Looking for a down-to-the-minute definition of rapid ejaculation is a natural impulse, but not an ideal way of looking at it. Mulhall says it comes down to whether the guy lasts long enough. If his partner is made wholly replete in 90 seconds, then a man who lasts 95 seconds can be fine. But if another guy lasts 15 minutes, and that's not cutting it, then it's a problem and can be considered rapid.
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In the late 1980s, when physicians started prescribing SSRI medications to treat depression (now known as Zoloft, Paxil, Prozac, etc.), some patients taking them noticed that they were also taking longer to ejaculate. So doctors started prescribing SSRIs for non-depressed patients, to treat premature ejaculation. And, largely, it worked.
Still a lot of people don't like the idea of taking a pill. Costs, side effects -- especially for people tangentially on the rapid ejaculation spectrum, it's not always easy to justify being on an SSRI. That's where topical numbing treatments can come in.
Dr. Ronald Gilbert, a urologist in Newport Beach, California, is the Chief Medical Officer of a company that makes a lidocaine spray used in situations like these. Gilbert personally sees it beyond that, as a first-line therapy for premature ejaculation.
The concept isn't new, and these lidocaine sprays have received a thoroughly mixed bag of reviews. That may be because they don't address the psychological component of the problem (which, some argue, is the only component). But Gilbert believes that his formula, called Promescent, works. He told me about it in flowing jargon involving binary eutectic, a pKa very near the pH of lidocaine, and a two-phase meld system that drives lidocaine through the stratum corneum of the skin of the penis.
The numbing spray idea immediately struck me as one that makes perfect sense to scientifically-minded people but sounds absurd to everyone else. It's a coldly rational approach. But the problem is nuanced, and this solution involves making a man who already feels insecure in sexual situations excuse himself during a heated moment, get out a (secret) vial of penis spray, and numb up his genitals -- all in anticipation of a sexual endeavor that, even if it goes well, may still leave him conflicted in the way Lance Armstrong must have felt in a yellow jersey on the Champs-Élysées.
It's a suboptimal scenario, but so is an unsatisfying sexual relationship. Gilbert recommends the topical treatment to his patients before he prescribes an SSRI, and so does Mulhall.
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In the interest of science and curiosity, I tried the lidocaine spray on one of my hands. A few points of note:
It makes you smell like a new iPhone. This seems like it would be a giveaway -- a numb penis tell, if you will. It does feel strange, but not at all like you're existentially detached from yourself. If you're envisioning a total numbness (which I was -- like your unfeeling lip after a dental procedure, or Krang remotely operating a detached body), you'll be disappointed. You do lose fine sensory details. If someone lightly brushed your penis with a feather, you probably wouldn't know it. It could be likened to wearing two condoms -- or, as the proverb goes, eating a steak with a balloon on your tongue.
