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There are many options for treating premature ejaculation, including prescription and over-the-counter (OTC) medication. Doctors may also recommend other treatment options for people with this condition.
This article looks into the most common available medication for premature ejaculation (PE). It also explores the side effects of these medications, alternatives, and frequently asked questions.
PE is a type of sexual dysfunction that affects up to 30% of people with a penis.
Individuals with PE have one or more of these characteristics:
PE can be a temporary or long-term condition.
Learn more about PE.
People should always speak with a doctor about medication for treating PE, as some pills for the condition may interact with other medication 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:
Certain ED medication can also help treat PE.
These are called phosphodiesterase-5 inhibitors (PDE5s) and include:
They work by affecting the enzymes in the penis and lung to prolong erections and decrease pressure on the lungs, which calms down breathing.
A 2017 study found that PDE5s are significantly more effective in treating PE both on their own and in combination with SSRIs or behavioral therapy.
The overall benefits of PDE5s are similar to other medications and include better ejaculation control, confidence, and delaying ejaculation.
Side effects depend on the specific type of drug, and they may include:
People taking nitrate medications, such as nitroglycerin, should avoid taking PDE5 inhibitors because of a risk of a sharp decline in blood pressure.
Additionally, those looking to use off-label ED drugs, such as Viagra, need to 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 on prescription.
Learn more about ED medication.
The common use for antidepressant medication is to treat individuals with depression and anxiety.
However, several studies show that the off-label use of two types of antidepressants may help treat PE by delaying ejaculations.
These antidepressants are selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs)
A 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:
The FDA also lists some medicines that individuals cannot take with antidepressants, including monoamine oxidase inhibitors, thioridazine, and pimozide (Orap).
It also cautions the use of SSRIs and TCAs for individuals with narrow-angle glaucoma.
Tramadol is an analgesic drug that reduces sensitivity to the receptors that produce serotonin. An older study shows 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 lowered 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 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.
People should also avoid pills that companies market to treat PE that make unsubstantiated health claims or do not have any studies and research to support their benefits.
Individuals with PE should also speak with a doctor to find the safest and most effective course of 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.
Individuals with concerns about PE may wish to try OTC products and exercises before considering medication or surgical treatments. Alternative treatment for this condition include:
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 on 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.
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 condoms for PE.
Learn about PE wipes.
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 their partner’s vaginal area.
Learn about PE sprays.
There are various surgical treatments that individuals with moderate-to-severe PE can consider, including:
Here are some frequently asked questions about 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 future recurrence.
There are alternative treatments that can improve ejaculation control and reduce PE. These include pelvic floor exercises, condoms, and desensitizing sprays or creams.
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 they choose the safest PE option for their needs.
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 want to try proven OTC and exercise treatments for PE first.
Finally, individuals with PE considering pills should consult a doctor first to find the most effective and safest options.
Last medically reviewed on February 17, 2022
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