Premature Ejaculation Pills: Does PE Medication Really 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. Gary Bellman
By Dr. Justin Lehmiller Medically reviewed by Dr. Gary Bellman Last updated 04/12/2024
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Pills For Premature Ejaculation

Premature ejaculation pills are prescription and over-the-counter medications that have been found to help treat PE. Some examples of these type pills include:

  • SSRIs
  • Pain Relievers
  • PDE5 Inhibitors

It should be noted that the Food and Drug Administration hasn't specifically approved these medications for PE. Nonetheless, it’s worth consulting with your doctor to see if they may be a good option for you.

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® Desensitizing Spray, but you can also try a more holistic approach such as doing Kegels, using the squeeze technique, or trying the edging method.

Here are some of the best delay pills to consider taking to treat premature ejaculation.

Best Premature Ejaculation Pills

1. SSRIs

Paroxetine

In some cases, premature ejaculation can be physiological. SSRIs work as early ejaculation pills by increasing central serotonin neurotransmission.

Paroxetine (Paxil) has been shown to be an effective treatment for premature ejaculation and is well-tolerated on a daily or as-needed basis.

According to research, Paroxetine appears to have more clinical benefits than placebo, fluoxetine, and escitalopram.

Escitalopram

AIPE, or Arabic index of premature ejaculation, is a scoring system researchers used to determine if men were suffering from premature ejaculation.

Men with AIPE scores below 30 were diagnosed with PE, while men with scores above 30 were not diagnosed with PE.

In a study of 100 men who had an AIPE score below 30, all experienced a significant increase in their total score after taking escitalopram with few side effects.

Citalopram

A scientific study confirmed that citalopram (Celexa) can delay ejaculation in those suffering from PE.

The same research found that citalopram did not affect sexual desire or penile erection according to an objective assessment done by RigiScan.

When compared with fluoxetine, citalopram had a more statistically significant effect on ejaculation latency time.

Sertraline

Findings suggest that sertraline (Zoloft) can be potentially effective as a premature ejaculation medicine.

Men with a mean ejaculatory interval were each prescribed 25 mg daily, and then increased to 50 mg after 3 weeks, and 100 mg after a further 3 weeks. The results were as follows:

  • 25 mg - Mean ejaculatory interval increased to 7.6 min
  • 50 mg - Mean ejaculatory interval increased to 13.1 min
  • 100 mg - Mean ejaculatory interval increased to 16.4 min

While the majority of men experienced no side effects, some participants did experience anxiety, dizziness, drowsiness, and erectile dysfunction.

When dosage was increased to 50 mg and 100 mg, some men experienced anejaculation, which is when orgasm occurs but semen isn’t released from the penis.

Fluoxetine

Fluoxetine was found to provide a significant improvement to ejaculation latency time in men suffering from PE.

The amount of men who rated their ejaculatory control as poor decreased from 98% to 41%. 

High personal distress rates among the participants decreased from 47% to 11%, and high partner distress rates decreased from 72% to 27%.

Clomipramine

Clomipramine is an SSRI used to treat OCD and has shown promise when increasing ejaculatory latency in men with primary premature ejaculation.

Ejaculation time during sexual activity increased on average from approximately 2 to 8 minutes in men with PE.

Further investigation has shown, however, that clomipramine is not effective for men with premature ejaculation plus erectile dysfunction.

Dapoxetine

Dapoxetine is an SSRI that was specifically developed for the treatment of PE. Participants in a study took the drug 1-3 hours prior to planned sexual activity.

In a study of men who took dapoxetine, more women reported that their partners' ejaculatory control was good or very good.

A majority of participants also reported their PE was slightly better than taking a placebo.

Dapoxetine is well tolerated with limited side effects and doesn't interact with ED pills such as tadalafil or sildenafil.

2. Pain relievers

Tramadol

Tramadol hydrochloride is an opioid analgesic prescribed to treat moderate to severe pain. However, research has shown that it can help delay ejaculation.

300 participants in a study were given different dosages of tramadol. After collecting the data, it was found that all participants experienced a highly significant increase in their mean intravaginal ejaculatory latency time.

The researchers concluded that tramadol at different doses on demand is effective, safe, and tolerable for treating PE.

3. ED Pills

Sildenafil

Sildenafil was found to have a higher efficacy in treating premature ejaculation than paroxetine and the squeeze technique.

An additional study also concluded that sildenafil combined with paroxetine significantly prolonged intravaginal ejaculation latency time and was associated with better intercourse satisfaction.

Tadalafil

Similar to sildenafil, tadalafil was also proven to increase ejaculatory latency time in comparison to a placebo.

Even more noteworthy, two years after cessation of tadalafil, there was still a statistically significant improvement in the IELT.

Modafinil

Modafinil is typically used to treat conditions that cause daytime sleepiness. In patients with lifelong PE, it’s also been found to help increase IELT.

Patients who had taken modafinil reported having better control over ejaculation and improved satisfaction with sexual intercourse.

The patients also noted that they had lesser personal distress and reduced interpersonal difficulty.

4. Alpha-blockers

Alpha blockers, including silodosin, tamsulosin, alfuzosin, and terazosin, were all found to be helpful in treating PE.

In particular, silodosin was found to be the most effective in improving the quality of life of premature ejaculation patients.

Chinese herbal medicine

Yimusake

In a 2014 study, 300 patients were given 8 weeks of treatment with Yimusake Tablet. There were also 4 weeks in which the patients were not given any treatment.

Of the 288 that completed the trial, it was found that the mean IELT of the patients increased from 62.5 seconds to 168.9 seconds after 4 weeks of treatment. After 8 weeks, the mean IELT increased to 222.2 seconds.

Other PE Treatments

Topical Numbing Agents

Lidocaine spray

Over-the-counter (OTC) lidocaine-based ejaculation-delaying spray has been shown to increase the time to ejaculation and overall sexual satisfaction in men struggling with subjective PE.

Applying topical lidocaine-prilocaine spray like Promescent to the underside and glans of the penis treats premature ejaculation by reducing sensation and delaying orgasm.

When taking Promescent, participants in a study saw their average IELT increase from 6.81 minutes to 11.16 minutes.

Benzocaine wipes

In one study, benzocaine wipes applied prior to sexual intercourse resulted in a statistically significant prolongation of time to ejaculation.

By the second month of treatment, men who were using benzocaine wipes had a mean IELT of 329.70s. 88% of the men who were treated were considered to no longer have PE.

Lidocaine cream

Lidocaine cream works for treating PE by reducing nerve activity in the penis. Medication for premature ejaculation that includes lidocaine also increases intravaginal ejaculatory time.

Topical lidocaine creams are applied 20 minutes before sexual contact, and the effects can last up to 3 hours.

Research discovered that participants who applied lidocaine cream for 20 minutes prior to sex had their pre-ejaculation period increase to 6.71 minutes. 

It should be noted when cream was applied for 30 minutes and 45 minutes, a majority of patients experienced erection loss due to numbness.

Behavioral techniques

Stop-start method

The stop-start method consists of penis stimulation until just before ejaculation, then stopping the stimulation until the urge to orgasm has passed.

Studies have demonstrated that the stop-start method helps increase the time spent in the vagina. 

Stop-start was found to be most effective when used at the same time as sphincter control training

These are exercises that are designed to provide patients more awareness and control of the external urethral sphincter and its role in the ejaculatory reflex.

The squeeze method

The squeeze method involves an individual or their partner squeezing the penis until the urge to orgasm or ejaculate has gone away. 

It’s been described in some research studies as partially effective in preventing premature ejaculation. 

Researchers noted that despite showing a high success rate for short-term management of PE, the success rate is poor for long-term management.

Pelvic floor exercises

For some men, difficulty delaying ejaculation is due to having a weak pelvic floor. Strengthening pelvic floor muscles helps men to gain control of their ejaculatory reflex and extend IELT.

Results from a study of 40 PE patients showed that 82.5% were able to regain control of ejaculatory reflex. IELT increased from 39.8 seconds to 112.6. seconds.

Combined Behavioral and Drug Therapy

While drugs may be an effective PE treatment for some men, in other cases, a combination of treatment may be required.

In a systematic review of behavioral therapies for management of PE, researchers concluded that behavioral therapies combined with drug treatments gave better treatment outcomes than drugs alone.

Thickened Condoms

A group of researchers investigated whether thickened condoms could help with delaying ejaculation.

Through their research, they discovered that thickened condoms physically preserved and extended the time of penile erection, and helped patients resist premature ejaculation. 

Total erection time was higher in the thickened condom group compared to the ordinary condom group.

Botulinum-A Toxin

While more research is needed, one study found that Botulinum-A toxin (Botox) could potentially be a safe and effective means to prolong ejaculatory latency.

It was theorized that rhythmic contractions of muscles involved in the ejection phase of ejaculation may be inhibited by the injection of botulinum-A toxin.

Takeaways

There are a variety of medications that can potentially help treat premature ejaculation.

These include SSRIs, Pain relievers, ED pills, Modanafil, Alpha Blockers, and Chinese herbal medicine. 

Most of these medications have been found to cause only mild side effects if any at all.

Nonetheless, patients may find that drugs alone won’t help. In this case, behavioral techniques, a combination of behavioral techniques and drugs, or other alternative treatments might be more helpful

Patients should consult with a doctor to determine their best option before starting a treatment plan for premature ejaculation.

Dr. Gary Bellman

Dr. Gary Bellman

Dr. Gary Bellman is a board certified urologist specializing in Men's Health. He is the owner and founder of the Southern California Urology Institute and has 30 years of experience taking care of men's health issues.

Sources:

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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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