Topical therapy is based on the use of numbing agents such as lidocaine gel or spray being applied to the penis skin, particularly the head of the penis, just before starting sexual activity. The reduced sensitivity of the penis diminishes the nerve signals that travel to the spine before traveling to the pelvic organs and muscles that cause ejaculation.

There are several concerns with topical therapy. One is that it will reduce sensation too much for some men, thereby reducing sexual pleasure more than desired. Another is that the topical agent will be inadvertently transferred to a partner, reducing the partner’s sensitivity. If penile sensation is reduced too much, difficulty achieving or maintaining an erection (ED) can result. Finally, some topical therapies can irritate the skin of the patient or his partner.

Trial and error, starting with a relatively low amount of topical agent, is often the best way to find an effective dose without overly reducing sensation. Use of PDE5i along with topical therapy can help men prolong ejaculatory latency time without worrying about losing their erectile rigidity. Wiping the penis with a wet cloth soon after applying topical agents can reduce skin irritation for both partners and inadvertent partner numbness by preventing transfer of the gel or spray. There is a topical spray available that has been reported to penetrate the skin layer and remain effective for the patient while reducing the risk of transfer to his partner. Use of a condom after applying topical therapy to the penis can also prevent transfer of gel to the partner, and may help reduce sensation for the patient, but may also reduce sensation to the point that it’s difficult to get or maintain erections.

 

This information is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment, and should never be relied upon for specific medical advice. If you have any questions or concerns, please talk to your doctor.  

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