For healthcare professionals. Compounded preparations are dispensed on a doctor’s prescription.
Short answer: Topical lidocaine-containing preparations have been studied for premature ejaculation. A 2025 randomised study of 273 men found that ejaculatory latency lengthened in every group, with the lidocaine spray group showing the largest increase, followed by EMLA cream (lidocaine with prilocaine) (PMID 41144023). Evidence from these preparations does not establish an outcome for a lidocaine-only cream prescribed for a named patient.
The indication and the formulation question
Premature ejaculation (PE) is described in the 2025 trial as “the most common sexual dysfunction in men, negatively affecting quality of life and psychological well-being” (PMID 41144023). The same trial notes that local anaesthetic agents, lidocaine and benzocaine among them, are widely used for PE by reducing glans sensitivity, but that “comparative data on the efficacy of different topical agents are limited” (PMID 41144023).
The products named in that study are lidocaine-prilocaine cream (EMLA), a lidocaine spray and benzocaine condoms (PMID 41144023). The findings for those forms cannot establish the clinical result of a lidocaine-only cream.
The mechanism that has been proposed
A mechanism has been proposed for a different study’s product. In a study of prilocaine-lidocaine cream, the authors wrote that the cream “could delay sensory latency and decrease glans penile hyperexcitability, which may be the mechanism for PPE treatment” (PMID 24572995). That statement concerns the prilocaine-lidocaine combination, not lidocaine alone.
What the trials show, in the abstracts’ own words
A systematic review and meta-analysis of topical anaesthetics for PE included nine randomised trials. Its pooled evidence, from two trials with 43 participants, “suggests that EMLA is significantly more effective than placebo at increasing IELT” (PMID 26599522). Individual RCT evidence in the same review suggests that lidocaine gel was significantly more effective than placebo (PMID 26599522). The review concludes that “topical anaesthetics appear more effective than placebo, paroxetine and sildenafil at increasing IELT in men with PE. However, the methodological quality of the existing RCT evidence base is uncertain” (PMID 26599522).
The 2025 randomised study allocated 273 men with lifelong PE to EMLA cream (59 men), a lidocaine spray (126 men) or benzocaine condoms (88 men) (PMID 41144023). Intravaginal ejaculation latency time (IELT) “was significantly prolonged in all groups after treatment”, and “the highest IELT increase was observed in the lidocaine spray group, followed by the EMLA cream and benzocaine condom groups” (PMID 41144023). The authors add that “side effects were minimal and the lowest in the condom group” (PMID 41144023).
A 2004 randomised, double-blind, placebo-controlled study of 42 men compared a lidocaine-prilocaine solution with an inert cream. Its abstract reports that the mean IELT rose “from 1.49 (0.9) to 8.45 (0.9) min” in the lidocaine-prilocaine group and did not rise significantly in the inert cream group (PMID 15142155). That is a combination product, not a lidocaine-only cream.
| Design | Participants | Preparation | Outcome as reported | PMID |
|---|---|---|---|---|
| Systematic review and meta-analysis of RCTs | Nine RCTs; two RCTs (43 participants) pooled for EMLA | EMLA (lidocaine with prilocaine); lidocaine gel | EMLA significantly more effective than placebo at increasing IELT in the pooled analysis | 26599522 |
| Randomised clinical study | 273 men with lifelong PE | EMLA cream; lidocaine spray; benzocaine condoms | IELT significantly prolonged in all groups; largest increase with lidocaine spray | 41144023 |
| Randomised, double-blind, placebo-controlled study | 42 men | Lidocaine-prilocaine solution versus inert cream | Mean IELT rose from 1.49 to 8.45 min in the lidocaine-prilocaine group only | 15142155 |
What the evidence does not show
- The quality of the trial evidence is uncertain (PMID 26599522).
- The 2025 study measured short-term effects and states that “further studies are needed to evaluate the long-term efficacy and patient satisfaction” (PMID 41144023).
Forms Lynnity prepares for this indication
Lynnity prepares lidocaine as a cream, made to the prescriber’s written specification for one named patient. The studies above do not test that preparation.
Safety and monitoring
In the 2025 comparison of EMLA cream, lidocaine spray and benzocaine condoms, the authors reported that side effects were minimal and lowest in the condom group, for the products and participants studied (PMID 41144023). This is not a safety finding for a lidocaine-only cream. The prescriber should review the patient’s full medication list and consider any history of local anaesthetic sensitivity.
Reviewed by Vitthia Rama Murti, RPh (RPh 15632).
How to prescribe
Who can prescribe. A registered doctor practising in Malaysia prescribes the compounded preparation for a named patient.
What the prescription must state. The active (lidocaine), the strength the prescriber has determined, the form (cream), the quantity, the directions, and the patient’s identity.
How to send it. Lynnity’s referral process is a named-patient prescription with a short formulation brief, sent to the pharmacy. The steps are set out in the Kuala Lumpur and Klang Valley referral guide for clinics.
Contact. Vitthia Rama Murti, RPh (RPh 15632). Start the conversation through the contact page.
Related reading: compounded lidocaine cream for KL clinics and the systemic absorption ceiling, five prescriber-specified topical pain formulations, and compounded men’s wellness options explained.
Frequently asked questions
What do studies of topical lidocaine-containing preparations show for premature ejaculation?
The studies cited here tested EMLA cream (lidocaine with prilocaine), lidocaine gel and a lidocaine-prilocaine solution, not a lidocaine-only cream. A review of two trials with 43 participants reported a longer IELT for EMLA than placebo (PMID 26599522). The result cannot be attributed to a lidocaine-only cream.
How does the studied combination cream compare with a lidocaine spray?
A 2025 randomised study of 273 men found that IELT was significantly prolonged in every group, with the largest increase in the lidocaine spray group, followed by EMLA cream (PMID 41144023). These were different preparations, and the study did not examine lidocaine-only cream.
What safety information is available for the studied topical products?
In the 2025 comparison of EMLA cream, lidocaine spray and benzocaine condoms, the authors reported that side effects were minimal and lowest in the condom group (PMID 41144023). That result is specific to the products and participants studied; it is not a safety finding for a lidocaine-only cream.
What must a prescription for compounded lidocaine cream state?
It should name lidocaine, the strength the prescriber has chosen, the form (cream), the quantity, the directions and the patient’s identity.