Which Premature Ejaculation Pills Work? Options and Safety

PE is a type of sexual dysfunction that affects up to 30% of people with a penis. It can be a short- or long-term condition. Some people look to medication to help reduce their symptoms, such as ejaculating within 1 minute of penetration and difficulty controlling or delaying ejaculation during penetration.

While lifelong PE has no cure, symptoms may resolve in 30–70% of cases with treatment. However, it is important to note that a recurrence of symptoms is common and will require further treatment.

Please note that the writer of this article has not tried these products. All information presented is purely research-based and correct at the time of publication.

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It is always best to speak with a doctor about medication for treating PE, as some pills for the condition may interact with other drugs or existing health conditions. The safest option is to consult a medical professional for recommendations.

Some prescription and nonprescription pill medications that may help with PE include:

ED pills

Certain ED medications can also help treat PE. Taking these to treat PE is an off-label use.

They 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.

Research from 2020 suggests PDE5 inhibitors are effective in treating PE. However, they may be more effective if a person takes them with selective serotonin reuptake inhibitors (SSRIs).

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

All the above ED medications are available via prescription.

Precautions

People taking nitrate medications, such as nitroglycerin, need 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.

Learn more about ED medication.

Antidepressants

Although the everyday use of antidepressant medication is to treat individuals with depression and anxiety, several studies suggest the off-label use of two types of antidepressants may help treat PE by delaying ejaculations. These are SSRIs and tricyclic antidepressants (TCAs).

A person could take SSRI medications daily or as needed to manage PE, depending on their active ingredients. It takes 1–5 hours for these drugs to take effect when people use them as needed. It takes 2–3 weeks for daily medications to take effect since a person usually starts with a small dose before gradually increasing it.

Availability can be an issue, as most antidepressant medications the FDA has tested and approved are only available via prescription.

Precautions

Antidepressants commonly cause side effects, such as:

The FDA states that severe but less common side effects can include:

Antidepressants may also cause erection problems in rare cases.

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

It also lists some medications that individuals cannot take with antidepressants, including:

Tramadol

Tramadol is an analgesic drug that reduces sensitivity to the receptors that produce serotonin. It is only available with a prescription. Using tramadol for PE is an off-label use.

Studies suggest tramadol can help people manage PE. It may work by blocking the serotonin transporter, with additional action by 5-HT(1A) receptors, which help people reach ejaculation and can stop erections.

A 2021 study notes that administering the drug hours before sexual intercourse resulted in higher intercourse satisfaction and reduced PE.

Precautions

Tramadol is an opioid. These drugs can create dependency and lead to 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 the serious risks of combining this drug with benzodiazepines. This can be fatal.

Learn more about tramadol.

Codeine

Codeine is another type of analgesic drug. Using codeine for PE is an off-label use.

A 2017 case study documents one case where a person taking codeine saw improvements in controlling their ejaculations during intercourse.

Precautions

The individual in the study above developed a dependency on codeine, which is a derivative of opium. The authors state that while there were no liver or blood sugar abnormalities, this person had to undergo a 6-month withdrawal process.

It is best for people considering taking codeine to treat PE to consult a doctor to determine the best course of action and limit side effects.

Learn about codeine withdrawal.

Doctors can advise people on PE treatments that will not conflict with existing health conditions or medications. After people get this advice, they can buy PE medication from the following direct-to-consumer health companies that ship products across the United States.

Customers need to create profiles on the companies’ secure platforms and include their medical history and symptoms.

A healthcare professional will then review the person’s application before answering any questions they may have, describing potential treatments, and approving medication.

Numerous PE pills on the market reportedly do not work or contain untested amounts of prescription medication.

For example, the FDA issued a warning to one company, MS Bionic, 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 with unsubstantiated health claims or those that do not have any research to support their benefits. People should not use PE treatments that do not clearly list the ingredients on the packaging.

It is always best to consult a doctor to find the safest and most effective treatment for PE.

This condition is common in all age groups. However, 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 also worsen PE.

There are primary and secondary triggers for this condition:

Primary PE

The following may trigger PE:

• a person’s upbringing
• conditioning by family and society
• traumatic sexual experiences

Secondary PE

Several health conditions that may trigger or worsen PE include:

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. It 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 partners’ vaginal areas.

Learn about the best PE sprays.

Surgical treatments

There are various investigational 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 suggests that participants found an overall improvement in both testosterone levels 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 had no side effects after the procedure.

Therapy

A person may consider talk therapy to work on any anxiety related to sex or relationships. This may help them identify and address underlying emotional issues relating to PE.

A 2019 review suggests that a combination of psychological and pharmacological treatment may be most effective for PE.

Learn about the best online therapy options in 2023.

Online sources

A 2019 study looked into the reliability of YouTube videos for treating PE. The authors concluded that the video platform was helpful and most videos had reliable information.

However, it is important to exercise caution when getting advice from the internet, as not all content creators offer reliable or safe information.

Before acting on advice found online, it is always best to speak with a doctor.

Home remedies

Some home treatment methods for PE include:

• trying techniques for delaying an orgasm
• using thicker condoms to decrease sensation
• masturbating 1–2 hours before sex
• exercising regularly
• resting well
• eating plenty of fruits

People can also try extending foreplay and using alternate sex positions.

There are two common edging techniques a person may use to delay ejaculation. Both require people to recognize when they are about to ejaculate, also known as their “point of no return.” These methods include:

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. They then 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. It 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.

The below table compares some of the treatments for PE.

People can contact a doctor if they believe they are ejaculating too soon while 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 has been experiencing PE
• 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 medication.

Below, we answer some of the most common questions about PE.

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.

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.

Experts recommend that people speak with their doctor to ensure they choose the safest option.

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 PE, 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 daily. Others may prefer to use PDE5 inhibitors, which they take as and when needed. A doctor will be able to recommend the most appropriate medication.

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.

Not all individuals with PE can take 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.

It is best to consult a doctor to find the most effective and safest pill options for PE.