Which premature ejaculation pills work? Options and safety

Premature ejaculation (PE) is a type of sexual dysfunction that affects up to 30% of people with a penis.

Individuals with PE display 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.

Learn more about PE.

This condition is common in all age groups, but older adults 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:

People should always speak with a doctor about medication for treating PE, as some pills for the condition may interact with other medications 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:

ED pills

Certain ED medications can also help treat PE.

These are called phosphodiesterase 5 (PDE5) inhibitors and include:

They work by affecting the enzymes in the penis and lungs to prolong erections and decrease pressure on the lungs, which calms down breathing.

Current research suggests that PDE5 inhibitors are effective in treating PE. However, these medications are more effective if a person takes them in combination with selective serotonin reuptake inhibitors (SSRIs).

The overall benefits of PDE5 inhibitors are similar to those of other medications and include better ejaculation control, confidence, and delayed ejaculation.

Side effects depend on the specific type of drug and may include:

People taking nitrate medications, such as nitroglycerin, should try to avoid taking PDE5 inhibitors due to 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 via prescription.

Learn more about ED medication.

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 SSRIs and tricyclic antidepressants (TCAs).

An older 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 medications that individuals cannot take with antidepressants, including monoamine oxidase (MAOI) inhibitors, thioridazine, and pimozide (Orap).

It also advises that individuals with narrow-angle glaucoma exercise caution when using SSRIs and TCAs.

Tramadol

Tramadol is an analgesic drug that reduces sensitivity to the receptors that produce serotonin.

An older study states that there are 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 reduced 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.

Learn more about tramadol.

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.

Learn about codeine withdrawal.

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.

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.

It is best to avoid pills that companies market as PE treatments that make unsubstantiated health claims or do not have any studies and research to support their benefits.

Additionally, individuals with PE should consult a doctor to find the safest and most effective treatment.

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 is an online men’s health service specializing in prescription medication for erectile dysfunction. However, the company also provides treatment options for PE.

The company offers Roman Swipes and prescription medication for PE.

Roman Swipes cost $27. These wipes contain benzocaine and do not require a prescription. To use this product, a person should wipe the towel over the most sensitive parts of their penis at least 5 minutes before sex.

Learn more about Roman Swipes.

The company also offers prescription medication, including PDE5 inhibitors and sertraline. As these medications require a prescription, a person will need to book a free initial consultation online with the platform’s healthcare professionals.

The prescription medication starts at $2 per dose.

Roman offers 2-day shipping, which is free of charge. It ships in discreet packaging.

Hims

Hims is another telemedicine company specializing in men’s health. The company offers prescription and OTC medications for PE.

Similar to Roman, all prescription pills require a free consultation with a healthcare professional through the platform.

Prescription medications include sertraline, sildenafil, and paroxetine, starting from $3 per pill or $24 per month.

OTC treatments include Climax Delay spray and Climax Delay wipes. These start at $19.

Learn more about the best premature ejaculation wipes.

Hims offers free and discreet shipping, and people can expect to receive their package within 2–5 days.

Lemonaid Health

Lemonaid Health is a telemedicine service that offers treatment for a variety of conditions, including PE.

The company offers sertraline and PDE5 inhibitors, starting from $1 per pill.

As Lemonaid Health only offers prescription treatment, a person will need to attend an online consultation with a healthcare professional. The initial consultation costs $25.

Shipping is free of charge and takes 2–3 business days. Lemonaid Health states that it ships all orders in discreet packaging.

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 in 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.

Learn about the best condoms for PE.

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 the partner’s vaginal area.

Learn about the best PE sprays.

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 2020 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. Recipients showed significant improvements in PE and no side effects after the procedure.

Therapy

A person may consider talk therapy to work on anxiety related to sex or relationships. This may help them identify and tackle difficulties relating to premature ejaculation.

A 2019 review suggests that a combination of psychological and pharmacological treatment may be most 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:

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 U.S., as the Food and Drug Administration (FDA) has not given its approval.

The below table compares some of the treatments for PE.

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 regarding:

• how often, and for how long, the person been experiencing premature ejaculation
• whether this happens with one partner or has happened with several
• whether the person experiences PE with every sexual activity, including masturbation
• whether there is 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.

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.

To prolong sex before ejaculation, a person may try:

• 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.

Learn more about edging.

Here are some common questions about this condition.

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 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 that they choose the safest PE option for their needs.

Are there any premature ejaculation pills without side effects?

No, every premature ejaculation pill has a chance of causing side effects.

If a person is concerned about the side effects a pill may cause, they should discuss this with a healthcare professional.

Is it safe to take premature ejaculation pills every day?

Some medications, such as antidepressants, are safe to take every day. However, opioid medications, such as tramadol, carry 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 1–2 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 PDE5 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 that specific fruits and vegetables reduced the effects of erectile dysfunction. However, there are no current studies showing that food and drink positively affect premature ejaculation.

Is Viagra a treatment for premature ejaculation?

PDE5 inhibitors, such as Viagra, are a treatment for premature ejaculation if a person also experiences erectile dysfunction.

However, these medications cannot help manage premature ejaculation alone.

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.