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.
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.
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.
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.
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.
If SSRIs and PDE5 inhibitors don’t work, your doctor may prescribe an antidepressant called clomipramine (Anafranil, Clofranil).
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.
- 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.
- 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.
- 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.
- 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
K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.
Ask the Doctor: What Works Best for Premature Ejaculation? (2015). https://www.health.harvard.edu/mens-health/ask-the-doctor-what-works-best-for-premature-ejaculation
Can Sildenafil Treat Primary Premature Ejaculation? A Prospective Clinical Study. (2007). https://pubmed.ncbi.nlm.nih.gov/17470165/
Effect of SSRI Antidepressants on Ejaculation: A Double-blind, Randomized, Placebo-controlled Study with Fluoxetine, Fluvoxamine, Paroxetine and Sertraline. (1998). https://pubmed.ncbi.nlm.nih.gov/9690692/
Premature Ejaculation. (2007). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2721550/
Premature Ejaculation. (2020). https://www.mayoclinic.org/diseases-conditions/premature-ejaculation/symptoms-causes/syc-20354900
Which of Available Selective Serotonin Reuptake Inhibitors (SSRIs) Is More Effective in Treatment of Premature Ejaculation? A Randomized Clinical Trial. (2019). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6909853/