Premature Ejaculation · Medication Guide
Lidocaine Numbing & Delay Products in Thailand
What topical lidocaine is, how it is used to treat premature ejaculation, what the trials show, and how men in Bangkok get pharmaceutical-grade products legally. Reviewed by a licensed physician at a MOPH-registered men's health clinic.
- Numbs in minutes (timing depends on format) and lasts 15–30
- Thai FDA-registered anesthetics · doctor-matched
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Medically reviewed by Dr. Sirirat Nakdang (Pong)
Menscape Clinic
Last reviewed
11 July 2026
4–6×
Longer time to ejaculation
in randomized trials of lidocaine–prilocaine spray
2–5 min
Onset of numbing
after applying to clean, dry skin
15–30 min
How long it lasts
sensation then returns to normal
20–30%
Men affected by PE
the most common male sexual complaint
Key takeaways
Topical lidocaine is the oldest and simplest medical treatment for premature ejaculation: it reduces penile sensitivity for 15–30 minutes so that ejaculation takes longer.
In randomized controlled trials, lidocaine–prilocaine products increased average time to ejaculation 4–6-fold versus little change on placebo. It works on demand and only while applied. It is not a cure.
In Thailand, pharmaceutical lidocaine is a dangerous-drug class medicine (ยาอันตราย) dispensed by pharmacists and clinics. The novelty 'delay sprays' sold online and in sex shops are unregulated, with unknown anesthetic content.
Transfer to your partner is the main practical problem: the product must be wiped off before sex or covered with a condom, and a doctor should set the format and dose.
01
What topical lidocaine is & how it delays ejaculation
Premature ejaculation is a recognised medical condition, and the most common sexual complaint men report: prevalence estimates run at 20–30%.⁴ It is also one of the least discussed. Topical anesthetics are the oldest documented treatment for it, and they remain a first-line option in international urology guidelines.⁴
Lidocaine is a local anesthetic. Applied to the glans and frenulum before sex, it blocks sodium channels in the skin's nerve endings, dampening the sensory signals that trigger the ejaculatory reflex.⁶ Sensation is reduced, not eliminated. Numbing starts within 2–5 minutes and lasts roughly 15–30 minutes, after which the skin returns to normal. It manages the symptom while it is on the skin; it does not change the underlying reflex, and it does nothing on the nights you don't use it.
Lidocaine comes in several formats: a 2% jelly, a lidocaine–prilocaine 2.5%/2.5% cream, and stronger 10% preparations that clinics use for numbing before injections, laser and minor procedures. Which one is appropriate, at what dose, and whether a topical is the right first step at all, depends on your pattern, your relationship situation and your health history. That is what the doctor's assessment is for.
Heightened sensitivity
In many men with premature ejaculation, sensory signalling from the penis triggers the ejaculatory reflex earlier than they want.⁴
Lidocaine blocks the signal
It blocks sodium channels in skin nerve endings, locally dampening sensation within 2–5 minutes.⁶
Applied, then removed
It goes on 5–20 minutes before sex depending on format, then is wiped off or covered with a condom to protect the partner.²
Ejaculation is delayed
In phase 3 trials, average time to ejaculation rose 4–6-fold while the anesthetic was active.²·³
02
Getting lidocaine delay products in Thailand
Thai FDA status
Topical lidocaine products are registered with the Thai FDA as local anesthetics and classified as dangerous drugs (ยาอันตราย), sold in Thailand under brands such as Xylocaine and EMLA. They are legal only through licensed pharmacies and licensed clinics.⁷
How Menscape dispenses it
A doctor consults first, then matches the format to the use: the 2% jelly or the lidocaine–prilocaine 2.5%/2.5% cream for premature ejaculation, and the 10% cream and 10% metered spray for in-clinic numbing before injections, laser and minor procedures. Dispensed by a licensed pharmacy with clear application and removal instructions.
The grey-market problem
The 'delay sprays' sold on marketplaces and in sex shops are typically unregistered, with undeclared or mislabeled anesthetic content. Too weak does nothing; too strong numbs you and your partner, and nobody is accountable for what is actually in the bottle.
Regulatory note. These products are registered in Thailand as local anesthetics; use for premature ejaculation is a doctor-directed use of an anesthetic, decided case by case. The 10% preparations are procedure-strength products for clinical use, not self-applied delay products.
03
Does it work? The evidence
Topical anesthetics are among the better-studied treatments for premature ejaculation. In a double-blind randomized trial of lidocaine–prilocaine cream, men applying it before sex showed several-fold increases in time to ejaculation versus placebo.¹ In the phase 3 trials of a metered lidocaine–prilocaine spray applied 5 minutes before intercourse, average time to ejaculation rose from about 0.6 minutes at baseline to 2.6–3.8 minutes, versus 0.8–1.1 minutes with placebo, with improved control and satisfaction scores.²·³ A dedicated lidocaine–prilocaine spray for premature ejaculation has been approved in the EU since 2013.
The International Society for Sexual Medicine lists topical anesthetics as an effective first-line option, alongside oral dapoxetine.⁴ A 2016 systematic review and meta-analysis reached the same conclusion, while noting the trade-offs: the effect is on-demand only, reduced sensation and partner transfer are the main complaints, and a topical does not address the anxiety or relationship factors that often ride along with the condition.⁵
2.6–3.8 min
Lidocaine–prilocaine spray
average time to ejaculation, from 0.6 minutes at baseline
0.8–1.1 min
Placebo
same trials, same measure
Phase 3 randomized, placebo-controlled trials of lidocaine–prilocaine spray applied 5 minutes before intercourse.²·³ Individual results vary.
04
Side effects & who shouldn't use it
Common, local, usually mild
A brief burning or stinging on application, temporary redness or blanching of the skin (more with lidocaine–prilocaine), and numbness that outlasts the useful window if the dose is too high. Partner tingling or numbness if the product is not removed before sex.⁶
Rare but serious
Systemic toxicity with heavy overuse: dizziness, ringing in the ears, irregular heartbeat. Dose ceilings exist for a reason: about 4.5 mg/kg for the jelly, and the 10% spray is capped at 20 actuations in clinical use. Methemoglobinemia, a rare blood-oxygen disorder, is associated mainly with prilocaine, large treated areas or prolonged occlusion.⁶
Not suitable for
Men with allergy to amide anesthetics, broken or inflamed genital skin, or (for prilocaine-containing mixes) G6PD deficiency or congenital methemoglobinemia. Significant heart-rhythm or liver disease should be flagged to the doctor before use.
Partner transfer & interactions
Wipe the product off before penetration or use a condom; trials did both.¹·² Avoid oral contact while it is active. Tell your doctor if you take class I antiarrhythmics such as mexiletine, and never stack multiple numbing products on the same skin.
05
Alternatives & combinations
Oral · on-demand
Dapoxetine
The only SSRI registered for on-demand treatment of premature ejaculation, taken 1–3 hours before sex. A doctor may prescribe it instead of a topical, or alongside one when a single approach is not enough.
Behavioural · foundation
Stop-start & pelvic floor training
Structured techniques and pelvic-floor exercises have modest evidence on their own but no side effects, and they build lasting control. Often combined with medication rather than replaced by it.
Treat the driver
Coexisting erectile dysfunction
When erectile dysfunction and premature ejaculation occur together, treating the erection problem first often improves the pattern. The doctor may start with a PDE5 inhibitor before, or alongside, any delay product.
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How prescription works at Menscape
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A few minutes on your phone: your history, what you have tried, current medications. Confidential and PDPA-protected.
Doctor consultation
A licensed Thai physician reviews your case by video call or in clinic at Asoke, rules out contributing causes, and decides whether a topical anesthetic is appropriate, and in which format and strength.
Prescription, if suitable
If the doctor approves, the product is dispensed by a licensed pharmacy for pickup or discreet delivery, with exact instructions on how much to apply, when, and how to remove it before sex.
Follow-up & adjustment
A check-in after the first few weeks. The dose or format is adjusted, and if a topical alone is not enough, the doctor discusses dapoxetine or a combined plan.
The doctor decides. Starting a conversation is not a commitment and does not guarantee a prescription. If a topical anesthetic is not right for you, your doctor will say so and discuss alternatives.
Medically reviewed by
Dr. Sirirat Nakdang (Pong)
Menscape Clinic, Bangkok
“Premature ejaculation is the most common sexual complaint I see, and the least talked about. A topical anesthetic is a simple, low-risk starting point for many men, but the format and dose have to be matched to you, not bought off a shelf.”
- Reviewed
- 11 July 2026
- Next review
- January 2027
- Editorial standard
- Each guide is checked against the Thai FDA label and the primary literature, then reviewed by a licensed physician.
07
Frequently asked questions
Can I buy lidocaine delay products over the counter in Thailand?
Not legally as self-service items. Pharmaceutical lidocaine is a dangerous-drug class medicine (ยาอันตราย): it must be dispensed by a licensed pharmacist or prescribed by a doctor. The novelty delay sprays on online marketplaces and in sex shops are unregistered products with unknown anesthetic content.
How do I stop the numbing transferring to my partner?
Two options, both used in the clinical trials: wipe the product off thoroughly before penetration, or put a condom on after applying. Your doctor and pharmacist will show you the exact routine for the format you are prescribed.
Will it make sex feel like nothing?
At the right dose, no. The goal is to reduce sensation enough to delay the reflex, not to eliminate it. Too much product causes exactly that complaint, and can soften erections, which is why dose and timing are set by a doctor rather than by trial and error.
Which format is best: jelly, cream or spray?
The trial evidence is strongest for lidocaine–prilocaine formulations. The 2% jelly is milder and easy to titrate; the 10% cream and 10% spray are procedure-strength anesthetics used for numbing before injections and laser, not for self-directed use. The doctor matches the format to your case.
How long before sex do I apply it?
It depends on the format. In the phase 3 trials the spray was applied 5 minutes before intercourse; creams typically need 10–20 minutes. Numbing starts within 2–5 minutes and lasts about 15–30 minutes, so timing matters more than quantity.
Is it safe to use every time, long term?
There is no dependence and no rebound, but skin irritation is possible with frequent use, and maximum doses exist: around 4.5 mg/kg for the jelly. If you find you need it every time, that is a reason to review the plan with your doctor, not to keep increasing the amount.
Does lidocaine treat the cause of premature ejaculation?
No. It manages the symptom for the 15–30 minutes it is active. Premature ejaculation usually has several contributors: sensitivity, anxiety, sometimes an erection problem. Most doctors treat a topical as one tool in a plan, not the whole plan.
Should I try lidocaine or dapoxetine first?
Both are first-line options in international guidelines. A topical acts only where it is applied and has few systemic effects; dapoxetine is an on-demand tablet with its own precautions. The doctor weighs your health history and preferences, and in some cases combines the two.
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References
1. Busato W, Galindo CC. Topical anaesthetic use for treating premature ejaculation: a double-blind, randomized, placebo-controlled study. BJU Int. 2004;93(7):1018-1021.
2. Dinsmore WW, Wyllie MG. PSD502 improves ejaculatory latency, control and sexual satisfaction when applied topically 5 min before intercourse in men with premature ejaculation: results of a phase III, multicentre, double-blind, placebo-controlled study. BJU Int. 2009;103(7):940-949.
3. Carson C, Wyllie M. Improved ejaculatory latency, control and sexual satisfaction when PSD502 is applied topically in men with premature ejaculation: results of phase III, double-blind, placebo-controlled study. J Sex Med. 2010;7(9):3179-3189.
4. Althof SE, et al. An update of the International Society of Sexual Medicine's guidelines for the diagnosis and treatment of premature ejaculation (PE). Sexual Medicine. 2014;2(2):60-90.
5. Martyn-St James M, et al. Topical anaesthetics for premature ejaculation: a systematic review and meta-analysis. Sexual Health. 2016;13(2):114-123.
6. AstraZeneca. Xylocaine (lidocaine) and EMLA (lidocaine 2.5% / prilocaine 2.5%) prescribing information. Accessed July 2026.
7. Thai Food and Drug Administration — drug registration database, ndi.fda.moph.go.th. Accessed July 2026.
This guide is educational information, not medical advice. Topical anesthetics are medicines that must be selected, dosed and monitored by a licensed physician or pharmacist; premature ejaculation is a medical condition that deserves a proper assessment.
This guide is part of the Menscape PE library
Explore the condition hubWorried about premature ejaculation? Ask a doctor, not a sex shop.
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