There are many options for treating premature ejaculation, including prescription and over-the-counter (OTC) medication. Doctors may also recommend other treatment options for people with this condition.
This article looks into the most common available medication for premature ejaculation (PE). It also explores the side effects of these medications, alternatives, and frequently asked questions.
Please note that the writer of this article has not tried these products. All information presented is purely research-based and correct at the time of publication.
What is premature ejaculation?
PE is a type of sexual dysfunction that affects up to 30% of people with a penis.
Individuals with PE have one or more of these characteristics:
- ejaculation within 1 minute of penetration
- inability to control or delay ejaculation during penetration
- avoidance of sex due to negative feelings about ejaculation issues
PE can be a temporary or long-term condition.
What are the causes of premature ejaculation?
This condition is common in all age groups, but older people and those with underlying health conditions such as diabetes are more likely to experience PE.
Anxiety, depression, and stress about a person’s sexual performance can worsen PE. There are also primary and secondary triggers for this condition:
Primary PE
The following may trigger PE:
- a person’s upbringing
- a person’s conditioning by family and society
- traumatic sexual experiences
Secondary PE
Several health conditions that may trigger or worsen PE include:
- diabetes
- hypertension
- hyperthyroidism
- alcohol use disorder
- substance use disorder
What are the best premature ejaculation pills?
People should always speak with a doctor about medication for treating PE, as some pills for the condition may interact with other medication or existing health issues. Therefore, the safest option is to consult a medical professional for recommendations.
Some prescription and nonprescription pill medications that may help PE include:
- some erectile dysfunction (ED) medications
- antidepressants
- analgesics
ED pills
Certain ED medications can also help treat PE.
These are called phosphodiesterase-5 inhibitors (PDE5s) and include:
- sildenafil (Viagra)
- tadalafil (Cialis)
- vardenafil (Levitra)
- avanafil (Stendra)
They work by affecting the enzymes in the penis and lung to prolong erections and decrease pressure on the lungs, which calms down breathing.
A 2017 study found that PDE5s are significantly more effective in treating PE both independently and in combination with SSRIs or behavioral therapy.
The overall benefits of PDE5s are similar to other medications and include better ejaculation control, confidence, and delaying ejaculation.
Side effects depend on the specific type of drug, and they may include:
- headaches
- palpitations
- nausea
- vomiting
- sleep disturbance
- changes in vision
- back pain
- hearing changes
- a painful erection
- an erection that lasts longer than 4 hours
People taking nitrate medications, such as nitroglycerin, should avoid taking PDE5 inhibitors because of a risk of a sharp decline in blood pressure.
Additionally, those looking to use off-label ED drugs, such as Viagra, must be aware of how they may interact with other medications.
For example, health experts warn that individuals should not combine the hypertension drug riociguat with ED medication.
All the above ED medications are available on prescription.
Antidepressants
The common use of antidepressant medication is to treat individuals with depression and anxiety.
However, several studies show that the off-label use of two antidepressants may help treat PE by delaying ejaculations.
These antidepressants are selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs).
A 2016 study shows that ejaculation delay can increase within 10 days of taking the drug. However, individuals may need up to 3 weeks of treatment to achieve the maximum effect.
That study showed that the SSRI drug paroxetine was the most effective drug for delaying ejaculation.
However, there are a few concerns with antidepressant use:
- Availability: The Food and Drug Administration (FDA) provides a list of antidepressant medications it has tested and approved. Though most of these are only available by prescription, some antidepressants, such as chlorpheniramine, are available over the counter. However, more studies are necessary to determine their effectiveness in treating PE.
- Side effects: These include nausea, diarrhea, fatigue, and perspiration. Antidepressants may also cause erection problems in rare cases. The FDA states that severe but less common side effects can include seizures, irregular heartbeat, and withdrawal symptoms.
- Cost: An older study showed that people may refuse to take antidepressants for PE because of the costs and the risk of side effects. Therefore, individuals may wish to check their medical plan or insurance before deciding on long-term benefits and adherence.
The FDA also lists some medicines individuals cannot take with antidepressants, including monoamine oxidase inhibitors, thioridazine, and pimozide (Orap).
It also cautions the use of SSRIs and TCAs for individuals with narrow-angle glaucoma.
Tramadol
Tramadol is an analgesic drug that reduces sensitivity to the receptors that produce serotonin. An older study shows two types of serotonin: 5-HT(2C), which increases erections and stops ejaculation, and 5-HT(1A), which helps people reach ejaculation and can stop erections.
The drug works by blocking this second type of serotonin.
A 2021 study shows that administering the drug hours before sexual intercourse resulted in higher intercourse satisfaction and lowered PE.
However, tramadol is only available with a prescription.
It is also an opioid, which carries concerns for drug dependency and misuse. Further research is necessary to understand the risk of opioid addiction from tramadol.
Individuals looking to take tramadol should be aware that the FDA warns of serious risks, including death, if they combine this drug with benzodiazepines.
Codeine
Codeine is another type of analgesic drug.
A 2017 study shows one case where a person taking codeine saw improvements in controlling their ejaculations during intercourse.
However, this individual developed a dependency on the drug, which is a derivative of opium.
The study shows that while there were no abnormalities with liver and blood sugar, this person had to undergo a 6-month withdrawal process.
People considering taking codeine to treat PE should consult with a doctor or physician to determine the best course of action and to limit side effects.
What premature ejaculation pills to avoid
There are numerous PE pills on the market that reportedly do not work or contain untested amounts of prescription medication.
For example, the FDA issued a warning to one company because it failed to declare the active ingredients sildenafil and tadalafil in its PE pills.
People should also avoid pills that companies market to treat PE that make unsubstantiated health claims or do not have any studies and research to support their benefits.
Individuals with PE should also consult a doctor to find the safest and most effective treatment.
Where to get premature ejaculation pills
People looking to take PE pills should consult a doctor to help ensure that their health conditions or existing medications will not conflict with PE treatments.
The following are direct-to-consumer health companies that can ship PE medication to people in the United States.
Customers need to create secure profiles and include their medical history and symptoms.
A healthcare professional will then review the application, answer any questions, and discuss potential treatments, including approving medication.
- Roman: Roman specializes in ED pills such as sildenafil or Cialis. Prices start from $2 per dose.
- Hims: Hims provides both OTC and prescription medication, with free shipping in discrete packaging. Prices start from $4 per dose.
- Lemonaid Health: Lemonaid Health provides various health services, such as antidepressants and ED medication. Prices for PE medication start from $1 per pill after a $25 online consultation. Shipping is free, and the company sends products in discrete plain packaging.
Other treatments for premature ejaculation
Individuals with concerns about PE may wish to try OTC products and exercises before considering medication or surgical treatments. Alternative treatments for this condition include:
Pelvic floor exercises
An individual can perform pelvic floor exercises, sometimes called Kegels, to strengthen the pelvic muscles. This can lead to greater ejaculation control.
A 2019 study looked at the effectiveness of pelvic floor muscle training on improving PE in people over 18 years old.
The study found that while this type of training is effective, the optimal training method and frequency are unknown.
Condoms and wipes
Certain condoms and wipes may help reduce stimulation and delay ejaculation.
However, no studies have looked at the long-term treatment of PE when individuals have relied solely on condoms or wipes.
Sprays and creams
Some sprays and creams that contain desensitizing ingredients can decrease stimulation.
A 2021 study found that while such topical applications are helpful, they may have some side effects. These include skin irritation and the loss of sensation in the penis and their partner’s vaginal area.
Surgical treatments
There are various surgical treatments that individuals with moderate-to-severe PE can consider, including:
- Glans augmentation: A surgeon injects hyaluronic acid and a bulking agent into the glans of the penis to reduce nerve sensitivity. A 2021 study reports a decrease in PE among participants who underwent glans augmentation.
- Varicocelectomy: This surgery removes swollen veins from inside the scrotum. A 2016 study shows that participants found an overall improvement in both testosterone and PE after a varicocelectomy.
- Pulsed radiofrequency neuromodulation: According to a 2021 study, this procedure uses radiofrequency to treat the penile nerves. It showed significant improvements in PE and no side effects after the procedure.
Therapy
A person may consider talk therapy to work on anxiety-related issues related to sex or relationships. This may help to identify and tackle difficulties relating to premature ejaculation.
A 2016 study considered a combination of psychological and pharmacological treatment effective for premature ejaculation.
Online sources
A 2019 study looked into the reliability of YouTube videos for the treatment of premature ejaculation. The authors concluded that the video platform was a useful tool for premature ejaculation treatment and most videos had reliable information.
Home remedies
Some home treatment methods for premature ejaculation include:
- trying techniques for delaying an orgasm
- using thicker condoms to decrease sensation
- masturbating 1–2 hours before sex
Dapoxetine
Dapoxetine is another type of SSRI specifically designed to treat premature ejaculation.
A 2018 meta-analysis found that Dapoxetine is effective and safe in treating premature ejaculation.
However, this is not currently available in the US as the Food and Drug Administration (FDA) has not given its approval.
Comparing premature ejaculation treatments
The below table compares some of the treatments for PE.
| Availability | Price | |
|---|---|---|
| PDE5 inhibitors, including sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra), and avanafil (Stendra). | prescription only | around $2–4 per dose for generic options, plus consultation fees where applicable |
| Antidepressants, including selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs). | prescription only | varies per drug |
| Condoms, wipes, sprays, and creams | over the counter from drug stores and online companies | from around $15–90 |
| Surgical options | in-patient or day-case treatment only | varies per surgical option |
| Therapy | online or in person | varying, but for some services, such as Talkspace, standard therapy prices are between $69–129 per week |
When to contact a doctor
A person should contact a doctor if they believe they are ejaculating too soon after engaging in sexual activity.
Healthcare professionals will take a thorough history, including sexual history, erectile function, and libido. Doctors may also ask questions, such as:
- How often, and for how long, has the person been experiencing premature ejaculation?
- Does this happen with one partner, or has it happened with several?
- Does the person experience PE with every sexual activity, including masturbation?
- Is there anything, such as drugs or alcohol, that makes PE more or less likely?
After taking a history and diagnosing PE, a doctor may prescribe medications such as antidepressants.
Prevention tips
While lifelong PE has no cure, there is a 30–70% success rate with treatment. However, it is important to note that relapse is common and will require further treatment.
People may wish to do the following during sex to prolong the time it takes to ejaculate:
- wearing a condom
- extending foreplay
- using alternate sex positions
There are two common edging techniques that a person may use to delay ejaculation. Both of these methods require people to recognize when they are about to ejaculate, or their “point of no return.”
The “squeeze” technique
Once a person reaches their point of no return, they hold their thumb over the frenulum and two fingers on the opposite side of the glans and squeeze for a few seconds until the desire to ejaculate passes. People may instead wish to contract their pelvic floor muscles, which may provide the same results.
The “stop-start” technique
Some people may use this method during penetrative sex.
This technique requires a person or their partner to stimulate the penis until the person reaches their point of no return. Then, they should cease all stimulation until the desire to ejaculate passes.
Frequently asked questions
Here are some common questions about premature ejaculation.
Can you permanently fix premature ejaculation?
Some medications and surgical procedures show promising improvements in PE.
However, more studies are necessary to understand whether any procedures can permanently treat the condition without future recurrence.
There are alternative treatments that can improve ejaculation control and reduce PE. These include pelvic floor exercises, condoms, and desensitizing sprays or creams.
Do premature ejaculation pills have any side effects?
Yes. Different pills have varying side effects, ranging from headaches to more serious conditions. People taking various medications may also have to refrain from taking certain PE pills.
A person should speak with their doctor to ensure they choose the safest PE option for their needs.
Is it safe to take premature ejaculation pills every day?
Some medications, such as antidepressants, are safe to take every day. However, prescription medications that are an opioid, such as tramadol, have a risk of dependency.
A person should only take PE pills as often as a doctor recommends.
How do I stop premature ejaculation immediately?
For a more immediate solution to premature ejaculation, a person may consider masturbating 1 to 2 hours before having sex, using a thicker condom, and delaying their orgasm using techniques such as edging.
What is the best pill for premature ejaculation?
This varies depending on a person’s needs. Some people may find SSRIs most effective as they take them on a daily basis. However, others may prefer to use PDE-5 inhibitors as they take them as and when needed. A doctor will be able to recommend the most appropriate medication.
What can I eat or drink to last longer in bed, naturally?
In a 2018 study, experts found specific fruit and vegetables reduce the effects of erectile dysfunction. However, there are no current studies showing food and drink positively impact premature ejaculation.
Summary
Numerous OTC and prescription pills may help treat PE. Many of these options involve off-label use for the condition, meaning their primary use is for treating other health issues, but they may treat PE incidentally.
Additionally, not all individuals with PE are suitable candidates for taking some of these pills because of their side effects and drug interactions.
Before considering prescription medication or surgery, people may first want to try proven OTC and exercise treatments for PE.
Finally, individuals with PE considering pills should consult a doctor first to find the most effective and safest options.
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