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Premature Ejaculation Pills: How Exactly Do They Work?

Premature ejaculation pills, with so many options, how do you know which ones work and which ones to avoid? We've got the answers.

Dr. Justin Lehmiller
Social Psychologist, researcher at The Kinsey Institute

by Dr. Justin Lehmiller Last updated 04/28/2022

Pills For Premature Ejaculation

Roughly one in three men experience premature ejaculation, meaning they ejaculate uncontrollably in a minute or less of sexual intercourse.

Most men, and their partners, who deal with premature ejaculation, understandably, aren’t content with this.

With that said, here is everything you need to know about premature ejaculation pills.

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 pills 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:

  • Prescription medications (Rx)
  • Over-the-counter (OTC)

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

However, there is little evidence to show that they can successfully treat premature ejaculation.

If you're looking for premature ejaculation pills that actually work, then it’s worth looking into prescription medications.

Some doctors agree that certain drugs have the potential to stop premature ejaculation.  

However, this is what's known as off-label use since they were originally developed to treat depression.

Graphic showing prescription pills that can help with premature ejaculation (anti-anxiety, antidepressants, ed pills, and Phosphodiesterase inhibitors).

Things like:

  • Antidepressants
  • Anxiolytics (anti-anxiety)
  • Phosphodiesterase (PDE) Inhibitors
  • Erectile dysfunction pills

Doctors have a lot of leeways when it comes to prescriptions and can pretty much prescribe any legal medication for any reason.

So there's no reason a doctor can't, for example, take a medicine used to treat depression and repurpose it to treat 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

You’ll often hear herbal supplements advertised as a way of increasing male sexual stamina and treating premature ejaculation.

But when looking at the herbs currently on the market, a couple of key things stand out.

Firstly: Different brands often have very different combinations of ingredients.

Secondly: Many brands make outrageous claims about their effectiveness, and they sometimes warn against competing products, making for a mess of contradictory claims.

That said, there is one common ingredient 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, and it’s thought to help with a variety of ailments, such as:

  • Depression
  • Menopause
  • Wound healing assistance (when applied directly to the skin)

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 helping with premature ejaculation by 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 prevent premature ejaculation.

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

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 serotonin, which regulates mood.

Allowing serotonin to remain active in the brain for longer periods of time can create a greater sense of psychological well-being.

Dapoxetine is fast-acting, but it also leaves the body quickly, meaning that serotonin reuptake inhibition doesn't last too long.

A noted side effect of Dapoxetine and other SSRIs is that they help with premature ejaculation.

Clinical trials have found that Dapoxetine can delay premature ejaculation by several minutes.

This, combined with the fast-acting, fast-dissipating nature of the drug, makes it a reasonable choice for occasional use as a prolonged ejaculation pill.

In 2005, the FDA rejected Dapoxetine as a treatment for premature ejaculation.

Since that time, the drug has remained in Phase III clinical trials.

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.

Top reasons people stop using dapoxetine (cost, required before sex, side effects, poor efficacy, and seeking other treatment options).

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 take effect fully.

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

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

Chart showing the effectiveness of Lexapro (4.9 fold increase with lexapro as opposed to 1.4 with placebo group).

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.

These men took longer to ejaculate as the dosage increased, 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 essential.

What are the Side Effects of SSRIs

  • Nervousness
  • Dry mouth
  • Heartburn
  • Shaking
  • Nausea
  • Diarrhea
  • Constipation
  • Dizziness
  • Tiredness
  • Headache
  • Vomiting
  • Difficulty sleeping
  • Excessive sweating
  • Appetite or weight changes
  • Changes in sex drive or sexual performance

    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 often administered to treat pain, but it’s occasionally prescribed off-label to treat premature ejaculation.

    Studies have shown that it does indeed help with PE.

    However, it isn’t entirely clear how it works to delay ejaculation.

    That said, it does tend to inhibit the reuptake of the neurotransmitters norepinephrine and serotonin, which suggests that the mechanism of action might be similar to SSRIs.

    What are the side effects of Tramadol

    • dizziness
    • headache
    • drowsiness
    • nausea and vomiting
    • constipation
    • lack of energy
    • sweating
    • dry mouth
    • itching

    If you are considering this route, you should be aware that there are additional, much more serious side effects that you can read about here.

    Phosphodiesterase-5 inhibitors(PDE-5)

    You know these as erectile dysfunction drugs: sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra).

    These medications promote blood flow to the penis and 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 ordinarily 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.

    What are the side effects of Phosphodiesterase-5 inhibitors?

    • Headache
    • Flushing
    • Nasal congestion
    • Heartburn
    • Nasopharyngitis
    • Nose bleeds
    • Increase sensitivity to light
    • Dyspepsia (Indigestion)

    Do Pills Work For Premature Ejaculation?

    Do Pills for Premature Ejaculation Work?

    While there is evidence supporting a lot of different premature ejaculation 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.

    Also, keep in mind that while some studies showed impressive increases in mean (IELT), these are averages and don’t reflect what happens to everyone.

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

    Where can you buy premature ejaculation pills?

    Once your doctor has written you a prescription, you can fill it at any pharmacy, just like any other prescription.

    For OTC treatments, you can find them online and in various 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, even if you decide to go the OTC route.

    No pill completely cures premature ejaculation, and there’s often a trade-off between:

    • Monetary costs
    • Side effects
    • Doctors visits
    • Time it take to find the right one

    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 Premature Ejaculation Pills

    Desensitizing Sprays

    Delay sprays, like Promescent, offer an on-demand medical solution to fast ejaculation and come at the recommendation of over 2,000 Urologists.

    The spray contains the topical anesthetic lidocaine, which lightly desensitizes your penis, allowing you to feel less sensation during intercourse, thereby delaying ejaculation.

    The great part is that you can still experience all the same great sensations of sex, just slightly muted, so you can still enjoy a satisfying orgasm.

    Simply apply the spray ten minutes before intercourse, and you’re good to go!

    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.

    Edging Method

    This exercise can be practiced while masturbating or during sex with a partner. The goal is 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. That’s okay; 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.

    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 not only know what you’re putting in your body but where it came from.

    In the meantime, consider alternative treatments like delay spray from Promescent; it offers a fantastic on-demand treatment option for PE that has helped over 500,000 men just like you enjoy better, longer-lasting sex.

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    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.

    Sources:

    Absorption Pharmaceuticals LLC (Promescent) has strict informational citing guidelines and relies on peer-reviewed studies, academic or research institutions, medical associations, and medical experts. We attempt to use primary sources and refrain from using tertiary references and only citing trustworthy sources. Each article is reviewed, written, and updated by Medical Professionals or authoritative Experts in a specific, related field of practice. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

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    The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.


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