What to Know About Premature Ejaculation Pills

By Zina Semenovskaya, MD
Medically reviewed
May 10, 2021

Premature ejaculation is one of the most common male sexual disorders, affecting up to 39% of men.

Though it can be stressful, a variety of treatments, including premature ejaculation pills, can help delay ejaculation.

In this article, I’ll describe the symptoms and causes of premature ejaculation, how to get diagnosed, and the most common prescription pills used to treat premature ejaculation.

I’ll also explain when it’s important to talk to your doctor and which premature ejaculation treatment option might be right for you. 

What Are Premature Ejaculation Pills?

Premature ejaculation pills are prescription pills used to treat premature ejaculation.

None of these are FDA-approved for this purpose, so doctors prescribe them “off label,” which simply means the medication is FDA-approved for other conditions. 

Though some premature ejaculation medicines are in development, the most common prescription pills used in the treatment of premature ejaculation are selective serotonin reuptake inhibitors (SSRIs), including citalopram (Celexa) and fluoxetine (Prozac, Sarafem).

Doctors typically prescribe these drugs to treat depression and anxiety, but a common side effect is delayed orgasm. Hence, some doctors prescribe them to men who have premature ejaculation.

Other prescription treatment options include PDE-5 inhibitors, which are typically used to treat erectile dysfunction, along with a host of other medications.

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Symptoms of Premature Ejaculation

Most doctors define premature ejaculation as ejaculation within one minute of penetration and the inability to delay ejaculation beyond that point.

The condition is often classified in two ways:

  • Lifelong: You’ve experienced premature ejaculation during all or nearly all of your sexual encounters.
  • Acquired: You experience premature ejaculation after having other sexual experiences with no ejaculatory problems. 

Causes of Premature Ejaculation

Researchers are still unclear on the exact primary cause of premature ejaculation, but there are a variety of possible causes, including biological and psychological factors. 

Biological factors include serotonin levels in the body, physical sensitivity, erectile dysfunction, and thyroid and prostate issues.

It’s also possible for psychological factors, such as performance anxiety, depression, and stress, to contribute to or cause premature ejaculation.

How to Get Diagnosed with Premature Ejaculation

For an official diagnosis of premature ejaculation, you need a consultation with a medical professional.

During this process, your provider will assess your medical and sexual history and may perform additional mental and physical health exams.

If your doctor suspects abnormal hormone levels may be at play, they may also order blood tests. 

Though it can be difficult to discuss this intimate subject with your doctor, the more they know about your health, lifestyle, and history, the more likely they can help determine the cause of your premature ejaculation and the right course of treatment. 

Treatments for Premature Ejaculation

A number of prescription pills are used to treat premature ejaculation, including SSRIs, PDE5 inhibitors, clomipramine, and tramadol.

SSRIs

Antidepressant medications known as selective serotonin reuptake inhibitors (SSRIs) have been found to effectively delay ejaculation in men with premature ejaculation.

In one study, 480 men with premature ejaculation took sertraline (Zoloft), fluoxetine (Prozac, Sarafem), paroxetine (Paxil), or citalopram (Celexa) twice daily.

At the start of the trial, they lasted a little more than one minute before ejaculating. After eight weeks of medication, they lasted from about five to more than six minutes, depending on the specific SSRI. 

SSRIs have a low risk of side effects and good efficacy in delaying ejaculation, and they can be taken either daily or on-demand.

PDE5 inhibitors

Common prescriptions used to treat erectile dysfunction (ED), such as sildenafil (Viagra) and tadalafil (Cialis), have been shown to be safe and effective treatment options for premature ejaculation.

A meta analysis of 15 trials concluded that PDE5 inhibitors are significantly more effective than a placebo at treating premature ejaculation and that taking a PDE5 inhibitor with an SSRI is more effective than the SSRI alone. 

Clomipramine

If SSRIs and PDE5 inhibitors don’t work, your doctor may prescribe an antidepressant called clomipramine (Anafranil, Clofranil). 

Tramadol

Tramadol (Ultram) is a prescription medication used to treat pain that can also work to delay ejaculation.

Since tramadol can be habit forming, your doctor will likely only suggest trying it when all other avenues have failed to deliver results.

How to Get Prescribed Premature Ejaculation Pills

To get a prescription for premature ejaculation medicine, you must consult with a medical professional. Speaking with a doctor will help determine which prescription pill, if any, is right for you.

You can chat with a K Health physician about your symptoms and get prescription treatment for as low as $9.

Risks of Taking Premature Ejaculation Pills

All of the pills used to treat premature ejaculation come with potential side effects as well as risks if you have any existing medical conditions or take certain medications.

Be sure your doctor knows your full health history and any prescription or herbal remedies you’re using.

SSRIs

  • Side effects: The most common side effects of SSRIs include nausea, drowsiness, headache, and decreased libido.
  • Risks: SSRIs may not be suitable if you have a history of bipolar disorder or manic episodes, bleeding disorders (such as haemophilia), type 1 or type 2 diabetes, epilepsy, narrow angle glaucoma, or serious kidney, liver, or heart problems.
  • Interactions: Some medications can interact with SSRIs, including non-steroidal anti-inflammatory drugs (NSAIDs), antiplatelets, theophylline (a medication used to treat asthma), clozapine and pimozide (medications used to treat psychosis), lithium, triptans, and other antidepressants. Alcohol, caffeine, and St. John’s wort may also interact with SSRIs.

PDE5 inhibitors

  • Side effects: The most common side effects of these ED drugs are headache, flushing of the skin, nasal congestion, back pain, muscle aches, and nausea.
  • Risks: You should not take PDE5 inhibitors if you have a history of heart disease, high or low blood pressure, liver or kidney disease, sickle cell anemia, peyronie’s disease, or bleeding disorders.
  • Interactions: PDE5 inhibitors can react with common medications, including alpha blockers, nitrates, and some antibiotics. Alcohol and grapefruit may also interact with ED medications.

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Clomipramine

  • Side effects: The most common side effects of clomipramine are drowsiness, constipation, headache, nausea, vomiting, diarrhea, and decreased concentration.
  • Risks: You should not take clomipramine if you have a history of heart disease, hyperthyroidism, alcohol abuse, liver or kidney disease, bipolar disorder, seizures, brain damage, or adrenal gland tumors, and other conditions.
  • Interactions: Clomipramine should not be combined with tobacco, alcohol, monoamine oxidase (MAO) inhibitors, St. John’s wort, and other medicines.

Tramadol

  • Side effects: The most common side effects of tramadol are constipation, sleepiness, nervousness, tingling muscles, indigestion, and tremors.
  • Risks: Tramadol is not recommended for people 65 and older or those with alcohol abuse problems or respiratory conditions.
  • Interactions: Tramadol can react with alcohol, benzodiazepines, and other medications. 

When to See a Doctor

If you’re experiencing symptoms of premature ejaculation, it’s important to talk to your doctor to help identify the cause and determine which treatment option is right for you. 

How K Health Can Help 

You don’t need to suffer with premature ejaculation. Did you know you can get affordable primary care with the K Health app? Download K to check your symptoms, explore conditions and treatments, and if needed text with a doctor in minutes. K Health’s AI-powered app is HIPAA compliant and based on 20 years of clinical data.

Frequently Asked Questions

What is the best pill for premature ejaculation?
Doctors most commonly prescribe selective serotonin reuptake inhibitors (SSRIs) to treat premature ejaculation because of SSRIs’ efficacy and low risk of side effects.
How long should a man last before ejaculation?
Ejaculation times vary from man to man and encounter to encounter, but premature ejaculation is primarily defined as ejaculation within a minute of penetration.
When to take premature ejaculation pills?
When you take premature ejaculation pills depends on the pill prescribed by your doctor. Always follow their instructions.
How to cure premature ejaculation without pills?
Some at-home remedies may help with delaying ejaculations, including behavioral techniques, ayurvedic herbal medicine, Chinese herbal medicine, topical creams, and lidocaine spray. However, not all of these remedies are well proven. Talk to a healthcare provider about your options.
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Zina Semenovskaya, MD

Dr. Semenovskaya specializes in emergency medicine, and received her medical degree from Weill Cornell Medical College. She is currently the medical director at Remote Emergency Medicine Consulting, LLC and splits her time working clinically as an emergency medicine attending in California and Alaska. She is the first of our doctors to be fluent in Russian.