Here’s a bit of a sexual health reality check, guys: premature ejaculation is actually one of the most common male sexual problems, affecting as much as 30–70 percent of us (although reports are subjective and estimates vary widely). So if you’re looking for access to premature ejaculation treatment in the form of a pill, you’re definitely not alone. Unfortunately, the answer is tricky.
There are treatments that work by delaying ejaculation and helping men to avoid reaching orgasm too early, but all “premature ejaculation pills” are actually not designed to treat PE. Instead, they’re typically things like antidepressants like selective serotonin reuptake inhibitors (SSRIs) or phosphodiesterase type -5 inhibitors (PDE5 inhibitors) like sildenafil (the active ingredient in Viagra®) prescribed for off-label use. Treatments also include local anesthetics like lidocaine or benzocaine.
Premature ejaculation pills, then, are a little more complicated than “pop the pill, start the timer.” Let’s break down the complicated state of effective premature ejaculation pills, starting with a more detailed look at what they are.
Several treatments can help with premature ejaculation by delaying ejaculation, including locally applied anesthetics like lidocaine or benzocaine. 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. 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. 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.
PDE5 inhibitors. 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. 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. These PDE5 inhibitors work as vasodilators. 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. Let’s look at why.
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.
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.
Here’s how it went:
After taking a 25-milligram daily 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.
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.
Can Viagra make you last longer? It’s possible that everyone’s favorite stay-hard pill may also function as a PE pill. Research has found that many men with PE experience improvements after using ED medications like Viagra or generic sildenafil.
Let’s look at the data:
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.
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:
Nausea, vomiting, diarrhea, or constipation
Dizziness
Tiredness or difficulty sleeping
Headache
Nervousness
Excessive sweating or shaking
Dry mouth
Heartburn
Appetite or weight changes
Changes in sex drive (libido) or sexual performance
Many of these are common potential side effects of all antidepressants. 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. Potential side effects of sildenafil include:
Headache
Facial flushing
Heartburn
Nosebleeds
Difficulty sleeping
Muscle aches
Numbness or tingling in the limbs
Increased sensitivity to light
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 or lidocaine wipes. Benzocaine and lidocaine are topical anesthetics that, when applied to the penis, help you avoid premature ejaculation by reducing sensitivity in the penis. 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.
Premature ejaculation cream. 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.
Climax-control condoms. Some condoms have benzocaine on the inside to desensitize the penis during sex — and help you stay safe at the same time.
PE prevention techniques. Techniques like the stop-start strategy and squeeze technique appear to help prevent PE. We’ve covered the squeeze technique and others (and the scientific research on their effectiveness) in our guide to stopping premature ejaculation.
Behavioral therapy. PE sometimes has psychological causes, such as sexual performance anxiety. Because of that, some forms of behavioral therapy may help treat it, including cognitive-behavioral therapy (CBT) and sex therapy.
Pelvic floor exercises. Also referred to as Kegel exercises, pelvic floor exercises involve strengthening the pelvic floor muscles to help control ejaculation. Research shows Kegel exercises can often improve ejaculatory control and delay orgasm in men with PE.
Masturbating before sex. 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.
Holding off from the main event. Some men with PE can last longer by focusing more on foreplay instead of penetrative sex.
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. You can also grab a 64-ounce soda and some lottery tickets.
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. But they’re far from anything close to a treatment.
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.
Until PE gets its own medication class, certain antidepressants and ED meds are your best treatment options for premature ejaculation.
Whether you’re ready to try pills to last longer in bed or want to give the home remedies more time to work, here’s what to remember:
You’re not alone if you’re dealing with PE. Premature ejaculation is a common issue that can affect men of all ages.
Don’t be ashamed. As with erectile dysfunction and other common medical conditions, there’s no shame in using premature ejaculation medication to treat PE and improve your sexual performance, sexual relationship with your partner(s), sexual health, or your own personal sexual pleasure.
The solution is to get treated safely. Stick to proven prescription treatments, such as sertraline, paroxetine, or sildenafil, or use over-the-counter options like products containing lidocaine or benzocaine.
Hims offers access to these prescription premature ejaculation treatments online, following an online consultation with a licensed healthcare provider who can determine if a prescription is appropriate. Get medical advice today.
Worried about premature ejaculation? Explore more options on how to improve your sexual stamina in our blog.
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