Diaphragmatic Breathing May Help with Premature Ejaculation Treatments

What is Premature Ejaculation and How is it Treated?

Premature ejaculation (PE) is considered the most common sexual dysfunction in men and is clinically defined in two ways: lifelong and acquired. Lifelong PE is consistent with early ejaculation (often within one minute of intercourse), since one’s very first sexual experience. Acquired PE is a significant reduction in time that it takes to ejaculate, typically defined as two minutes or less, that occurs later in life. These symptoms are present for at least six months and occur during almost all sexual occasions. Current treatment methods typically include (but are not limited to) behavioral therapy (BT), pelvic floor muscle (PFM) training, local anesthetics, and antidepressants.

BT involves practices such as the “start and stop” technique, where patients stimulate the penis until they feel the pre-orgasm sensation, which is when they stop until the ejaculation reflex is paused. Additionally, PFM contraction before the pre-orgasm phase has been found to be helpful in controlling the ejaculatory reflex.

What is Diaphragmatic Breathing?

Diaphragmatic breathing can help to slow breathing and regulate certain nervous system functions needed for reflex control. Researchers recently looked into the effect of diaphragmatic breathing exercises (DBE) on the effectiveness of other PE treatments, namely BT and PFM training. Those with PE may also have higher levels of anxiety and can benefit from regulatory, focused, deep breathing techniques such as DBE.

Does DBE Work?

In a recent study, 62 men with PE were divided into two groups to test for time to ejaculation and improvements in PFM strength and endurance. All patients received BT and PFM training but only the test group received DBE instruction (timed deep breaths in and out through the nose, with hands on the ribcage to feel the movement of breath). Participants began each therapy prior to the testing period, to make sure they were correctly performing the exercises.

PFM contraction exercises were prescribed twice daily, three days per week for eight weeks. For the test group, DBE was repeated 10 times per session, with two sessions per day, every day for eight weeks. All men involved were instructed to maintain normal breathing during sexual activity.

For the best results, it was advised not to use condoms or topical anesthetics, and to begin penetrative sex in a position where the female partner was on top. Time to ejaculation was recorded by patients using a stopwatch, from penetration to ejaculation.

DBE Assists with an Increase in Ejaculation Time

All men saw improvement in their time to ejaculation over the course of the eight-week study. However, the test group saw more improvement (2-15 minutes longer) than the control group (1.5-10 minutes longer). This suggests that DBE was successful as an addition to typical non-medical treatment methods. Additionally, the men saw improvements in PFM strength and endurance in terms of controlling their ejaculatory reflex.

After a year, both groups continued to see changes in their time to ejaculation. However, the control group actually reported a decrease in time to ejaculation, which researchers believe reinforces the notion that DBE is more beneficial when added to other treatments.

Key Points

• This is the first study demonstrating diaphragmatic breathing exercises contributed to delay in ejaculation in PE.
• DBE combined with PFM training and BT resulted in an increase in the time to ejaculation by an average of just under 5 minutes (compared to 3.5 minutes with BT and PFM training alone).
• Other guideline-supported treatments for PE include topical anesthetics and off-label use of antidepressants
• If you believe you may have premature ejaculation, it’s important to speak with a sexual health professional, as they may be able to help find a treatment method that’s right for you.

Resources:

Erkut, U., Karagozoglu Coskunsu, D., Erkut, K., & Ozden, A. V. (2025). The effects of diaphragmatic breathing exercises on individuals with premature ejaculation: A randomized controlled trial. The Journal of Sexual Medicine, 22(8), 1422–1429. https://doi.org/10.1093/jsxmed/qdaf107