Lexapro For Premature Ejaculation: Can It Really Help Me Last Longer

Premature ejaculation treatments vary from over-the-counter desensitizers to prescription medications. One such medication is Lexapro. Can this Pe treatment option work for you?

Dr. Jed Kaminetsky
Board Certified Urologist, expert in male sexual dysfunction
by Dr. Jed Kaminetsky Last updated 11/28/2022
Man happy that lexapro helped with premature ejaculation

Some research has found using Lexapro for premature ejaculation can help men last longer. Ejaculating too soon can really affect sexual satisfaction.

Unfortunately, premature ejaculation (PE) is one of the top sexual dysfunction issues for men, with up to 39 percent affected at some point.

Men dealing with PE have different options when it comes to delaying orgasm, both over-the-counter and otherwise.

Quick FAQs

Lexapro, also known as escitalopram, is a drug typically prescribed for anxiety or depression.

Doctors prescribe Lexapro as an "off-label" treatment because of its known side effect of delaying ejaculation.

It's suggested to take 10 mg of Lexapro once daily, but be sure to take the dosage that your doctor recommends.

Certain prescription medicines may also help, one of which is Lexapro for premature ejaculation.

Does Lexapro help with premature ejaculation?

Here is a closer look at Lexapro, how it works, and other PE treatment options.

What is Lexapro (Escitalopram)?

Lexapro is a branded prescription drug that is otherwise known as escitalopram.

Escitalopram is normally prescribed for the treatment of generalized anxiety disorder (GAD) and major depressive disorder (MDD) in adults.

Lexapro acts as a selective serotonin reuptake inhibitor (SSRI) in the brain, much like many other anti-depressant drugs.

These types of medications help with depression and anxiety by boosting serotonin levels in the brain.

Low serotonin is thought to be related to a number of mood disorders.

However, heightened serotonin while taking SSRIs may also have an effect on arousal.

In fact, in Lexapro's placebo-controlled clinical trials, 12 percent of men experienced ejaculation delay, and 2 percent experienced erectile dysfunction (ED).

Does Lexapro Treat Premature Ejaculation Effectively?

The Food and Drug Administration (FDA) does not recognize Lexapro for premature ejaculation treatment.

However, due to the known side effects of SSRIs in terms of delaying ejaculation, some doctors do prescribe Lexapro for the "off-label" treatment of PE.

It should be noted that escitalopram is the only type of SSRI that has been studied for treating PE.

A handful of others have been better researched and are more commonly prescribed, including:

  • Fluoxetine (Prozac)
  • Paroxetine (Paxil)
  • Sertraline (Zoloft)
  • Citalopram (Celexa)

While Lexapro may not be as commonly prescribed for PE, comparison studies of escitalopram, fluoxetine, and paroxetine for PE have shown similar efficacy between the three SSRIs.

How to Use Lexapro for Premature Ejaculation

Lexapro is prescribed in tablet or oral solution forms. In most cases, you will be told to take Lexapro for premature ejaculation once daily.

The typical dosage used in clinical trials is 10mg per day. It's not meant to be on-demand and needs to be taken daily to achieve any benefit.

However, since Lexapro is used off-label for PE, a doctor or healthcare provider will determine the proper dosage and how you should take the medication.

How Long Does Lexapro Take to Work for Premature Ejaculation?

Lexapro may not offer immediate improvement for premature ejaculation.

In clinical trials published by the Journal of Human Andrology, the best outcomes came after two weeks or longer of treatment.

The study participants experienced a 226 percent increase in ejaculation time after two weeks and a 506 percent increase after four weeks.

Therefore, if you take Lexapro for PE, be sure to take the medication as prescribed daily, even if there is no change in ejaculation times.

If, after several weeks of treatment, Lexapro does not seem to offer any improvements, be sure to discuss the concerns with a healthcare professional.

Risks and Side Effects of Lexapro

While Lexapro has been shown to be effective for treating PE, the results do not come without some concerns.

In one study published in the journal of Human Andrology, researchers noted that patients taking Lexapro as part of a study experienced substantial side effects after two weeks.

However, the side effects subsided after four weeks of treatment.

Side effects initially reported at the two-week mark included:

  • Headache
  • Nausea
  • Drowsiness

As noted earlier, it is possible for SSRIs to cause undesirable sexual side effects as well.

For example, some men who take SSRIs have issues with erectile dysfunction, especially with long-term treatment.

And lack of sex drive is also a possibility, which means you may have little interest in sex.

Taking Lexapro can also lead to more serious side effects, even though these side effects are considered rare.

These more serious side effects include:

  • Low blood sodium levels
  • Risk of bleeding events
  • Seizures
  • Teeth grinding
  • Angle-closure glaucoma
  • Serotonin syndrome
  • GI side effects
  • Suicide ideation

In an original article posted in the International Journal of Impotence Research in 2011, another major concern was brought up regarding Lexapro for premature ejaculation: a negative effect on sperm.

In the study, 25 men with PE who had undergone sperm analysis were given Lexapro every day for 12 weeks, at which time sperm quality was again examined.

After 12 weeks of treatment with the SSRI, there was a decrease in the number of sperm, sperm motility, and sperm morphology (size and shape).

Alternatives to Lexapro for PE

While Lexapro may be effective, several other options may help to treat premature ejaculation.

Further, treatments that are not pharmaceutical can often be combined for more profound results. Take a look at other PE treatment options to consider.

Over-the-Counter Options

Men with PE have a number of over-the-counter options that are considered highly effective for PE, including:

  • PE condoms - PE condoms come in two varieties. The first type is condoms, which are made with thicker latex. The second type is condoms that have been pre-treated with a desensitizing agent like benzocaine.
  • Topical lidocaine sprays - Topical sprays like Promescent Delay Spray contain lidocaine and have been shown to prolong ejaculation times by almost double.
  • Benzocaine wipes - Benzocaine wipes like Promescent Delay Wipes are applied topically to reduce penis sensations and prolong ejaculation.

Therapy

Different types of therapy may be helpful for some men who struggle with premature ejaculation. PE can have a number of underlying causes, some of which are psychological.

Psychotherapy, which is a type of talk therapy, may be beneficial for men who may have negative emotions attached to issues with PE.

For example, lacking confidence about sexual performance may contribute, but talk therapy may help an individual address these issues.

Hypnotherapy for PE may also be something to consider, even though research into its effectiveness is lacking.

Behavioral Techniques (Kegels, edging, squeeze technique)

Certain behavioral techniques may also help curb issues with PE. These techniques can be combined with something like delay spray to enhance outcomes further as well.

Kegels may help strengthen the pelvic floor to give a man with PE better control over ejaculation. 

Kegel exercises involve strengthening the muscles in the pelvic floor by doing strength-training exercises. Studies have shown this training to be effective for PE.

Edging, also known as the start/stop method, involves having sex until the urge to ejaculate is obvious, stopping until that feeling subsides, and then resuming activity.

This can be done repeatedly to prolong sexual activity.

Another technique to try is the squeeze technique.

Much like start/stop, this technique involves stopping sex before ejaculation.

However, this method involves squeezing firmly on the penis for several seconds until the urge to ejaculate passes.

ED Medications

In some cases, ED medications may help with PE.

Medications usually prescribed for ED include:

  • Sildenafil (Viagra)
  • Tadalafil (Cialis)
  • Vardenafil (Levitra)
  • Avanafil (Stendra)

While these medications are primarily to help men achieve and maintain an erection by increasing blood flow to the penis, they may also be helpful for PE.

For example, a study of sildenafil found that the medication was more effective than the SSRI paroxetine for PE when taken as needed.

Important Takeaways

Does Lexapro help with premature ejaculation? Yes. However, taking Lexapro for PE can come along with worrying side effects.

While Lexapro may offer some help for PE, safer alternatives are recommended.

Lexapro may even cause changes in sperm quality when taken for long periods.

Alternatives like over-the-counter Promescent Delay Spray, behavioral techniques, and even therapy may be effective solutions for PE.

Additionally, these options come along with little-to-know risk.

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Dr. Jed Kaminetsky

Dr. Jed Kaminetsky

Dr. Jed Kaminetsky M.D. is an American Board Certified Urologist and earned his Medical Degree at New York University. In his tenure he became a member of the American Urological Association and the American College of Surgeons. Dr. Kaminetsky pioneered the minimally invasive Rezum BPH treatment and is an expert in male and female dysfunction.

Sources:

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  • McMahon CG. Premature ejaculation. Indian J Urol. 2007 Apr;23(2):97-108. doi: 10.4103/0970-1591.32056. PMID: 19675782; PMCID: PMC2721550. Accessed on October 13, 2022.
  • “Escitalopram: MedlinePlus Drug Information.” Medlineplus.gov, 2022, medlineplus.gov/druginfo/meds/a603005.html. Accessed on October 13, 2022.
  • NHS Choices. Overview - Selective Serotonin Reuptake Inhibitors (SSRIs). Nhs.uk, 2022, www.nhs.uk/mental-health/talking-therapies-medicine-treatments/medicines-and-psychiatry/ssri-antidepressants/overview/. Accessed on October 13, 2022.
  • "Lexapro (escitalopram oxalate) - FDA." Fda.gov, 2022, www.accessdata.fda.gov/drugsatfda_docs/label/2017/021323s047lbl.pdf. Accessed on Nov, 23, 2022.
  • Siroosbakht S, Rezakhaniha S, Rezakhaniha B. Which of available selective serotonin reuptake inhibitors (SSRIs) is more effective in treatment of premature ejaculation? A randomized clinical trial. Int Braz J Urol. 2019 Nov-Dec;45(6):1209-1215. doi: 10.1590/S1677-5538.IBJU.2019.0121. PMID: 31808410; PMCID: PMC6909853. Accessed on October 13, 2022.
  • Arafa M, Shamloul R. A randomized study examining the effect of 3 SSRI on premature ejaculation using a validated questionnaire. Ther Clin Risk Manag. 2007 Aug;3(4):527-31. PMID: 18472973; PMCID: PMC2374931. Accessed on October 13, 2022.
  • Zaazaa, Adham; Selim, Osama; Hosny Awad, Hossam; Soltan, Gamal; Ghanem, Hussein. Safety and efficacy of escitalopram in the treatment of premature ejaculation: a double-blind, placebo-controlled, fixed-dose, randomized study. Human Andrology: March 2012 - Volume 2 - Issue 1 - p 16-18 doi: 10.1097/01.XHA.0000410959.63823.93. Accessed on October 13, 2022.
  • “Escitalopram (Lexapro) | NAMI: National Alliance on Mental Illness.” Nami.org, 2022, www.nami.org/About-Mental-Illness/Treatments/Mental-Health-Medications/Types-of-Medication/Escitalopram-(Lexapro). Accessed on October 13, 2022.
  • Koyuncu, H., et al. “Escitalopram Treatment for Premature Ejaculation Has a Negative Effect on Semen Parameters.” International Journal of Impotence Research, vol. 23, no. 6, July 2011, pp. 257–61, https://doi.org/10.1038/ijir.2011.35. Accessed on October 13, 2022.
  • Mark KP, Kerner I. Event-level impact of Promescent on quality of sexual experience in men with subjective premature ejaculation. Int J Impot Res. 2016 Nov;28(6):216-220. doi: 10.1038/ijir.2016.31. Epub 2016 Aug 25. PMID: 27557610; PMCID: PMC5399162. Accessed on October 13, 2022.
  • Pastore AL, Palleschi G, Fuschi A, Maggioni C, Rago R, Zucchi A, Costantini E, Carbone A. Pelvic floor muscle rehabilitation for patients with lifelong premature ejaculation: a novel therapeutic approach. Ther Adv Urol. 2014 Jun;6(3):83-8. doi: 10.1177/1756287214523329. PMID: 24883105; PMCID: PMC4003840. Accessed on October 13, 2022.
  • Wang WF, Wang Y, Minhas S, Ralph DJ. Can sildenafil treat primary premature ejaculation? A prospective clinical study. Int J Urol. 2007 Apr;14(4):331-5. doi: 10.1111/j.1442-2042.2007.01606.x. PMID: 17470165. Accessed on October 13, 2022.
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