added. Dr Skinner consults Australia-wide via phone telehealth from the East Melbourne clinic, with the in-person pathway available for Melbourne residents who prefer face-to-face care.
How PE is diagnosed in Australia. Diagnosis is clinical and uses three core criteria from the International Society for Sexual Medicine (ISSM) definition: (1) intravaginal ejaculatory latency time (IELT) consistently under 1 minute for lifelong PE, or a clinically significant reduction in IELT for acquired PE; (2) inability to delay ejaculation on all or nearly all penetrations; (3) negative personal consequences such as distress, frustration, or avoidance of sexual intimacy. Dr Skinner 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 for PE consultations and is the standard validated instrument referenced in current Australian sexual-health guidelines.
Lifelong vs acquired PE — 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 medication approaches. Acquired (secondary) PE develops after a period of normal ejaculatory control and is more commonly linked to psychological factors (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 at the consult, as this shapes the treatment plan significantly. Over 10 years of practice, Dr Skinner has found that getting this distinction right at the first consult avoids weeks or months of trial-and-error on the wrong treatment approach.
Oral therapy options. Two pharmacological pathways are used in Australia. (1) An on-demand oral medication taken 1 to 3 hours before sex — with a short half-life designed for as-needed use. Side effects can include nausea, dizziness, and headache, particularly at first. (2) Daily SSRI-class antidepressants used off-label for PE — these have strong evidence for PE specifically, build up over 2 to 4 weeks, and work continuously rather than as-needed. Dr Skinner works through which fits your situation (lifelong vs acquired PE, frequency of sex, any current antidepressant use, side-effect tolerance, and preference between on-demand vs daily dosing). For combination therapy — adding a topical preparation to an oral treatment — the consult covers timing and partner considerations.
Topical desensitiser preparations. Anaesthetic preparations applied to the penile glans 10 to 15 minutes before sex to reduce sensitivity and delay ejaculation. Available as sprays, gels, or wipes. Side effects can include reduced sensation for the user and transfer to the partner causing reduced sensation there too (a condom worn after application reduces partner transfer). Topical preparations can be used as monotherapy or combined with oral treatment for better effect. Some preparations are available over-the-counter at Australian pharmacies; others are by prescription. Dr Skinner discusses which preparations are typically well-tolerated, how to apply them effectively, and the common pitfalls (too much applied, application too early before sex, partner sensation issues).
Behavioural strategies — evidence-based and widely under-used. Three core techniques have evidence in PE management: (1) Start-stop method — pause sexual stimulation just before ejaculation, wait until the urge subsides, then resume; repeat several cycles before allowing ejaculation. (2) Squeeze technique — partner or self applies firm pressure to the glans-shaft junction when ejaculation feels imminent, holding for a few seconds until the urge passes. (3) Pelvic floor training — strengthening the pelvic-floor muscles through targeted exercises (similar to Kegels in women) has moderate evidence for delaying ejaculation. Behavioural strategies work most consistently when practised over weeks and combined with oral or topical treatment in many cases. Dr Skinner's experience: many men under-use these because they sound too simple to be useful — but the evidence is there, the cost is zero, and combined with medication the effect is additive.
The mental-health intersect. PE is bidirectionally linked with anxiety (especially performance anxiety in newer or transitional sexual relationships), depression, and relationship distress. Treating PE often improves these; treating these often improves PE. Dr Skinner works through whether mental-health factors are driving PE, whether the PE itself is driving anxiety or relationship distress, or both. Where appropriate, the discussion covers Australian mental-health support pathways including GP Mental Health Treatment Plans (which provide partially Medicare-funded sessions with psychologists or counsellors) and ASSERT-registered sex therapists who work specifically with sexual concerns. The Mental Health Plan and the referral can be arranged at the same PE consult where useful.
Antidepressant-related sexual side effects. Some antidepressants prescribed 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 medications. Paradoxically, this side-effect profile is also what makes daily SSRIs useful as off-label PE treatment. If you are currently on an antidepressant and have noticed sexual side effects, Dr Skinner works through whether the medication is helping your PE (delaying ejaculation usefully), whether dose adjustment would help, or whether switching to an antidepressant with a different side-effect profile is the right next step. Coordination with your prescribing doctor where appropriate.
When in-person urology referral is needed. Most PE is managed in primary care by Dr Skinner. Referral to a urologist (USANZ — Urological Society of Australia and New Zealand) 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 that is not improving with first-line treatment, or where you simply want specialist input on diagnosis or management. For Melbourne residents, our Melbourne page covers the local USANZ urology referral pathway. For non-Melbourne patients, Dr Skinner refers to a local USANZ urologist near you.
Substance use review. Acute and chronic alcohol use, recreational drug use (cannabis, cocaine, MDMA, methamphetamine), and certain prescription medications (some antihypertensives, antiepileptics, antipsychotics) can either contribute to PE or mask its presence. Dr Skinner takes a brief substance-use history at the consult — non-judgmental, focused on patterns rather than labels — to identify whether any of these factors fit your situation. For substance-related sexual dysfunction, addressing the underlying use is often the most useful treatment direction. For Australian-context patient resources on PE and the broader picture of men's sexual health, see Andrology Australia (formerly the Centre for Male Reproductive Health).
Realistic treatment timelines. Setting expectations matters for PE treatment because different treatments work on different timeframes. Topical desensitiser preparations work the same day from first application — useful when a quick effect matters. On-demand oral medication taken 1 to 3 hours before sex works for that occasion. Daily SSRI-class antidepressants build up over 2 to 4 weeks and need dose adjustment over the first 6 to 12 weeks; effect typically plateaus by 12 weeks. Behavioural strategies typically show effect after several weeks of consistent practice. For most men, a multi-modal approach combining one or two treatments produces meaningful improvement within 4 to 8 weeks. Dr Skinner arranges follow-up consults at the right cadence to review progress and fine-tune the plan. Refill consults are available at $39 once a treatment plan is established.
Confidentiality. All Clinic365 PE consultations are confidential. We do not notify your regular GP, partner, employer, school, or insurer by default. Many Australian men prefer a separate clinic for sexual health, particularly for items like PE that are deeply personal. The prescription appears as a generic medication item on your pharmacy record; if you would prefer this not appear on your My Health Record, Dr Skinner can adjust settings during the consult. A summary letter to your regular GP can be sent with your explicit consent if continuity matters. For fee details across all Clinic365 products, see our fees page.
