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If you’ve struggled with premature ejaculation (PE), it may have done more than blow the potential of a great night. PE is one of the most common sexual dysfunction types in men, and it can lead to depression, anxiety and lots of awkward moments if left untreated.
While research suggests that up to 39 percent of men experience this sexual function issue, there are very few proven ways to actually solve the problem. One of the surprisingly effective options, however, is an antidepressant called sertraline.
Sertraline (also known by the brand name Zoloft®) is an antidepressant used off-label for sexual function and performance issues like premature ejaculation. But why a medication designed to help with depression can affect your performance is as complicated as it is nonsensical.
Below, we’ll explain how this antidepressant can extend your stamina, discuss how it’s used, and go over the dosage and side effects you’ll need to know about. We’ll also share some other ways to beat the clock if you’re struggling to stay harder longer.
Sertraline (also known as sertraline hydrochloride or Zoloft) works to delay ejaculation in a sort of roundabout way. But it does help many men in the treatment of premature ejaculation.
The antidepressant known as sertraline does many things for your brain. Along with other selective serotonin reuptake inhibitors (SSRIs), it can help regulate mood in people with certain mood disorders.
Sertraline does this by preventing the reuptake (absorption) of your brain’s serotonin supply. Higher serotonin levels mean the brain has more of this neurotransmitter to regulate mood. As a result, you can avoid the extreme highs and lows associated with some mood disorders.
As for your penis, the benefits are a little less clear but no less impressive.
Numerous studies of sertraline over the years have shown that it can extend your stamina. Known medically as intravaginal ejaculation latency time or IELT, it basically helps prolong the period from penetration to orgasm and ejaculation.
In one small clinical trial, a group of 46 men aged 22 to 63 with PE were treated with oral sertraline tablets at a dose of 25 milligrams per day, with increases to 50 milligrams of sertraline at three weeks and 100 milligrams at six weeks.
With a 25-milligram dose of sertraline, the average ejaculatory interval increased from one minute to 7.6 minutes. With a 50-milligram dose, the average increased to 13.1 minutes. The men’s average ejaculatory time at 100 milligrams was 16.4 minutes.
Side effects were limited during the trial and reported by less than 10 percent of the population— the most common adverse effects were dyspepsia (indigestion) and anxiety at 100 mg, as well as drowsiness, anorexia, erectile dysfunction (ED) and reduced libido.
Other studies included in the meta-analysis produced similarly promising results on the efficacy of sertraline.
One study published in 1999 found that men who used sertraline significantly increased their average ejaculation latency time. This same study found sertraline works when used on an as-needed basis — meaning you don’t have to take it every day. That said, this study only included 24 participants, and six dropped out early.
Both the men and their partners reported higher levels of sexual satisfaction after the men started treatment with sertraline — and they experienced few side effects.
Real talk: There’s no such thing as PE pills.
Though there are a number of proven-effective treatments for erectile dysfunction, premature ejaculation is still very much an area of ongoing research. Controlling ejaculation with or without the use of sertraline is something you’ll have to navigate with tailored medical advice from your healthcare provider.
That said, if you do want to use it, there are two ways to do so.
The first is as a daily-use medication — taking a dose every day like your favorite Flintstones vitamin or espresso shot.
The second is sort of a stamina-on-demand approach — taking sertraline on an as-needed basis. On those days, you’ll take a sertraline tablet only when you plan to have sexual intercourse or other sexual interactions.
Which method is more effective? To be honest, neither.
The most effective approach to the treatment of PE is to follow your healthcare provider’s instructions.
Since sertraline is currently only approved by the FDA (U.S. Food and Drug Administration) to treat major depressive disorder (MDD), obsessive-compulsive disorder (OCD), panic disorder and other mental health conditions, there’s no official guidance on how to use it for PE.
Sertraline to treat premature ejaculation is considered an off-label use of the medication.
That said, most studies — including those mentioned above — involve a daily dose of 25 to 100 milligrams. We offer sertraline for premature ejaculation in 50-milligram tablets, following an online consultation with a real, licensed healthcare provider.
FYI: It may take several weeks for any dose of sertraline to effectively treat PE. Most men in the studies we mentioned experienced the largest improvements after four weeks.
Sertraline is both safe and effective — but it can cause side effects, especially if used incorrectly.
Luckily, most sertraline side effects (and most side effects of SSRIs, in general) are mild. And they only occur in a small percentage of users, so at the lower doses most often used for PE, your risk is very low.
Common side effects of sertraline include:
Difficulty falling asleep or staying asleep
Changes in sex drive and sexual desire
Changes in sexual function or performance
Nausea or vomiting
Loss of appetite
Overall, only a tiny percentage of men who use sertraline — just 4 percent in clinical trials of Zoloft — experience erectile dysfunction.
Most side effects from sertraline are mild. Still, there are some safety risks and interactions you should be aware of before using sertraline to treat PE.
Serotonin syndrome. The first is that sertraline can cause an issue called serotonin syndrome when used at the same time as serotonergic medications. Serotonergic medications are other drugs that cause an increase in your body’s serotonin levels.
Antidepressants that could cause serotonin syndrome. The most common serotonergic medications that may lead to serotonin syndrome are other antidepressants, such as SSRIs, SNRIs (serotonin–norepinephrine reuptake inhibitors), tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs).
Other potential drug interactions. Other medications that can cause serotonin syndrome when used with sertraline include opioid pain medications, triptans, amphetamines and supplements such as St. John’s wort.
Symptoms of serotonin syndrome. Serotonin syndrome can cause a range of serious symptoms, including delirium, hallucinations and other changes in your mental state. In some cases, it may be life-threatening.
To avoid drug interactions while using sertraline for PE, inform your healthcare provider about any medications you currently use or have recently used. This includes both prescription and over-the-counter drugs and anything you’ve taken in the last two weeks.
You may want to talk to a urology expert about these problems and get a prescription ASAP. But there are numerous ways to boost your sexual experience without antidepressants getting involved.
No offense to sertraline (or medications like fluoxetine, citalopram and other SSRIs out there), but a number of other tools may help with premature ejaculation. This includes topical sprays, ED medications, talk therapy, behavioral techniques and masturbating before sex.
Here’s what to know.
Topical sprays containing lidocaine are applied to your penis before sex to reduce its sensitivity. Lidocaine is a safe and widely used local anesthetic — you’ve probably already encountered it in a dentist’s office.
With lidocaine treatment, you’ll feel slightly less physical stimulation during sex but should still be able to stay hard and enjoy the experience.
The precise mechanism by which these drugs treat PE isn’t known. But studies show that men with premature ejaculation who use erectile dysfunction drugs tend to have longer ejaculation times than their peers.
One theory: Sildenafil, tadalafil and other ED drugs shorten the refractory period.
When premature ejaculation is caused by a psychological issue, like a lack of self-confidence or an anxiety disorder, taking part in therapy is often the best way to change your thought patterns and perform better.
Research shows medication and sexual behavioral treatment work better together than medication alone. And several different forms of therapy may treat sexual performance issues, such as cognitive behavioral therapy (CBT), sex therapy and couples therapy.
If you have mild premature ejaculation, you might be able to solve the problem at home. The “stop-start” strategy or “squeeze” technique can be effective when used properly.
You can learn more in our guide to PE techniques. Just know that these methods are associated with short-term benefits, not long-term effectiveness.
If you want to take the PE problem into your own hand, so to speak, masturbating before sex can initiate your refractory period. As a refresher, this is the recovery phase after orgasm when you’ll typically find it more difficult to orgasm again.
Real talk: There’s not much research on the effectiveness of this technique, and it’s often suggested to men with higher libidos — specifically younger men. You’ll also want to get the timing right so you don’t end up unable to perform at all.
But the reality is, this common type of sexual dysfunction (also known as rapid ejaculation) and problems like ED or anejaculation are all solvable only with professional help.
Even more good news: Premature ejaculation is usually easily treatable with medication, therapy, behavioral techniques or a mix of approaches.
The steps may be complicated, but what you’ll need to remember going forward is fairly simple:
Sexual health is a mental and physical arena — your body and brain both contribute.
While sertraline is safe, convenient and highly effective, it’s not the only treatment option available for premature ejaculation. Behavioral therapy and other methods can help too.
To avoid sertraline’s sexual side effects, read up on systematic review data from places like PubMed (we already covered the best resources above), and talk to a healthcare professional.
Tired of dealing with PE? We offer a range of premature ejaculation treatments online.
This includes prescription medications like sertraline and paroxetine, along with over-the-counter treatments like our Delay Spray for men and Clockstopper climax-delay wipes, following a consultation with a healthcare provider.
You can also find out more about PE, from its causes and symptoms to treatment options, in our premature ejaculation guide.
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]!
Kristin Hall is a board-certified Family Nurse Practitioner with decades of experience in clinical practice and leadership.
She has an extensive background in Family Medicine as both a front-line healthcare provider and clinical leader through her work as a primary care provider, retail health clinician and as Principal Investigator with the NIH.
Certified through the American Nurses Credentialing Center, she brings her expertise in Family Medicine into your home by helping people improve their health and actively participate in their own healthcare.
Kristin is a St. Louis native and earned her master’s degree in Nursing from St. Louis University, and is also a member of the American Academy of Nurse Practitioners. You can find Kristin on LinkedIn for more information.