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Doctor-trusted PE treatments
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*Online consultation required. Prescription products are not FDA-approved for the treatment premature ejaculation and are only available if a healthcare provider determines they are necessary and appropriate. Sex Rx+Climax Control is a compounded product. Compounded drug products are not approved or verified for safety or effectiveness by FDA.
*Online consultation required. Prescription products are not FDA-approved for the treatment premature ejaculation and are only available if a healthcare provider determines they are necessary and appropriate. Sex Rx+Climax Control is a compounded product. Compounded drug products are not approved or verified for safety or effectiveness by FDA.
Doctor-trusted prescription options for treating PE
While no FDA-approved premature ejaculation pills exist today, medical providers can prescribe medication “off-label” when appropriate. These PE treatments are clinically proven to help men last longer in bed, no topical sprays or goopy gels required. We call that a win-win.
1. An Update of the International Society of Sexual Medicine's Guidelines for the Diagnosis and Treatment of Premature Ejaculation (PE); 2. Phosphodiesterase-5 Inhibitors for Premature Ejaculation, U.S. National Library of Medicine; Prescription products are not FDA-approved for the treatment of premature ejaculation and available only if prescribed by a healthcare provider after an online consultation. Learn about off-label uses. This page has been medically reviewed by Peter J. Stahl, MD.
Got PE questions?
We’ve got answers.
What is premature ejaculation?
Technically, PE occurs when you ejaculate less than a few minutes after you start penetrative sex. More generally, PE is when you ejaculate much sooner than you or your partner wishes. In severe cases, it may even happen before sexual intercourse. PE can negatively affect one’s sex life and may be referred to as early ejaculation, rapid ejaculation or premature climax. PE is one of the most common sexual dysfunctions you may encounter.
What causes premature ejaculation?
Premature ejaculation has a number of different causes, including psychological factors like concern over your sexual performance (aka sexual performance anxiety), relationship problems, stress or depression, as well as some physical factors, like a hormonal imbalance or an infection in your urethra or prostate. In many cases, the cause cannot be determined. All of these factors can cause problems ejaculating, including premature or early ejaculation, which can impact your sexual relationships and encounters.
How can you fix premature ejaculation?
There are several prescription, over-the-counter and home remedies that all can be effective in treating PE. The best option for you depends on your specific situation, but these are a few of the most popular options:
- SSRIs: Also known as selective serotonin reuptake inhibitors, prescription medications like paroxetine, sertraline, fluoxetine and dapoxetine have been shown to be effective in treating premature ejaculation.
- PDE5 inhibitors: ED medications, such as sildenafil (generic for Viagra®) or tadalafil (generic for Cialis®), can be used to treat both premature ejaculation and erectile dysfunction. If you ejaculate too quickly, this may be the option for you, especially if you also struggle with getting erections, maintaining them, or achieving another one after your refractory period.
- Anesthetic creams or sprays: Topical anesthetics are a popular choice for management of premature ejaculation because they are over-the-counter and since they aren’t ingested, they don’t have systemic effects on your body, which reduces the risk of experiencing systemic side effects
- Stop-start or edging: This is a method of training your body to recognize when you are about to ejaculate during sexual stimulation, so that you can stop stimulation for a time to delay ejaculation for longer during sexual intercourse.
- Sex therapy: Starting behavioral therapy with a licensed mental health provider, such as a psychiatrist or sex therapist, can help you to work through any psychological reasons that you might be experience premature ejaculation.
- Squeeze technique: The squeeze method is simply putting pressure on your penis when you are close to ejaculating to decrease arousal.
- Kegel exercises: Strengthening the pelvic floor muscles can help you to control the muscles around your urethra, which studies show can help with premature ejaculation.
- Masturbation: Masturbating before sexual intercourse can help you to last longer during sexual activity
Why do I need a prescription for PE treatment?
There are non-prescription treatment options for PE, but to get a prescription treatment, you must first see a healthcare provider, who can determine if a prescription is appropriate for you. Discussing premature ejaculation with a healthcare provider can also help improve outcomes (especially if there are underlying medical conditions causing PE). Some medications available through our platform for the treatment of premature ejaculation, such as PDE5 inhibitors like sildenafil and antidepressants like sertraline, are only available with a prescription by a licensed healthcare provider.
Can PE treatment increase my sexual performance?
It depends. PE treatment can improve your sexual experiences if you have a sexual problem on the PE spectrum. Talk with a medical provider to find out if PE treatment could help improve your sexual function.
What are signs of lifelong premature ejaculation?
Lifelong PE is an innate, lifelong low threshold for orgasm that often results in a consistent very short time to ejaculation and a sense that you can’t control climax. This is on the serious end of the PE spectrum and typically will not subside without professional help. The signs include coming during early foreplay, with minimal sexual stimulation, or within the first 1-3 minutes of sexual intercourse. There are a range of interventions proven to help in management of premature ejaculation so it does not affect your sex life.
Important Safety Information
WARNING: SUICIDALITY AND ANTIDEPRESSANT DRUGS
Sertraline and other antidepressant drugs may increase suicidal thoughts or actions in some people 24 years of age and younger, especially within the first few months of treatment or when the dose is changed. Watch for these changes and call your healthcare provider right away if you notice new or sudden changes in mood, behavior, actions, thoughts, or feelings, especially if severe. Pay particular attention to such changes when sertraline is started or when the dose is changed.
Who should not take sertraline?
Do not take sertraline if:
You take a Monoamine Oxidase Inhibitor (MAOI), including linezolid or methylene blue, or if you stopped taking an MAOI in the last 2 weeks. Do not take an MAOI within 2 weeks of stopping sertraline. Ask your healthcare provider or pharmacist if you are not sure if your medicine is an MAOI. People who take sertraline close in time to an MAOI may have serious or even life threatening side effects.
Get medical help right away if you have any of these symptoms:
- high fever
- uncontrolled muscle spasms
- stiff muscles
- rapid changes in heart rate or blood pressure
- confusion
- loss of consciousness (pass out)
Take Orap® (pimozide) because this can cause serious heart problems
Take MELLARIL® (thioridazine) because this can cause serious heart rhythm problems or sudden death.
Are allergic to sertraline or any of the ingredients in sertraline
Sertraline and other antidepressant medicines may cause serious side effects. Call a healthcare provider right away if you or a person you know who is taking sertraline has any of the following symptoms, especially if they are new, worse, or worry you:
- Attempts to commit suicide
- Acting aggressive or violent
- New or worse depression
- Feeling agitated, restless, angry, or irritable
- An increase in activity or talking more than what is normal for you
- Acting on dangerous impulses
- Thoughts about suicide or dying
- New or worse anxiety or panic attacks
- Trouble sleeping
- Other unusual changes in behavior or mood
- Depression or other serious mental illnesses are the most important causes of suicidal thoughts or actions. Watch for these changes and call your healthcare provider right away if you notice new or sudden changes in mood, behavior, actions, thoughts, or feelings, especially if severe. Keep all follow-up visits with your healthcare provider and call between visits if you are worried about symptoms.
Depression or other serious mental illnesses are the most important causes of suicidal thoughts or actions. Watch for these changes and call your healthcare provider right away if you notice new or sudden changes in mood, behavior, actions, thoughts, or feelings, especially if severe. Keep all follow-up visits with your healthcare provider and call between visits if you are worried about symptoms.
What should I tell my healthcare provider before taking sertraline?
Before taking sertraline, tell your healthcare provider and pharmacist about all prescription and over-the-counter medications and supplements you take or plan to take including:
- those to treat migraines
- psychiatric disorders (including other antidepressants or amphetamines) to avoid a potentially life-threatening condition called serotonin syndrome
- Aspirin
- other NSAID pain relievers
- other blood thinners because they may increase the risk of bleeding
- drugs used to treat irregular heartbeat
- drugs used to treat HIV infection
- drugs used to treat epilepsy
Before taking sertraline, tell your healthcare provider your complete list of medical conditions, including if you have liver problems, kidney problems, heart problems, seizures or convulsions, psychiatric disorders including bipolar disorder or mania, low sodium levels in your blood, history of a stroke, high blood pressure, bleeding problems, or glaucoma (high pressure in the eye).
Tell your healthcare provider immediately if you
- Become severely ill and have some or all of these symptoms: agitation, hallucinations, coma, or other changes in mental status; coordination problems or muscle twitching (overactive reflexes); racing heartbeat, high or low blood pressure; sweating or fever; nausea, vomiting, or diarrhea; muscle tightness, as these may be the symptoms of a life-threatening condition called Serotonin Syndrome
- Have a rash, hives, swelling, or trouble breathing as these may be the symptoms of an allergic reaction
- Have seizures or convulsions
- Have any increased or unusual bruising or bleeding, especially if you take the blood thinner warfarin (Coumadin®, Jantoven®), a non-steroidal anti-inflammatory drug (NSAID), or aspirin
- Have a headache; weakness or feeling unsteady; confusion, problems concentrating, thinking, or remembering, as these may be the symptoms of low salt (sodium) levels in the blood (hyponatremia). Elderly people may be at greater risk for this
Do not stop sertraline without first talking to your healthcare provider. Stopping sertraline may cause serious symptoms, including anxiety, irritability, high or low mood, feeling restless or sleepy; headache, sweating, nausea, dizziness; electric shock-like sensations, shaking, and confusion.
Some people are at risk for visual problems such as eye pain, changes in vision, or swelling or redness around the eye. You may want to undergo an eye examination to see if you are at risk and get preventative treatment if you are.
Should I avoid any activities while taking sertraline?
Sertraline can cause sleepiness or may affect your ability to make decisions, think clearly, or react quickly. You should not drive, operate heavy machinery, or do other dangerous activities until you know how sertraline affects you.
Drinking alcohol while taking sertraline is not recommended.
What are the possible side effects of sertraline in adults?
The most common side effects in adults treated with sertraline include:
- Nausea, loss of appetite, diarrhea, or indigestion
- Increased sweating
- Tremor or shaking
- Agitation
- Change in sleep habits including increased sleepiness or insomnia
- Sexual problems including decreased libido and ejaculation failure
- Feeling tired or fatigued
- Weakness
- Dizziness
- Sexual problems
- Dry mouth
- Constipation
- Infection
- Feeling anxious or trouble sleeping
Contact your healthcare provider if you have any side effect that continues or bothers you. These are not all the possible side effects of sertraline. Contact your healthcare provider or pharmacist if you need more information.
For medical advice on side effects, contact your healthcare provider. You can also report side effects to the FDA at 1-800-FDA-1088.
Your healthcare provider or pharmacist can tell you if it is safe to take sertraline with your other medicines. Do not start or stop any medicine while taking sertraline without talking to your healthcare provider first.
Important Safety Information
WARNING: SUICIDALITY AND ANTIDEPRESSANT DRUGS
Paroxetine and other antidepressant drugs may increase suicidal thoughts or actions in some people 24 years of age and younger, especially within the first few months of treatment or when the dose is changed. Watch for these changes and call your healthcare provider right away if you notice new or sudden changes in mood, behavior, actions, thoughts, or feelings, especially if severe. Pay particular attention to such changes when paroxetine is started or when the dose is changed.
Do not take paroxetine if:
You take a Monoamine Oxidase Inhibitor (MAOI), including linezolid or methylene blue, or if you stopped taking an MAOI in the last 2 weeks. Do not take an MAOI within 2 weeks of stopping paroxetine. Ask your healthcare provider or pharmacist if you are not sure if your medicine is an MAOI. People who take paroxetine close in time to an MAOI may have serious or even life threatening side effects.
Get medical help right away if you have any of these symptoms:
- high fever
- uncontrolled muscle spasms
- stiff muscles
- rapid changes in heart rate or blood pressure
- confusion
- loss of consciousness (pass out)
Take Orap® (pimozide) because this can cause serious heart problems
Take MELLARIL® (thioridazine) because this can cause serious heart rhythm problems or sudden death.
Are allergic to paroxetine or any of the inactive ingredients in paroxetine
Paroxetine and other antidepressant medicines may cause serious side effects. Call a healthcare provider right away if you or a person you know who is taking paroxetine has any of the following symptoms, especially if they are new, worse, or worry you:
- Attempts to commit suicide
- Acting aggressive or violent
- New or worse depression
- Feeling agitated, restless, angry, or irritable
- An increase in activity or talking more than what is normal for you
- Acting on dangerous impulses
- Thoughts about suicide or dying
- New or worse anxiety or panic attacks
- Trouble sleeping
- Other unusual changes in behavior or mood
Depression or other serious mental illnesses are the most important causes of suicidal thoughts or actions. Watch for these changes and call your healthcare provider right away if you notice new or sudden changes in mood, behavior, actions, thoughts, or feelings, especially if severe. Keep all follow-up visits with your healthcare provider and call between visits if you are worried about symptoms.
Before taking paroxetine, tell your healthcare provider and pharmacist about all prescription and over-the-counter medications and supplements you take or plan to take including:
- those to treat migraines
- psychiatric disorders (including other antidepressants or amphetamines) to avoid a potentially life-threatening condition called serotonin syndrome
- Aspirin
- other NSAID pain relievers
- other blood thinners because they may increase the risk of bleeding
- drugs used to treat irregular heartbeat
- drugs used to treat HIV infection
- drugs used to treat epilepsy
Before taking paroxetine, tell your healthcare provider your complete list of medical conditions, including if you have liver problems, kidney problems, heart problems, seizures or convulsions, psychiatric disorders including bipolar disorder or mania, low sodium levels in your blood, history of a stroke, high blood pressure, bleeding problems, or glaucoma (high pressure in the eye).
Tell your healthcare provider immediately if you
- Become severely ill and have some or all of these symptoms: agitation, hallucinations, coma, or other changes in mental status; coordination problems or muscle twitching (overactive reflexes); racing heartbeat, high or low blood pressure; sweating or fever; nausea, vomiting, or diarrhea; muscle tightness, as these may be the symptoms of a life-threatening condition called Serotonin Syndrome
- Have a rash, hives, swelling, or trouble breathing as these may be the symptoms of an allergic reaction
- Have seizures or convulsions
- Have any increased or unusual bruising or bleeding, especially if you take the blood thinner warfarin (Coumadin®, Jantoven®), a non-steroidal anti-inflammatory drug (NSAID), or aspirin
- Have a headache; weakness or feeling unsteady; confusion, problems concentrating, thinking, or remembering, as these may be the symptoms of low salt (sodium) levels in the blood (hyponatremia). Elderly people may be at greater risk for this
Do not stop paroxetine without first talking to your healthcare provider. Stopping paroxetine may cause serious symptoms, including anxiety, irritability, high or low mood, feeling restless or sleepy; headache, sweating, nausea, dizziness; electric shock-like sensations, shaking, and confusion.
Some people are at risk for visual problems such as eye pain, changes in vision, or swelling or redness around the eye. You may want to undergo an eye examination to see if you are at risk and get preventative treatment if you are.
Should I avoid any activities while taking paroxetine?
Paroxetine can cause sleepiness or may affect your ability to make decisions, think clearly, or react quickly. You should not drive, operate heavy machinery, or do other dangerous activities until you know how paroxetine affects you.
Drinking alcohol while taking paroxetine is not recommended.
What are the possible side effects of paroxetine in adults?
The most common side effects in adults treated with paroxetine include:
- Nausea, loss of appetite, diarrhea, or indigestion
- Increased sweating
- Tremor or shaking
- Agitation
- Change in sleep habits including increased sleepiness or insomnia
- Sexual problems including decreased libido and ejaculation failure
- Feeling tired or fatigued
- Weakness
- Dizziness
- Sexual problems
- Dry mouth
- Constipation
- Infection
- Feeling anxious or trouble sleeping
Contact your healthcare provider if you have any side effect that continues or bothers you. These are not all the possible side effects of paroxetine. Contact your healthcare provider or pharmacist if you need more information.
For medical advice on side effects, contact your healthcare provider. You can also report side effects to the FDA at 1-800-FDA-1088.
Your healthcare provider or pharmacist can tell you if it is safe to take paroxetine with your other medicines. Do not start or stop any medicine while taking paroxetine without talking to your healthcare provider first.
Important Safety Information