2026 Men's Telehealth Guide to Lasting Longer in Bed featured image

Sexual Health

Erectile Dysfunction

2026 Men's Telehealth Guide to Lasting Longer in Bed

Reviewed by Felix Gussone, MD

Written by Erica Garza

Published 07/13/2026

Premature ejaculation is ejaculation that happens sooner than a man or his partner would like during sexual activity. It is the most common male sexual dysfunction, affecting an estimated 20% to 30% of men. Despite how widespread it is, the vast majority of men never bring it up with a doctor. Lasting longer in bed can be achievable through a combination of behavioral practice, physical training, lifestyle adjustments, and, when needed, clinician-guided prescription treatment. This guide reviews evidence-informed strategies available in 2026, and explains how telehealth platforms may make personalized care more accessible and private.

Rugiet personalized telehealth solutions for lasting longer

Research presented at EAU 2026 found that only about 9% of men with PE seek medical help. That suggests many men dealing with this issue are either suffering in silence or relying on unvetted advice. Rugiet's telehealth model helps close that gap by offering discreet, online consultations with board-certified doctors who specialize in men's sexual health.

Rugiet uses compounded, multi-ingredient formulations that are personalized to each patient's needs. Rugiet Go Long is a 2-in-1 tablet combining tadalafil and paroxetine, formulated for men who want to extend sexual endurance. For men whose stamina concerns overlap with erectile difficulties, Rugiet Ready combines sildenafil, tadalafil, and apomorphine in a fast-acting 3-in-1 sublingual tablet. These are prescription products issued only after a telehealth evaluation. Clinician oversight, pharmacy compounding, and scheduled follow-up are intended to help tailor dosing safely over time.

Convenience matters. Treatments typically cost approximately $1.95 to $10 per dose, ship directly to your door, and remove the need for in-person pharmacy visits. For many men, the combination of privacy, affordability, and clinician oversight can make it easier to seek care.

Understanding premature ejaculation and sexual endurance

Premature ejaculation is broadly defined as a persistent pattern of ejaculation occurring sooner than desired, causing distress for one or both partners. The International Society for Sexual Medicine (ISSM) specifies that lifelong PE often involves ejaculation within 30 to 60 seconds of penetration, while acquired PE may develop later in life due to medical, psychological, or relational factors. In severe cases, ejaculation can occur within 60 seconds of penetration.

Prevalence estimates vary by study and definition. PE may affect a substantial proportion of men at some point in their lives; some sources report ranges such as 30% to 70% and others estimate around 20% to 30% depending on criteria and sampling methods. The Cleveland Clinic and Mayo Clinic are common clinical references for clinicians and patients.

Setting realistic expectations about duration can help reduce pressure. Many reports show most sexual encounters last about 5 to 7 minutes, and some studies estimate the average intravaginal ejaculation latency time (IELT) at roughly 5.4 minutes.

Metric	Duration
Average intravaginal ejaculation latency time (IELT)	~5.4 minutes
Typical sexual encounter range	5–7 minutes
Lifelong PE threshold (ISSM)	≤30–60 seconds

There are two main categories. Lifelong (primary) PE has been present since the first sexual experiences and is often linked to biological sensitivity or neurological factors. Acquired (secondary) PE develops after a period of normal ejaculatory control and may be driven by psychological stress, relationship dynamics, hormonal changes, or underlying medical conditions like thyroid disease or prostatitis. Understanding which type applies can help guide treatment choices. For a deeper look at what research says about duration, see Rugiet's breakdown of average sex duration.

Behavioral techniques to improve ejaculatory control

Lasting longer is a trainable skill. The American Urological Association (AUA) lists behavioral techniques as first-line interventions for PE, and with consistent practice many men can meaningfully improve their ejaculatory control.

Stop-start method. The stop-start method is a behavioral technique in which a man pauses sexual stimulation just before reaching orgasm, allows arousal to subside, and then resumes. Repeating this process over time can build greater ejaculatory control. Begin by practicing during solo masturbation, then incorporate the technique with a partner as confidence grows.

Squeeze technique. When nearing climax, applying firm pressure to the frenulum or base of the glans for 10 to 20 seconds can temporarily reduce the urge to ejaculate. Release, wait about 30 seconds, and resume stimulation. Like the stop-start method, this technique may become more effective with repetition.

Edging. Edging involves repeatedly approaching, but not reaching, the point of orgasmic inevitability. Over time, this can build arousal awareness and teach the body to tolerate higher levels of stimulation without triggering ejaculation.

Paced breathing. Breathing and relaxation techniques activate the parasympathetic nervous system, which can reduce the urgency of arousal. Try box breathing: inhale for 4 counts, hold for 4 counts, exhale for 4 counts, hold for 4 counts. Maintaining slow, deliberate breathing during sex can help delay the ejaculatory reflex.

Digital-first approaches to PE training are also being investigated. The CLIMACS study, a randomized controlled trial presented at EAU 2026, tested a smartphone app that trained men in mindfulness, arousal awareness, cognitive behavioral therapy (CBT), and hands-on exercises like the stop-start technique. Final results were not yet peer reviewed at the time of release, but preliminary findings support structured, self-guided behavioral training.

One additional strategy that some men report finding helpful is masturbating one to two hours before sex, which can reduce sensitivity and lower psychological pressure for some individuals.

Rugiet clinicians can support structured practice plans and monitor progress remotely as part of a telehealth care plan.

Pelvic floor training for enhanced sexual stamina

The pelvic floor is a group of muscles that stretch like a hammock from the pubic bone to the tailbone, supporting bladder control, bowel function, and, for men, aspects of ejaculatory timing during sex. Strengthening these muscles can be an effective and often overlooked strategy for improving sexual stamina and ejaculatory control.

A common and practical routine is 3 sets of 10 repetitions daily, with progressive hold durations:

Week	Reps × Sets	Hold Duration	Frequency
1–2	10 × 3	3 seconds	Daily
3–4	10 × 3	5 seconds	Daily
5+	10 × 3	7–10 seconds	Daily

To identify the correct muscles, try stopping urination midstream once; the muscles you engage are your pelvic floor. After that, perform contractions while seated, standing, or lying down. Avoid making a habit of stopping urination midstream—use that maneuver only for initial identification.

Consistency is essential. Clinical improvements can require several weeks of daily practice before noticeable changes in ejaculatory control emerge. For many men, combining Kegel training with behavioral techniques may produce a greater effect than either approach alone. For practical tips, see Rugiet's guide to improved stamina in the bedroom.

Sensory modulation: condoms and topical desensitizers

Sensory modulation for PE includes products such as thicker condoms or topical anesthetic creams that reduce penile nerve sensitivity during sex, which can help delay the ejaculatory reflex without eliminating pleasurable sensation entirely.

Thicker or desensitizing condoms. Thicker condoms reduce the intensity of stimulation during intercourse. Some brands include a small amount of benzocaine inside the tip for an additional desensitizing effect. These are widely available over the counter. Always check for latex or anesthetic allergies, and discuss condom use openly with your partner.

Topical anesthetics (lidocaine/prilocaine). Clinical evidence suggests topical anesthetics can increase IELT for many men. Some studies have reported increases of roughly 2 to 6 times baseline in IELT for topical agents versus placebo in trial settings; for example, a 5% lidocaine-prilocaine cream increased IELT from 0.6 minutes to 3.8 minutes in one trial while also improving measures of control and satisfaction. These products can cause numbness or other side effects, and care should be taken to avoid transferring topical anesthetic to a partner.

Practical tips for topical use:

Apply 15 to 20 minutes before intercourse.
Wipe off excess before penetration to reduce transfer risk.
Start with a small amount to gauge individual sensitivity.
These products are available over the counter and can also be discussed during a Rugiet telehealth consultation for personalized guidance on dosing and timing.

Addressing mental health and lifestyle factors

Lasting longer in bed is not purely a physical challenge. Stress, anxiety, and depression can all affect sexual function, and performance anxiety is one of the most common drivers of worsened ejaculation control. Chronic stress may also interfere with arousal and testosterone levels, creating a cycle that can be difficult to break without deliberate intervention.

Performance anxiety and CBT. Counseling or therapy, particularly cognitive behavioral therapy, can be effective when psychological factors are driving PE. Mindfulness techniques help men stay relaxed and present during sex rather than spiraling into worry about performance. Many of these approaches are accessible through telehealth platforms.

Partner communication. Open communication with a partner can reduce performance pressure and improve intimacy during the treatment process. Consider starting with honest conversations about preferences, removing the pressure of penetration-focused sex, and incorporating extended foreplay to slow arousal build-up. Rugiet's guide to dealing with PE in your relationship offers practical conversation frameworks.

Lifestyle modifications. Daily habits can affect sexual endurance. Consider the following:

Exercise — Cardiovascular fitness supports vascular health and blood flow, which can influence erections and stamina.
Smoking cessation — Smoking contributes to vascular disease and may worsen sexual function.
Weight management — Obesity is linked to higher risk of sexual dysfunction in some studies.
Diet — Whole-food-focused diets tend to support better blood flow than diets high in unhealthy fats. See Rugiet's sex drive diet guide for suggestions.
Sleep — Aim for 7 to 9 hours nightly to support hormonal balance and recovery.

Using telehealth for assessment and ongoing support

That only a minority of men with PE seek medical help highlights a gap between need and care. Stigma, embarrassment, and inconvenience are common barriers. Telehealth can reduce those barriers by offering private, structured, and clinically rigorous care from home.

A step-by-step telehealth care pathway for addressing PE:

Screen and assess: complete an online intake that evaluates for PE, ED, current medications, medical causes, and psychological factors.
Start behavioral strategies: receive guided instructions on stop-start, squeeze, edging, and paced breathing to practice during masturbation and partnered sex.
Add pelvic floor training: begin daily Kegels with progressive holds and repetitions.
Incorporate sensory tools: discuss thicker condoms or topical desensitizers with your clinician and address partner comfort.
Address mental health and lifestyle: pursue CBT or mindfulness, improve exercise habits, optimize sleep and diet.
Escalate if needed: consult a clinician about prescription medications, further lab testing, or specialist referral.

Rugiet's telehealth model is designed to combine clinical evaluation, personalized prescription access, direct-to-door delivery, and ongoing follow-up with board-certified doctors. Regular clinician follow-up can allow treatment adjustments as needed.

The CLIMACS randomized controlled trial tested a smartphone app across several European countries that trained men in mindfulness, arousal awareness, CBT, and hands-on exercises. Final results were not yet peer reviewed at the time of release, but the study's design and preliminary findings suggest telehealth-delivered PE care may be effective for some men.

When to consider prescription medications and clinical advice

If behavioral techniques, pelvic floor training, and lifestyle changes have been practiced consistently for several weeks without meaningful improvement, or if PE is accompanied by erectile dysfunction, pain, or a suspected underlying condition, consult a clinician.

SSRIs for PE. A Cochrane systematic review found that selective serotonin reuptake inhibitors may significantly prolong ejaculation time versus placebo. Paroxetine, sertraline, and fluoxetine have all shown benefit in trials. Rugiet Go Long applies this evidence by combining tadalafil, a PDE5 inhibitor that supports blood flow and erection quality, with paroxetine, an SSRI that has been shown to delay ejaculation, in a single compounded tablet; this approach may address both PE and co-occurring erectile concerns for some patients.

PDE5 inhibitors. For men whose stamina concerns involve erectile dysfunction, prescription PDE5 inhibitors like sildenafil are commonly used and supported by clinical experience. Rugiet Ready combines sildenafil, tadalafil, and apomorphine in a sublingual format intended to provide comprehensive erectile support for those who need it. Discuss potential benefits, onset expectations, and side effects with a clinician.

Topical prescription agents. As noted above, a 5% lidocaine-prilocaine cream improved IELT in clinical trials. These topical options can be discussed during a Rugiet consultation for personalized guidance.

Product	Active Ingredients	Format	Best For
Rugiet Go Long	Tadalafil + Paroxetine	2-in-1 tablet	PE with or without mild ED
Rugiet Ready	Sildenafil + Tadalafil + Apomorphine	3-in-1 sublingual tablet	ED with stamina concerns

All Rugiet prescriptions require a consultation with a board-certified doctor and are personalized based on the individual's health profile. Consult a clinician for sudden changes in ejaculatory patterns, pain during sex, or suspected underlying disease.

Frequently asked questions about lasting longer in bed

What is premature ejaculation?

Premature ejaculation is ejaculation that happens sooner than a man or his partner would like during sexual activity. It is a common male sexual dysfunction and may affect an estimated 20% to 30% of men depending on definitions and study methods.

How common is premature ejaculation?

Prevalence estimates vary. PE may affect a substantial proportion of men at some point in their lives, with some studies reporting ranges such as 30% to 70% and others estimating around 20% to 30%, depending on criteria.

How long should sex typically last?

Many sexual encounters last about 5 to 7 minutes, and some studies estimate average intravaginal ejaculation latency time at approximately 5.4 minutes. There is no single "correct" duration; mutual satisfaction is what matters most.

What are the best behavioral techniques to last longer in bed?

First-line behavioral techniques include the stop-start method, the squeeze technique, edging, and paced breathing. Practicing these consistently during solo and partnered sessions can gradually improve ejaculatory control for many men.

Do pelvic floor exercises help with premature ejaculation?

They can. Strengthening the pelvic floor muscles through daily Kegel exercises, typically 3 sets of 10 repetitions, may improve muscular control over ejaculation and enhance overall sexual stamina over several weeks.

Can telehealth help me treat premature ejaculation?

Telehealth can help. Rugiet's telehealth platform allows men to consult licensed providers, receive personalized diagnoses, and access prescription treatments or behavioral guidance from home, which may reduce the stigma some men feel about seeking help.

Does mental health affect how long I last in bed?

Yes. Stress, anxiety, depression, and performance anxiety can worsen ejaculatory control. Cognitive behavioral therapy, mindfulness practices, and open communication with a partner are effective strategies to address these factors for many men.

Can condoms or topical products help me last longer?

Yes. Thicker condoms can reduce penile sensitivity, and topical anesthetics containing lidocaine or prilocaine have been shown in trials to increase ejaculation latency time by roughly 2 to 6 times baseline for some users. Side effects and partner transfer risk should be considered.

When should I consider prescription medication for PE?

If behavioral techniques, pelvic floor training, and lifestyle changes have not produced sufficient improvement after several weeks of consistent practice, or if PE occurs alongside erectile dysfunction or other medical concerns, consult a clinician about prescription options.

Does masturbating before sex help you last longer?

Masturbating one to two hours before sex can reduce sensitivity and lower psychological pressure for some men, potentially helping them last longer during intercourse. Individual responses vary.

Individual results may vary. The information in this guide is educational and not a substitute for professional medical advice, diagnosis, or treatment. Consult a licensed healthcare provider before starting any new treatment, particularly prescription medications; discuss potential side effects, contraindications, and interactions with other medications or medical conditions.