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How Do Premature Ejaculation Pills Work?

Mike Bohl, MD, MPH, ALM

Reviewed by Mike Bohl, MD, MPH, ALM

Written by Geoffrey Whittaker

Published 02/12/2019

Updated 01/31/2024

Here’s a bit of a sexual health reality check, guys: premature ejaculation is actually one of the most common male sexual problems, affecting as much as 30–70 percent of us (although reports are subjective and estimates vary widely). So if you’re looking for access to premature ejaculation treatment in the form of a pill, you’re definitely not alone.  Unfortunately, the answer is tricky.

There are treatments that work by delaying ejaculation and helping men to avoid reaching orgasm too early, but all “premature ejaculation pills” are actually not designed to treat PE. Instead, they’re typically things like antidepressants like selective serotonin reuptake inhibitors (SSRIs) or phosphodiesterase type -5 inhibitors (PDE5 inhibitors) like sildenafil (the active ingredient in Viagra®) prescribed for off-label use. Treatments also include local anesthetics like lidocaine or benzocaine.

Premature ejaculation pills, then, are a little more complicated than “pop the pill, start the timer.” Let’s break down the complicated state of effective premature ejaculation pills, starting with a more detailed look at what they are.

Premature ejaculation pills are an unofficial term for several types of pills that treat premature ejaculation. These “last longer” pills are some of the most reliable and safe treatments a healthcare provider can offer you — they’re just not approved for PE treatment by the Food and Drug Administration (FDA). In fact, every PE medication is actually a pill originally intended for another purpose.

For the best example, we need look no further than SSRIs. SSRIs are a class of medications generally used to treat depression by regulating the amount of serotonin between neurons at any one time, which is believed to help alleviate some of the symptoms of depression.

Sertraline (commonly sold as Zoloft®) is one of the most widely-used psychiatric medications available, and it’s also one of the most popular SSRIs among people with PE problems because one of its main “side effects” is delayed ejaculation. 

Yes, you read that right: the side effect is the treatment here.

Another commonly used PE pill, meanwhile, is actually another sexual dysfunction drug — phosphodiesterase type -5 inhibitors.

PDE5 inhibitors like sildenafil (Viagra), tadalafil (Cialis®) and avanafil (Stendra®) are technically intended to work as vasodilators.

They improve your sex life by increasing blood flow to your penis. Since healthy erections are all about blood flow, increased blood supply makes developing and maintaining an erection easier when you feel sexually aroused.

Aside from helping with erectile function, PDE5 inhibitors are also sometimes prescribed off-label for premature ejaculation. Talk about “bang for your buck” eh? 

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SSRIs are typically used to treat depression and anxiety, but some healthcare providers prescribe them “off-label” for premature ejaculation because they help slow down orgasm and ejaculation. This effect is typically regarded as a side effect of medications like paroxetine, sertraline and others. But for people with PE, it can be beneficial.

On the other hand, In addition to a selective serotonin reuptake inhibitor, healthcare professionals may also recommend prescription erectile dysfunction (ED) medications such as sildenafil (Viagra®). 

We understand why you’d be a little concerned about taking a medication designed for one purpose to treat something else, but you might be surprised to learn that healthcare professionals prescribe medications to treat issues outside their FDA approval status all the time. 

In fact, these medications are surprisingly well-targeted when used to treat PE — let’s look at why.

Our sexual experiences and sexual activity are very much mental exercises, but it’s not the emotional element of sexual dysfunction that SSRIs are addressing here. Instead, they make it harder for a person to reach orgasm. And there’s even research to prove it can help people with PE.

You may have read about medications like dapoxetine, fluoxetine and others having this “side effect,” but one of the most commonly prescribed SSRIs for PE is sertraline.

Studies of sertraline, for instance, show that these medications can often treat premature ejaculation symptoms when used daily, usually by a significant amount.

One study from 1998 gave men with premature ejaculation 25mg of sertraline daily, then 50 mg per day after three weeks, then 100 mg another three weeks later.

  • After taking a 25mg daily dose of sertraline, the mean ejaculation time of the group increased from one minute to 7.6 minutes.

  • Once the men started to take the higher 50mg per day dose of sertraline, their ejaculation time increased to a mean of 13.1 minutes.

  • At a 100mg dose, the men had a mean ejaculation time of 16.4 minutes. 

  • At the 50mg and 100mg doses of sertraline, a small number of men involved in the study started to develop anejaculation, or an inability to orgasm during sex.

While SSRIs are among the most common medications for the treatment of premature ejaculation, healthcare providers also sometimes prescribe tricyclic antidepressants (TCAs) like clomipramine.

Our guide to sertraline for premature ejaculation goes into more detail about the latest research behind sertraline as a PE treatment.

It’s possible that everyone’s favorite “last longer in bed” pills to treat ED may also function as PE pills. Research has found that many men with PE experience improvements after using ED medications such as sildenafil. Look at the data:

  • A 2007 study compared the effects of sildenafil, paroxetine (an SSRI) and the squeeze technique (a self-care technique for PE that involves squeezing the penis during sex) to see which option best treated PE. At the end of six months, the researchers found that sildenafil was the most effective treatment. 

  • Another study from 2005 found that while sildenafil doesn’t directly increase the time before orgasm, it can improve confidence and increase the perception of ejaculatory control.

  • The same researchers also found that sildenafil reduces refractory time, making it easier for men with premature ejaculation to get a second erection shortly after sex.

Even if there’s no improvement in ejaculation time the first time you have sex, sildenafil might make it easier to enjoy round two with your partner.

Like all medications, PDE5 inhibitors and SSRIs can cause potential side effects, and not all of them are actually PE benefits in disguise.

Potential side effects of sertraline include:

  • Nausea

  • Diarrhea

  • Constipation

  • Dizziness

  • Tiredness

  • Headache

  • Nervousness

  • Shaking

  • Vomiting

  • Difficulty sleeping

  • Dry mouth

  • Heartburn

  • Excessive sweating

  • Appetite and/or weight changes

  • Changes in sex drive and/or sexual performance

Many of these are common potential side effects of all antidepressants. You can learn more about what to expect from SSRIs in our guide to antidepressant side effects

Sildenafil and other PDE5 inhibitors, on the other hand, generally only cause mild side effects while they’re active in your body. Potential side effects of sildenafil include:

  • Headache

  • Facial flushing

  • Heartburn

  • Nosebleeds

  • Difficulty sleeping

  • Muscle aches

  • Numbness or tingling in the limbs

  • Increased sensitivity to light

  • Changes in your ability to perceive color

If your goal is to last longer during sex without prescription medication, there are some alternative treatments for PE that are worth considering, either as part of a broader treatment plan or on their own. 

Nothing’s going to replace talking with a healthcare professional, but you might see improvements from:

  • Lidocaine premature ejaculation spray. Lidocaine is a topical anesthetic that, when applied to your penis, helps you avoid premature ejaculation by reducing sensitivity. Lidocaine is a good alternative to prescription medications for PE. You can find it as an active ingredient in our Delay Spray for Men, which is designed for quick and easy use 10 to 15 minutes before you have sex.

  • Premature ejaculation cream. Like premature ejaculation sprays, these creams contain topical anesthetics such as lidocaine to lower the sensitivity level of your penis and help you avoid ejaculating too soon. Benzocaine is another ingredient commonly used in premature ejaculation treatments.

  • PE prevention techniques. Techniques like the stop-start strategy and squeeze technique appear to help prevent PE. We’ve covered the squeeze technique and others (and the scientific research on their effectiveness) in our guide to stopping premature ejaculation.

  • Behavioral therapy. PE is sometimes psychological. Because of that, some forms of behavioral therapy may help treat it. Common forms of therapy used to treat sexual performance issues include cognitive-behavioral therapy (CBT) and sex therapy.

  • Pelvic floor exercises. Also referred to as kegel exercises, pelvic floor exercises involve strengthening the pelvic floor muscles to control ejaculation. Research shows that kegel exercises can often improve ejaculatory control and delay orgasm in men with PE.

  • Masturbating before sex. While it’s certainly far from scientific, some people claim that masturbating a few hours before sex helps to delay orgasm and ejaculation by keeping you in the post-sex refractory period.

Step into your local sex store, gas station or search online and you’ll find countless supplements to help improve sexual intercourse and last longer in bed. You can also grab a 64-ounce soda and some lottery tickets.

Most of the time, these products contain herbal ingredients that may help to improve your sexual performance in a general “yay vitamins” kind of way — they’re far from anything close to a “treatment” though. 

These products also aren’t really regulated by the FDA in the same way as prescription medications, meaning they can be marketed using claims that might be misleading.

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Until PE gets its own medication class, antidepressants and ED meds are your best options of medicine for premature ejaculation. Regardless of whether you’re ready to try pills to last longer in bed or want to give the home remedies more time to work, here’s what you should remember:

  • You’re not alone if you’re dealing with PE. Premature ejaculation is a common issue that can affect men of all ages. 

  • Don’t be ashamed. As with erectile dysfunction and other common medical conditions, there’s no shame in using premature ejaculation medication to treat PE and improve your sexual performance, sexual relationship with your partner(s), sexual health or your own personal sexual pleasure. 

  • The solution is to get treated — safely. Stick to proven prescription treatments such as sertraline, paroxetine or sildenafil, or use over-the-counter options like products that contain lidocaine or benzocaine. 

We offer these prescription premature ejaculation treatments online, following a consultation with a licensed healthcare provider who will determine if a prescription is appropriate. 

Worried about premature ejaculation? Our guide to premature ejaculation explains how and why PE occurs, what you might notice if you’re prone to PE, and your options to improve your sexual stamina and delay ejaculation.

7 Sources

  1. Saleh, R., Majzoub, A., & Abu El-Hamd, M. (2021). An update on the treatment of premature ejaculation: A systematic review. Arab journal of urology, 19(3), 281–302. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8451625/.
  2. Pastore, A. L., Palleschi, G., Fuschi, A., Maggioni, C., Rago, R., Zucchi, A., Costantini, E., & Carbone, A. (2014). Pelvic floor muscle rehabilitation for patients with lifelong premature ejaculation: a novel therapeutic approach. Therapeutic advances in urology, 6(3), 83–88. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4003840/.
  3. Dhaliwal A, Gupta M. PDE5 Inhibitors. [Updated 2022 May 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK549843/.
  4. McMahon C. G. (1998). Treatment of premature ejaculation with sertraline hydrochloride. International journal of impotence research, 10(3), 181–185. https://pubmed.ncbi.nlm.nih.gov/9788108/.
  5. Wang, W. F., Wang, Y., Minhas, S., & Ralph, D. J. (2007). Can sildenafil treat primary premature ejaculation? A prospective clinical study. International journal of urology : official journal of the Japanese Urological Association, 14(4), 331–335. https://pubmed.ncbi.nlm.nih.gov/17470165/.
  6. McMahon, C. G., Stuckey, B. G., Andersen, M., Purvis, K., Koppiker, N., Haughie, S., & Boolell, M. (2005). Efficacy of sildenafil citrate (Viagra) in men with premature ejaculation. The journal of sexual medicine, 2(3), 368–375. https://pubmed.ncbi.nlm.nih.gov/16422868/.
  7. Center for Food Safety and Applied Nutrition. (n.d.). Information for consumers on using dietary supplements. U.S. Food and Drug Administration. Retrieved March 1, 2023, from https://www.fda.gov/food/dietary-supplements/information-consumers-using-dietary-supplements.
Editorial Standards

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references. See a mistake? Let us know at [email protected]!

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Mike Bohl, MD, MPH, ALM

Dr. Mike Bohl is a licensed physician, a Medical Advisor at Hims & Hers, and the Director of Scientific & Medical Content at a stealth biotech startup, where he is involved in pharmaceutical drug development. Prior to joining Hims & Hers, Dr. Bohl spent several years working in digital health, focusing on patient education. He has also worked in medical journalism for The Dr. Oz Show (receiving recognition for contributions from the National Academy of Television Arts and Sciences when the show won Outstanding Informative Talk Show at the 2016–2017 Daytime Emmy® Awards) and at Sharecare. He is a Medical Expert Board Member at Eat This, Not That! and a Board Member at International Veterinary Outreach.

Dr. Bohl obtained his Bachelor of Arts and Doctor of Medicine from Brown University, his Master of Public Health from Columbia University, and his Master of Liberal Arts in Extension Studies—Journalism from Harvard University. He is currently pursuing a Master of Business Administration and Master of Science in Healthcare Leadership at Cornell University. Dr. Bohl trained in internal medicine with a focus on community health at NYU Langone Health.

Dr. Bohl is Certified in Public Health by the National Board of Public Health Examiners, Medical Writer Certified by the American Medical Writers Association, a certified Editor in the Life Sciences by the Board of Editors in the Life Sciences, a Certified Personal Trainer and Certified Nutrition Coach by the National Academy of Sports Medicine, and a Board Certified Medical Affairs Specialist by the Accreditation Council for Medical Affairs. He has graduate certificates in Digital Storytelling and Marketing Management & Digital Strategy from Harvard Extension School and certificates in Business Law and Corporate Governance from Cornell Law School.

In addition to his written work, Dr. Bohl has experience creating medical segments for radio and producing patient education videos. He has also spent time conducting orthopedic and biomaterial research at Case Western Reserve University and University Hospitals of Cleveland and practicing clinically as a general practitioner on international medical aid projects with Medical Ministry International.

Dr. Bohl lives in Manhattan and enjoys biking, resistance training, sailing, scuba diving, skiing, tennis, and traveling. You can find Dr. Bohl on LinkedIn for more information.


  • Younesi, M., Knapik, D. M., Cumsky, J., Donmez, B. O., He, P., Islam, A., Learn, G., McClellan, P., Bohl, M., Gillespie, R. J., & Akkus, O. (2017). Effects of PDGF-BB delivery from heparinized collagen sutures on the healing of lacerated chicken flexor tendon in vivo. Acta biomaterialia, 63, 200–209. https://www.sciencedirect.com/science/article/abs/pii/S1742706117305652?via%3Dihub

  • Gebhart, J. J., Weinberg, D. S., Bohl, M. S., & Liu, R. W. (2016). Relationship between pelvic incidence and osteoarthritis of the hip. Bone & joint research, 5(2), 66–72. https://boneandjoint.org.uk/Article/10.1302/2046-3758.52.2000552

  • Gebhart, J. J., Bohl, M. S., Weinberg, D. S., Cooperman, D. R., & Liu, R. W. (2015). Pelvic Incidence and Acetabular Version in Slipped Capital Femoral Epiphysis. Journal of pediatric orthopedics, 35(6), 565–570. https://journals.lww.com/pedorthopaedics/abstract/2015/09000/pelvic_incidence_and_acetabular_version_in_slipped.5.aspx

  • Islam, A., Bohl, M. S., Tsai, A. G., Younesi, M., Gillespie, R., & Akkus, O. (2015). Biomechanical evaluation of a novel suturing scheme for grafting load-bearing collagen scaffolds for rotator cuff repair. Clinical biomechanics (Bristol, Avon), 30(7), 669–675. https://www.clinbiomech.com/article/S0268-0033(15)00143-6/fulltext

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