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Premature Ejaculation Pills: Do They Work?

by Dr. Justin Lehmiller

Dr. Justin Lehmiller
Dr. Justin Lehmiller

Dr. Justin Lehmiller is a social psychologist and Research Fellow at The Kinsey Institu...

Social Psychologist, researcher at The Kinsey Institute

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Pills For Premature Ejaculation

Roughly one in five men experience premature ejaculation (PE), in which they ejaculate uncontrollably in a minute or less during sexual intercourse. Most men—and their partners—who deal with premature ejaculation aren’t content with this, and most sex therapists agree that one minute of intercourse can make it very difficult to sustain a happy sex life. 

A lot of guys with PE and other sexual health conditions are in search of a quick fix—a magic pill that can solve their problem. Everyone knows that such a pill exists for erectile dysfunction, but what about a pill for PE?

Here’s what we know about premature ejaculation pills, and what you need to know if you’re thinking about trying them.

Quick FAQs

The most popular medications for premature ejaculation are, Dapoxetine (Priligy), Lexapro, Zoloft.

While these drugs may help most men, you should be conscious of the side effects that many premature ejaculations medications bring. Symptoms such as diarrhea, dizziness, dry mouth, headache, insomnia, nausea, and loss of libido can occur.

A safe and effective alternative is Promescent® Delay Spray but you can also try a more holistic approach such as doing kegels, using the squeeze technique, or trying the edging method. 

What are premature ejaculation pills?

Pills that can potentially help you last longer in bed come in two main categories: (1) prescription medications (Rx) that your doctor would need to write a script for or (2) over-the-counter (OTC) pills.

Over-the-counter pills can be found online or behind a glass case at sex shops and convenience stores.

However, be advised that none of the OTC pills are FDA-approved, and doctors typically do not recommend them because the claims they make have not been tested scientifically.

There is little evidence to show that they can successfully treat premature ejaculation, despite the bold claims that these products often make. As a result, you may very well end up wasting your money, and since we don’t always know exactly what’s in these products, it’s possible you might end up ingesting something harmful.

For guys who claim that OTC pills work, it’s probably due to a placebo effect more than anything—in other words, if you have a strong belief that a pill is going to change your behavior, it might end up having that effect simply because you convinced yourself that it would.

If you're looking for premature ejaculation pills that work through physiology rather than psychology, then it’s worth looking into prescription medications.  

Some doctors agree that certain drugs have the potential to increase internal ejaculatory latency time (IELT), or the time from the moment of penetration during intercourse to ejaculation. 

However, for most of these pills, medicating for premature ejaculation is an off-label use because that’s not what these pills were originally designed to do.

In other words, this is a usage that hasn’t necessarily been tested or approved by the FDA. As we’ll discuss below, antidepressants, anxiolytics, and erectile dysfunction drugs are sometimes also prescribed for premature ejaculation, even though this isn’t the primary indication for these drugs.

Doctors have a lot of leeway when it comes to prescriptions and can pretty much prescribe any legal medication for any reason, given that medications often produce multiple physiological effects.

So there's no reason a doctor can't, for example, take a medicine used to treat depression and repurpose it as a medicine to stop premature ejaculation if it also has that effect.

Let’s now take a closer look at some specific premature ejaculation pills, from herbs to medications.

Herbal Pills for Premature Ejaculation

Bowl of Herbal Medicine

Herbal medicines have been around for thousands of years and have historically been used to treat a range of conditions, sexually and otherwise.

Herbal supplements are often advertised as a way of increasing male sexual stamina and treating premature ejaculation. However, when looking at the herbs currently on the market, a few things stand out.

First, different brands often have very different combinations of ingredients. Second, many brands makes outrageous claims about their effectiveness, and they sometimes warn against competing products, making for a mess of contradictory claims.

The fact that there is often little overlap in key ingredients in the commonly advertised herbal sexual enhancement pills raises a lot of questions about whether these pills actually work as promised. That said, there is one ingredient that is common in many of these products, and there is some science to suggest that it just might work.

St. John’s Wort

St. John’s wort is an herb used in many supplements. It’s said to treat a variety of ailments, from depression to menopause symptoms.

St. John’s wort is found in some herbal products aimed at treating premature ejaculation. At least two studies have concluded that it’s a potentially promising treatment, including a 2010 study of 50 men with PE, which suggested that this herb may assist in delaying ejaculation due to increasing the neurotransmitter serotonin in the brain.

In addition, a 2005 study suggested that St. John’s wort seems to affect the ability of the vas deferens (the sperm carrying tube) to contract, which is another mechanism through which this herb may potentially delay ejaculation.

Moving on from herbs, let’s take a look at prescription medicines sometimes used to treat PE.

Prescription Pills for Premature Ejaculation

Danger of Prescription Medication

Dapoxetine

Dapoxetine belongs to a class of antidepressants called selective serotonin reuptake inhibitors (SSRI). It slows down the brain's ability to reabsorb the neurotransmitter serotonin, which is involved in regulating mood. By allowing serotonin to remain active in the brain for longer periods of time, SSRIs can create a greater sense of psychological wellbeing.

Dapoxetine is fast-acting, but it also leaves the body quickly, meaning that serotonin reuptake inhibition doesn't last too long. Therefore, it’s often not the first line of treatment for chronic depression.

A noted side effect of Dapoxetine and other SSRIs is that it delays ejaculation and orgasm. For many users of these drugs, that’s an unpleasant side effect. However, there are some who specifically want that side effect, which is why it’s sometimes used to treat PE.

Clinical trials have found that Dapoxetine can delay ejaculation by several minutes. This, combined with the fast-acting, fast-dissipating nature of the drug, making it a reasonable choice for occasional use as a prolonged ejaculation pill.

In 2005, the FDA rejected Dapoxetine as a medication to treat premature ejaculation. Since that time, the drug has remained in Phase III clinical trials.

However, Dapoxetinedidachieve regulatory approval and hit the market in several countries, including Argentina, France, Iran, Italy, Malaysia, Mexico, New Zealand, the Philippines, Russia, South Korea, Spain, and Uruguay.

Dapoxetine is patent-protected, with no generic versions commercially available, as a result, it tends to be expensive.

2017 study noted that the discontinuation rate of Dapoxetine among men taking it for PE was quite high. Many men discontinued the drug due to the cost, side effects, and dissatisfaction with the results.

Lexapro

Lexapro (trade name for escitalopram) is another SSRI, one of many approved by the FDA in the United States as a treatment for depression.

However, some doctors prescribe it off-label to stop premature ejaculation.

Unlike Dapoxetine, Lexapro takes about ten days to notice the effects, and as much as two to three weeks for it to fully take effect.

Thus, rather than taking this drug intermittently as needed, users need to stay on a continued daily regimen to maintain sexual effects.

double-blind test evaluated the effectiveness of Lexapro in the treatment of premature ejaculation.

After twelve weeks on the drug, the group of men who received Lexapro reported a 4.9-fold increase in average IELT time, compared to a 1.4-fold increase for men receiving a placebo.

Zoloft or Sertraline

Sertraline, better known by the trade name Zoloft, is another SSRI, and it is available in generic form.

Sertraline was approved by the FDA in 1991 and remains one of the most commonly-prescribed psychiatric medications.

Again, it is sometimes prescribed off-label for premature ejaculation and at least one Australian study showed promise. In this study, 46 men between the ages of 22 and 63—all of whom had a mean IELT of 1 minute—were given escalating doses of sertraline over a period of several weeks.

As the dosage increased, these men took longer to ejaculate, suggesting that Sertraline is a potentially viable treatment for premature ejaculation. However, the researchers also found that, as the dosage increased, more and more men reported an inability to reach orgasm at all, which suggests that finding the optimal dosage is important.

Other Medications

Other Medication for PE

Besides SSRIs, the following medications have also been explored as current or future pills to treat premature ejaculation:

Tramadol

Tramadol is a strong, narcotic-like analgesic that is often administered to treat pain, but it is occasionally prescribed off-label to treat premature ejaculation.

Studies have shown that it does indeed increase IELT in men who take it.

However, it isn’t entirely clear how it works to delay ejaculation. That said, it does tend to inhibit reuptake of the neurotransmitters norepinephrine and serotonin, which suggests that the mechanism of action might be similar to SSRIs.

Phosphodiesterase-5 inhibitors

You know these as erectile dysfunction drugs: sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra). By promoting blood flow to the penis, these medications help men maintain erections. Some evidence suggests that they could also help some men delay ejaculation.

For example, a 2007 study concluded that sildenafil is a “very effective and safe” treatment for PE and can increase IELT. However, not all studies have produced consistent results.

For instance, a 2005 study found that sildenafil did not significantly increase IELT. However, it did increase sexual satisfaction for men with PE, in part, because it reduced the length of time it took for men to get another erection following ejaculation.

Modafinil (Provigil)

This medication is used to treat narcolepsy, a sleep disorder. Experiments are currently underway testing its effectiveness as a premature ejaculation pill, and preliminary evidence has been promising.

For example, a 2016 study found that Modafinil was linked to a “modest” improvement in IELT among men with PE.

Silodosin (Rapaflo)

This treatment for benign prostate tumors may hold promise as a premature ejaculation pill. A 2017 study found that men taking this drug reported longer IELTs.

Do Pills Work For Premature Ejaculation?

Do Pills for Premature Ejaculation Work?

While there is evidence supporting a lot of different PE pills, it’s important to recognize that none of these medications are magic cures and that you have to keep taking them to maintain the effects.

Also, while these drugs may help some men, they don’t work for everyone—and different things seem to work better for different people, so there may be quite a bit of trial and error necessary to obtain the desired results.

SSRIs in particular are notoriously patient-specific. Even in the treatment of depression, doctors often try multiple drugs over a period of time to see what works, sometimes taking months or even years before the most effective medication reveals itself.

Also, keep in mind that while some studies showed impressive increases in mean IELT, these areaverages and don’t reflect what happens to everyone. There’s always a lot of patient variability.

A pill that instantly makes any guy last all night in earth-shattering splendor just doesn't exist.

What side effects are caused by taking premature ejaculation pills?

Side Effects Caused from PE Medications

While some trials have shown promise, men looking for premature ejaculation pills would do well to be wary of potential side effects.

Fortunately, even if you take a drug for an off-label use, the on-label side effects are well-known and easy to find. Pay attention to them because you may have to deal with some of those side effects. Known side-effects of commonly prescribed PE pills include:

  • Dapoxetine: diarrhea, dizziness, dry mouth, headache, insomnia, nausea.
  • Lexapro: decreased libido, anorgasmia, suicidality, withdrawal symptoms.
  • Sertraline: diarrhea, anxiety, agitation, insomnia.
  • Tramadol: dependence, withdrawal, hallucinations, paranoia, extreme anxiety, panic attacks, confusion, nausea, dizziness, loss of appetite.
  • Phosphodiesterase-5 inhibitors: headache, flushing, indigestion, nasal congestion, impaired vision, impaired hearing, acid reflux, back pain, muscle aches.
  • Modafinil: anxiety, diarrhea, headache, nausea, nervousness, insomnia, dizziness, gastrointestinal problems.
  • Silodosin:difficulty ejaculating, anorgasmia, diarrhea, mild dizziness, headache, low blood pressure, runny or stuffy nose, sore throat.

SSRIs are also notorious for their libido-killing side effects. This by itself may be a deal-breaker for some people.

Are there any without side effects?

Most medications have known side-effects. You may experience none of them. You may experience some or evenallof them.

Everybody is different because our bodies interact with medications in unique ways. There's no way to know how you will respond until you try them.

With SSRIs, there is almost always another drug to try if one isn’t right for you, but the process can potentially be long and frustrating as you search for the right drug.

Also, there’s always the possibility that you mayneverfind the drug that offers the right blend of tolerable side effects and a satisfactory delay in ejaculation.

Where can you buy premature ejaculation pills?

Doctor-prescribed ejaculation pills must be filled by a pharmacy. For OTC drugs, you can find them online and in a variety of sex shops and other stores.

Should you Take Prescription Pills to Treat Premature Ejaculation?

Ultimately that is a decision for you to make, in consultation with your doctor. Also, even if taking OTC pills, it’s best to consult with a physician because some of them can interact with other medications you might be taking and may not be right for people with certain health conditions.

 

There is no pill that completely cures premature ejaculation, and there’s often a trade-off in terms of monetary costs, side effects, and time spent finding the right one for you

You could potentially find yourself on a long, frustrating merry-go-round, trying pill after pill. That's time and mental energy you could spend on exercises and other treatments that can delay ejaculation more readily.

Alternatives to Pills

Desensitizing Sprays

Delay sprays like Promescent offer an on-demand medical solution to fast ejaculation and it’s recommended by over 2,000 Urologists[2] . The spray contains the topical anesthetic lidocaine, which lightly desensitizes your penis, allowing you to feel less sensation during intercourse, thereby delaying ejaculation.

As the spray wears off, sensation returns, affording you a satisfying orgasm. Just apply the spray ten minutes before intercourse.

Kegels

Kegel exercises strengthen the muscles at the base of the penis. Often used to control urinary incontinence, they can also increase your ability over time to delay your ejaculation. To perform them:

  •    Contract the muscles at the base of your penis for a slow count of five.
  •    Release those muscles for a slow count of five.
  •    Repeat for ten repetitions, three times a day.

Read More:Male Kegel Exercises to Last Longer: Step by Step Guide 

Edging Method

This exercise can be practiced while masturbating or during sex with a partner. It is used to help you identify the "point of no return," after which ejaculation is inevitable.

As you feel orgasm approaching, stop the stimulation and give your penis a chance to relax. Then begin stimulation again.

You may take it too far sometimes and ejaculate early, but over time you will begin to recognize the physical sensations of your "point of no return" and adjust stimulation during sex to delay it.

Squeeze Technique

The squeeze technique can be used in conjunction with the edging method.

As you feel the point of no return approach, stop stimulation and firmly squeeze the head of the penis to suppress the ejaculatory response. With time, it will build muscle memory and help you control ejaculation.

Read More:The Squeeze Technique: Step by Step Guide (With Images) 

Conclusion

It's natural to want a quick fix to a frustrating problem.

Talk to your doctor about whether premature ejaculation pills are right for you. Be sure to discuss any underlying health issues as well as what you can expect when it comes to results and side effects.

Be wary of over-the-counter premature ejaculation pills and, if you decide to try one, do ample research beforehand and consult with your healthcare provider. It’s important to know what you are putting in your body and where it came from.

In the meantime, consider alternative treatments.

Delay sprays like Promescent are an on-demand treatment option that can be used any time you are ready to have sex. Additionally, delaying ejaculation through exercises offers a natural alternative; however, just remember they take some time and practice to master.

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Disclaimer for Promescent®. All the information on this website is published in good faith and for general information purpose only. Promescent® does not make any warranties about the completeness, reliability, and accuracy of this information. If you have specific medical concerns, please contact your local health provider or consult with your physician.

Dr. Justin Lehmiller
Dr. Justin Lehmiller

Dr. Justin Lehmiller is a social psychologist and Research Fellow at The Kinsey Institute. He is author of the blog Sex and Psychology and the popular book Tell Me What You Want: The Science of Sexual Desire and How It Can Help You Improve Your Sex Life. He is also a prolific researcher who has published more than 50 academic works, including a textbook titled The Psychology of Human Sexuality that is used in college classrooms around the world. Dr. Lehmiller is one of the media's go-to experts on sex and has been interviewed by The Wall Street Journal, The New York Times, and CNN; he has also appeared on dozens of radio, podcast, and television programs.


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