Botox injections: a novel treatment for premature ejaculation?

Increasing numbers of men are considering botox to help them last longer in bed.

Author holding a penis model with syringe

Now I don’t know about you, but the mere suggestion of penile injections gives me cold sweats and my legs snap together. But, dear reader, I will bravely attempt to power through this post.

Big caveat alert: this is not medical advice or recommendation and I’m not a doctor. Which is probably for the best.

Treatment plans for premature ejaculation usually involve muscular relaxation techniques. Guys learn how to minimise tension around the pelvis and the PC muscle. And I certainly cover this when I work with my clients in therapy.

To get technical for a moment, the bulbospongiosus muscle is a superficial muscle in the perineum area, between the ass and the penis. By superficial, we mean it lies close to the surface of the skin.

Diagram showing location of bulbospongiosus muscle
Image credit: Wumingbai, CC BY-SA 4.0, via Wikimedia Commons

The bulbospongiosus muscle helps with erections and ejaculation. We don’t have direct control over it, but what if we could make it relax somehow?

Enter botox, that popular provider of youth and timeless beauty. To be fair, botox does have legitimate medical uses too. From relieving neck spasms to correcting lazy eyes, medical science has discovered all kinds of interesting applications.

An injection of botox disrupts the signaling between nerves and muscles, right at the point of injection. That’s how botox smooths out wrinkles and frown lines; it forces the relaxation of tiny underling muscles.

And when it comes to the penis, botox has quite a lot to offer.

Relaxing the smooth muscle tissue located within the erectile chamber can help with erectile dysfunction. Botox injections to the dartos muscle, which is the muscle responsible for penile retraction, can help reduce shrinkage for guys who worry about their penis size and appearance.

Diagram showing location of the dartos muscle
Image credit: OpenStax College, CC BY 3.0, via Wikimedia Commons

There is even a treatment called Scrotox – to improve the appearance of the scrotum and reduce sweating down there. This is botox injected into the testicles, and that sound you can hear is my knees colliding under the table.

So is botox an effective treatment for premature ejaculation?

Well, research would suggest so. In one study, 33 sexually experienced rats were filmed having sex. Researchers watched closely and precisely noted how long they lasted (inwardly rejoicing in their career choices, I’m sure).

They then injected botox into the rats bulbospongiosus muscles and watched and timed again. And lo and behold, the rats lasted significantly longer. There was no negative impact on their performances. Researchers concluded that botox could be a safe and effective treatment for PE.

Right now, research into this prospect is ongoing. Botox penile injection isn’t a mainstream treatment for PE yet, but a quick search reveals that a few clinics are already offering consultations.

But beware: the market for botox treatments probably isn’t as well regulated as it could be. And there are reports of men self-injecting their own fillers.

Doctors have seen guys who injected their penises with vaseline, silicone and other random substances. Some of them needed skin grafts to put things right again. Ouch.

How about some hyaluronic acid instead?

Rapidly steering away from DIY to more legitimate injection treatments, it’s not all about botox. Some new research out of China suggests that glandular augmentation with hyaluronic acid could be way to go.

What is this, I hear you ask, and could it be a good match for your penis? Well, hyaluronic acid gel is a bulking agent that’s known for being non-toxic and easy on the skin. It can be injected into the glans of the penis. This increases glandular girth (for guys who want to be bigger) AND reduces sensitivity. Research has shown a 2 to 4 times increase in time to ejaculation.

This approach doesn’t relax muscles, but blocks off nerve receptors from the sensations of touch. The research concluded that it’s safe and doesn’t have adverse reactions except some penis discolouration and sometimes excessive swelling.

There are various different ways of doing the injections and inducing cold sweats in ridiculously squeamish therapists.

Glandular augmentation targets ouch

This form of glandular augmentation has been around for 15 years or so but there’s not much supplementary evidence of effectiveness yet. But the guys in this study – actual men this time, not rats – are lasting longer and report being more satisfied even a year later.

In another study, also out of China, micronised acellular dermal matrix particles were injected into an area of the penis known as Buck’s fascia. This had a similar effect of reducing penis sensitivity and the guys who volunteered lasted longer and longer as the weeks went by afterwards. They and their partners expressed more sexual satisfaction too.

Are these sensitivity-reducing injections available yet? Not that I’m aware of, but research continues no doubt.

And don’t go augmenting yourself with vaseline in the meantime. Hold your horses on this one.

While we’re at it, how about steroid injections? It works for body-builders

Yes, penile steroid injections are a thing too. Steroids are an established treatment for erectile dysfunction. Guys inject a kind of steroid mix to increase blood flow and achieve rock hard erections.

Men can get a prescription for this, and inject themselves typically a few minutes before sex – it goes to work that quickly. Usually a doctor will do it the first time to show you how, if you can bear to watch and he can prise your legs apart.

Why would men choose to inject their own penises instead of taking a pill? Well, it works fast as I say, and men get stronger and more rigid erections for 1-2 hours – even after ejaculation.

So steroid injections are effective, and not reliant on stimulation or actually fancying your partner. This method is much used in the adult industry, apparently.

BUT injecting yourself in your penis prior to sex? And the possible risk of priapism – that’s an erection that won’t go away, sometimes even after 4 hours. My legs are saying no.

Steroid injections aren’t a treatment specifically for premature ejaculation, but as I discussed in my video on little blue pills, PE and ED problems can co-exist.

Sometimes having more confidence in our erections, and feeling able to take our time and not worry about losing our erection, means we don’t over-stimulate ourselves and we last longer.

Is this an available treatment? Yes, I saw some London clinics offering private consultations.

The future feasibility of penile injections as a treatment for PE

As we can see, research into botox and other substance injections to treat early ejaculation has really gathered pace.

Some of these options target penile hypersensitivity, and yes – some guys are more sensitive than others. Or these injections relax penile muscles, definitely more than we can do voluntarily.

But here’s the thing: is premature ejaculation all about the penis?

And are researchers continuing the tradition of over-focusing on the penis? I believe so.

PE is a bio-psycho-social issue. Yes, our skin sensitivity and serotonin levels and our neurology are all real biological factors. But so are our stress levels, and our performance anxiety, our missing skills, and our relationship histories.

For each guy that struggles with PE, I believe there’s a mix of biological, mindset and often relationship factors going on. His own unique mix, but a mix all the same.

So even if injection treatments become more mainstream, they will always be best accompanied by therapy and/or gaining sexual skills.

As a psychotherapist and sex educator, I’m biased of course. But while research and medical innovation continues apace to remedy premature ejaculation, I continue to recommend sex therapy first.

And guys can get started on this right now. It’ll be more cost effective, and your penis may well thank you for it.

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