Men who experience premature ejaculation may be able to improve control and extend intercourse using a smartphone app, according to preliminary results from a small randomised trial.

Premature ejaculation is considered the most common sexual dysfunction among men, estimated to affect around 1 in 3 men. An array of treatment options including drugs such as topical anaesthetics or selective serotonin reuptake inhibitors (SSRIs) can delay ejaculation but must be taken repeatedly and may cause side effects. The pills also have to be taken some time before sex, which takes away from the spontaneity of the act. “The existing medical treatments are not curing the situation,” says Christer Groeben at Heidelberg University in Germany.

The app, Melonga, offers men a curriculum designed by psychologists and urologists that combines arousal-awareness training, pelvic floor exercises, mindfulness techniques and cognitive behavioural strategies. Users are taught to recognise the “point of no return” before ejaculation and use breathing, relaxation and start-stop techniques to reduce arousal. Modules also encourage communication with partners and challenge negative thought patterns through cognitive behavioural therapy.

In the trial, 80 men were randomised to either use the app or receive no structured intervention over an initial 12 weeks. Among the 66 participants who completed the study, those using the app increased their intravaginal ejaculation latency time from an average of 61 seconds to 125 seconds, with results seen after four weeks of use. The control group saw virtually no change.

Men who used the app reported that the benefits extended to a reduced impact on their relationship and improvement in the enjoyment of sex, tied to its longer duration. Premature ejaculation can be caused by prostate or thyroid issues, while it can also overlap with depression, but the inclusion criteria for the study ensured only healthy participants were selected.

Groeben presented the findings at the European Association of Urology congress in London today.

“Doctors prescribe pills much more than simple solutions,” says Giorgio Russo at the University of Catania, Italy, who was not involved in the research. “In 10 or 15 minutes [for an appointment], pills are the easiest solution for the doctor, but not for the patient.” The app, he says, “is like having a doctor on your phone” – giving men and their partners the opportunity to privately “understand their premature ejaculation issue”.

Russo describes the effects of the app, which was developed by Netherlands-based health start-up Prognoix, as “dramatic” – with 22 per cent of participants no longer qualifying for the definition of premature ejaculation after using it. “Improving just 1 or 2 minutes is a big result,” he says.

“One of the reasons patients have premature ejaculation is anxiety,” Russo adds. “Kegel [pelvic floor] exercises and muscle control can help them manage that anxiety and control the reflex.”

A slew of similar apps to combat premature ejaculation already exist, but none have been tested in a controlled study. One advantage of a digital approach is discretion. “A lot of patients don’t go to see their doctor about this condition because they feel a stigmatising effect when they sit in the waiting room with other patients,” says Groeben.