Dapoxetine: The On-Demand Treatment Option

Techniques like the stop-start strategy and squeeze technique appear to help prevent PE.

Selective Serotonin Reuptake Inhibitors

Research shows that PDE5 inhibitors work better than a placebo in helping with premature ejaculation. Combining a PDE5 inhibitor with an SSRI appears to be even more effective, helping men last longer than with an SSRI alone. Even if there’s no improvement in ejaculation time the first time you have sex, sildenafil might make it easier to enjoy round two with your partner. Like all medications, PDE5 inhibitors and SSRIs can cause potential side effects. For instance, potential side effects of sertraline include: Changes in sex drive (libido) or sexual performance Changes in sex drive (libido) or sexual performance Many of these are common potential side effects of all antidepressants.

Psychological causes

You can learn more about what to expect from SSRIs in our guide to antidepressant side effects. Sildenafil and other PDE5 inhibitors, on the other hand, generally only cause mild side effects while active in the body and when taken as prescribed. Changes in the ability to perceive color Changes in the ability to perceive color If you experience any of these side effects or are concerned about potential adverse effects, get in touch with your healthcare provider to discuss your options. If your goal is to last longer during sex without prescription medication, some alternative treatments for PE are worth considering, either as part of a broader treatment plan or on their own. Nothing’s going to replace medical advice from a licensed healthcare provider, but you might see improvements from: Benzocaine and lidocaine are topical anesthetics that, when applied to the penis, help you avoid premature ejaculation by reducing sensitivity in the penis. We’ve covered the squeeze technique and others (and the scientific research on their effectiveness) in our guide to stopping premature ejaculation.

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PE sometimes has psychological causes, such as sexual performance anxiety.

Beta-adrenergic Blocker

They regulate the amount of serotonin between neurons (the brain’s messengers), which is believed to help alleviate symptoms of depression. In some cases, healthcare providers might prescribe these drugs off-label for premature ejaculation since they help slow down orgasm and ejaculation. This effect is typically regarded as a side effect of medications like paroxetine and sertraline. But for folks with PE, this “adverse” effect can be beneficial. Healthcare professionals may also recommend combining an SSRI with a prescription ED medication such as Viagra or Cialis.

Symptoms of Premature Ejaculation

They improve your sex life by increasing blood flow to your penis, helping you obtain and sustain erections. Some research also shows ED meds improve the perception of ejaculatory control — meaning you might feel like you have more control over when you orgasm. We understand why you’d be a little concerned about taking a medication designed for one purpose to treat something else. But you might be surprised to learn that healthcare professionals often prescribe medications to treat issues outside their FDA-approved status. In fact, these off-label medications are surprisingly well-targeted when used to treat PE.

Surgical treatments

Sexual experiences and sexual activity are very much mental exercises, but SSRIs don’t address the emotional element of sexual dysfunction. Instead, they make it harder for a person to reach orgasm. This may seem like an obvious conclusion, but research suggests the effect can help people with PE. You may have read about various medications like dapoxetine, fluoxetine, and others having this delayed-orgasm side effect. But one of the most commonly prescribed PE treatments in pill form is sertraline. Because of that, some forms of behavioral therapy may help treat it, including cognitive-behavioral therapy (CBT) and sex therapy.

Risk factors

These numbing agents can be good alternatives to prescription medications for PE. You can find benzocaine as an active ingredient in Hims Clockstopper Climax Delay Wipes, which are designed for quick and easy use five minutes before sex. Benzocaine and lidocaine are topical anesthetics that, when applied to the penis, help you avoid premature ejaculation by reducing sensitivity in the penis. Like premature ejaculation sprays, these numbing creams contain topical anesthetics such as lidocaine to or benzocaine to lower the sensitivity level of your penis and help you avoid ejaculating too soon. Some condoms have benzocaine on the inside to desensitize the penis during sex — and help you stay safe at the same time. Also referred to as Kegel exercises, pelvic floor exercises involve strengthening the pelvic floor muscles to help control ejaculation.

• Dapoxetine is specifically designed for on-demand use in PE.
• Topical anesthetics require minimal use to avoid excessive numbness.
• SSRIs impact neurotransmitters involved in ejaculation control.
• Tramadol's side effects limit its routine use for PE.
• Non-drug approaches include psychological counseling and exercises.
• Pelvic strengthening exercises aid in delay of ejaculation.
• Partner education enhances understanding and support.
• Managing stress and anxiety can significantly improve PE.
• Some therapies combine medication with sex therapy sessions.
• Medical evaluation is essential before initiating treatment.
• Lifestyle factors like smoking can influence sexual performance.
• Patient adherence to treatment plans improves outcomes.

Research shows Kegel exercises can often improve ejaculatory control and delay orgasm in men with PE. While it’s certainly far from scientific, some people claim that masturbation before sex helps delay orgasm and ejaculation by keeping you in the post-sex refractory period. Some men with PE can last longer by focusing more on foreplay instead of penetrative sex.

Ethics declarations

But many of the so-called “premature ejaculation pills” are actually used off-label to treat PE. (Off-label use is when a product is used for something other than what it’s FDA-approved for.) PE pills include antidepressants like selective serotonin reuptake inhibitors (SSRIs). In some cases, healthcare providers may even prescribe phosphodiesterase type-5 inhibitors (PDE5 inhibitors) like sildenafil (the active ingredient in Viagra®) which are approved to treat erectile dysfunction (ED). If you want to prolong your erections, keep reading to explore the best pills for PE, topical medical treatments to consider, and why you should be cautious about over-the-counter treatments for PE. Premature ejaculation pills are an unofficial term for certain oral drugs healthcare providers prescribe off-label to treat premature ejaculation.

Treatment options

These medications include SSRIs like sertraline and PDE5 inhibitors like sildenafil. Though these drugs are widely prescribed for PE and other sexual dysfunctions, they aren’t FDA-approved for these purposes. In fact, every PE medication is actually a pill originally intended for another purpose. Some of the top pills that might help you last longer in bed include: SSRIs like sertraline (commonly sold as Zoloft®) are popular among people with PE problems.These medications increase serotonin levels in the brain. Low serotonin levels in the brain are believed to play a role in premature ejaculation, whereas increased serotonin activity can delay orgasm.

Early and Delayed Ejaculation: Psychological Considerations

SSRIs like sertraline (commonly sold as Zoloft®) are popular among people with PE problems.These medications increase serotonin levels in the brain. Another commonly used PE pill is actually intended for another sexual dysfunction: ED. PDE5 inhibitors like sildenafil (Viagra), tadalafil (Cialis®), vardenafil (Levitra®), and avanafil (Stendra®) are sometimes prescribed off-label for premature ejaculation because they improve blood flow and the perception of ejaculatory control. We’ll go into more detail on how these pills work (and how well they work to improve sexual function) in the following sections. SSRIs are typically used to treat depression and anxiety. Step into your local sex store or gas station — or do a quick search online — and you’ll find countless supplements promising to help you last longer in bed.

• Dapoxetine has a rapid onset, typically within 1-3 hours.
• Topical anesthetics should be applied in small amounts to avoid overdose.
• SSRI side effects may include sleep disturbances or gastrointestinal upset.
• Tramadol can cause dizziness, dry mouth, and nausea as side effects.
• Behavioral techniques teach men to recognize early signs of ejaculation.
• Pelvic floor training can enhance ejaculatory control.
• Counseling sessions help address performance anxiety and stress.
• Medications should be used as prescribed to minimize risks.
• Some men respond better to combination therapies.
• Abstaining from excessive masturbation may help in some cases.
• Lifestyle changes and psychological support are important adjuncts.
• Any medication or supplement should be discussed with a healthcare professional.

You can also grab a 64-ounce soda and some lottery tickets.

Medication Name	Type	Typical Dosage	Onset Time	Duration of Effect	Common Side Effects	Approval Status	Available By Prescription	Estimated Cost (USD)
Dapoxetine	SSRI	30 mg	1-3 hours	12-24 hours	Nausea, dizziness, headache	Approved	Yes	2-5
Paroxetine	SSRI	20 mg/day	1-2 hours	24 hours	Fatigue, dry mouth	Approved	Yes	1-4
Sertraline	SSRI	50 mg/day	2-4 hours	24 hours	Diarrhea, insomnia	Approved	Yes	2-4
Topical Anesthetics	Local anesthetic	Varies	Immediate	30-60 minutes	Loss of sensation in area	Approved	Yes	3-7

Most of the time, these products contain herbal ingredients like horny goat weed that might help improve sexual performance in a general “yay, vitamins” kind of way.

Class Summary

SSRIs are among the most common medications for the treatment of premature ejaculation. Older research on sertraline shows that this medication can treat premature ejaculation symptoms when used daily — often by a significant amount. One study from 1998 gave men with premature ejaculation 25 milligrams (mg) of sertraline daily, then 50 milligrams per day after three weeks, followed by 100 milligrams another three weeks later. After taking a 25-milligram daily fildena tablet dose of sertraline, the men’s average ejaculation time increased from one minute to 7.6 minutes. Once the study participants started taking the higher 50-milligram daily dose of sertraline, their average ejaculation time increased to 13.1 minutes.

What are common premature ejaculation medications?

At the 100-milligram dose, the men had an average ejaculation time of 16.4 minutes. At the 50- and 100-milligram doses of daily sertraline, a small number of participants started developing anejaculation (inability to orgasm during sex). Newer research has shown that SSRIs may help men last about three minutes longer during sex compared to a placebo. And they seem to improve key outcomes for men with premature ejaculation, including better control, more satisfaction during sex, and fewer symptoms. It’s possible that everyone’s favorite stay-hard pill may also function as a PE pill.

Using thicker condoms

Research has found that many men with PE experience improvements after using ED medications like Viagra or generic sildenafil. In a 2007 study, researchers compared the effects of sildenafil, paroxetine (an SSRI) and the squeeze technique (a PE method that involves squeezing the penis during sex) to see which option best treated PE. At the end of six months, sildenafil was shown to be the most effective treatment. Another study from 2005 found that although sildenafil didn’t directly increase the time before orgasm, it seemed to improve confidence and increase the perception of ejaculatory control. The researchers from the 2005 study also found that sildenafil reduces refractory time, making it easier for men with premature ejaculation to get a second erection shortly after sex. But they’re far from anything close to a treatment.

Drug Name	Approval Year	Primary Use	Recommended Dosage	Prescription Needed	Monitor Required	Typical Side Effects
Dapoxetine	2009	Premature ejaculation	30 mg before sex	Yes	Yes	Nausea, dizziness
Paroxetine	Approved for other uses, off-label for PE	20 mg/day	Yes	Yes	Yes	Fatigue, sexual dysfunction
Sertraline	Approved for depression, off-label for PE	50 mg/day	Yes	Yes	Yes	Insomnia, digestive issues

These products also aren’t regulated by the FDA in the same way as prescription medications, meaning they can be marketed using claims that are misleading. They may also contain undisclosed or harmful substances, including prescription drug analogues in unknown quantities, with real side effects.

Remedy	Type	Usage Description	Reported Benefits	Common Side Effects	Notes
Kegel Exercises	Physical activity	Repeatedly contracting pelvic muscles	Improved control	Muscle soreness	No medication involved
Herbal Supplements	Plant-based extract	Taken orally, e.g., ginseng, yohimbe	Possible enhancement of control	Interactions with medications	Evidence varies
Acupuncture	Traditional therapy	Stimulating specific body points	Stress reduction	Mild soreness	Limited scientific evidence