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Tramadol For Premature Ejaculation: Can It Help?

Vicky Davis

Reviewed by Vicky Davis, FNP

Written by Geoffrey Whittaker

Published 11/03/2021

Updated 10/21/2022

Can a prescription painkiller kill the pain of premature ejaculation issues? Tramadol is an opioid painkiller that’s often used as a form of prescription pain relief, generally for moderate to severe pain. 

The medical community is working long and hard to keep you harder longer, but where erectile dysfunction has a bevy of treatments available to its sufferers, premature ejaculation, or PE, is still an area of sexual dysfunction where reliable treatment options are somewhat lacking.

Premature ejaculation is a major concern for men suffering from it -- control over ejaculation can be an intimate issue, and difficulty in ejaculation can lead to intimacy problems and a real loss of confidence in bed. These issues can have lasting effects if left unaddressed.

Part of this concern is that PE, or rapid ejaculation has lots of potential causes, and the scientific community is still on the hunt for a root cause. 

But the science is catching up, and clinical trials are looking into the potential role of drugs such as tramadol in delaying orgasm and improving quality of life for men who are currently struggling with premature ejaculation. 

Currently, tramadol shows some promise as a treatment for premature ejaculation. However, as an opioid medication, it also has significant risks and safety issues that you should be aware of if you’re considering it as a form of treatment for PE. 

Below, we’ve covered what tramadol is, as well as how it’s usually prescribed. We’ve also gone into detail about how premature ejaculation may affect your sexual function, as well as the risks of using an opioid medication like tramadol to treat it.

Finally, we’ve shared some other options that you may want to consider if you’re one of the tens of millions of men in the United States affected by premature ejaculation every year.

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What is Tramadol?

Tramadol is a pain medication, or painkiller, that’s typically used to treat moderate to moderately severe pain. It belongs to a class of drugs called opioids, which work by binding to receptors in your central nervous system. 

This changes how your body perceives pain and makes certain forms of pain significantly easier to tolerate and less likely to have a negative impact on your life. 

Tramadol is used for a variety of relief situations, typically for pain experienced that’s outside of a hospital. Your healthcare provider may prescribe tramadol if you have pain from surgery, or a form of lasting pain from an injury.

How Tramadol is Prescribed

Tramadol comes in many forms, including liquid solutions and tablets. It’s also available in the form of long-lasting capsules and extended-release tablets. 

In general, tramadol is a flexible medication. Your healthcare provider might prescribe tramadol for immediate pain relief (for example, after an injury), or for you to use to reduce the severity of round-the-clock-pain caused by a chronic physical condition. 

Tramadol can be taken with or without food in some cases. However, it should always be taken exactly as directed by your healthcare professional for your particular needs. 

If you’re prescribed tramadol, it’s important to closely follow your healthcare provider’s directions and take it exactly as prescribed. Stopping tramadol suddenly may cause withdrawal symptoms, including anxiety, panic, sweating, insomnia, nausea and other potentially severe issues.

Tramadol Side Effects 

Before we get into specifics of the effectiveness of tramadol for premature ejaculation, it’s very important to get one thing out of the way -- tramadol can, and often does, produce side effects, particularly in the first few weeks of treatment. 

Common adverse effects of tramadol include:

  • Nausea

  • Headache

  • Nervousness

  • Sleepiness

  • Constipation

  • Vomiting

  • Muscle tightness

  • Changes in mood

  • Uncontrollable shaking

  • Indigestion (heartburn)

  • Dry mouth

Many of these effects start to develop during the early stages of treatment with tramadol, such as during the weeks after your first doses of tramadol. Some adverse effects of tramadol may become less severe over time.

Although uncommon, tramadol can also produce more severe side effects, including some that may affect your health, wellbeing and personal safety.

These include hives, rash, hoarseness, blisters, difficulty swallowing and/or breathing, swelling that affects your face, eyes, throat, tongue, lips or extremities, hallucinations, agitation, loss of coordination, loss of appetite, weakness, dizziness, vomiting or changes in heartbeat.

It’s important to seek medical attention if you develop any severe or persistent side effects after starting treatment with tramadol. 

In addition to these undesirable effects, there’s also a significant risk of misuse of tramadol and similar opioid painkillers. 

Like with other opioids, abuse of tramadol -- particularly in the context of long-term treatment -- is a major problem both in the United States and around the world. Many people who use drugs like tramadol experience addiction that may lead to drug abuse.

We’ve talked about the safety of tramadol and its addiction potential in more detail further down the page. 

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What Studies Say About Tramadol and Premature Ejaculation

So, what does the scientific research say about tramadol’s real potential benefits as a premature ejaculation treatment? 

Perhaps surprisingly for a pain relief medication, a few studies actually do suggest that tramadol helps to lower the severity of premature ejaculation and increase intravaginal ejaculatory latency time (IELT, a measure of ejaculation time in men).

For example, a study of tramadol as a treatment for premature ejaculation, which was published in the Indian Journal of Psychological Medicine in 2013, compared the effects of tramadol and a non-therapeutic placebo in men with PE aged between 28 and 45.

The men participating in the study weren’t taking any other types of medication, preventing any other treatments from affecting the results. 

The researchers found that men who used 100mg of tramadol on a daily basis for 12 weeks had a significant increase in ejaculation latency time, even when tramadol was only used as-needed before sex.

At the start of the study, the men had a mean ejaculation time of 59 seconds, or just under one minute. By the end of the study period, the men had an average ejaculation time of 202 to 238 seconds, or slightly more than three minutes.

In comparison, the men in the placebo group went from an average ejaculation time of just 58.7 seconds prior to treatment to 94.8 or 96.6 seconds with the placebo treatment.

Not only did the men treated with tramadol show longer sexual endurance and a greater level of ejaculation control -- they also reported greater sexual satisfaction. 

What’s more interesting, though, is that the study did not conclude that any significant difference was found between regular use of tramadol (meaning treatment with tramadol on a steady daily basis) and sporadic treatment, or as-needed treatment, with tramadol.

In other words, this study suggests that tramadol for premature ejaculation could theoretically be taken either as needed or on a daily basis, which would offer patients a large variety of different treatment options to employ based on their individual needs. 

This study also noted that selective serotonin reuptake inhibitors (SSRIs), a class of drugs that are commonly prescribed off-label to treat premature ejaculation, were also effective, their risk of adverse effects and psychiatric issues was worthy of concern.

This is perhaps ironic, given that tramadol itself could be considered a habit-forming pain relief medication with prolonged use. 

We’ve discussed SSRIs and other non-opioid options for treating premature ejaculation in more detail further down the page.

A more recent systematic review and meta-analysis published in the journal BMC Urology also looked at the potential benefits of tramadol as a premature ejaculation treatment.

This review looked at findings from eight randomized controlled trials which compared tramadol with other pharmacological treatments for PE.

The researchers noted that tramadol appears to be more effective than a placebo at producing delay in ejaculation. They also found that individual trials suggest that tramadol works better as a PE treatment than medications such as paroxetine and sildenafil (Viagra®).

However, the same research suggested that tramadol was more likely to cause adverse effects when used to increase intravaginal ejaculation latency time -- an issue that may make it a less appropriate option for men with PE.

The researchers also noted that they did not consider the addiction potential of tramadol, which is a major issue that could prevent it from being an appropriate PE treatment. 

Put simply, research on the efficacy of tramadol on demand or used long-term as a medication for PE is certainly promising, but it also reveals that tramadol is far from perfect.

It’s also essential to keep in mind that the level of scientific evidence on tramadol and PE is far from totally comprehensive right now, meaning there’s likely still a lot that we don’t know about how tramadol works to treat PE (or whether it’s the best treatment option available). 

Opioid Addiction and the Downsides of Using Tramadol

However, one thing that we definitely do know is that tramadol is an opioid medication, and like other drugs in this class, it has the potential for addiction. 

This is a concern we really need to address -- in fact, it’s the largest single concern associated with the safety of tramadol for premature ejaculation. 

Chances are, if you’re even the most occasional national and world news consumer, you know that opioids cause significant community problems for addiction and overdose every year, both across the United States and the world.

While other opioids may get most of the media headlines, even a lesser known medication like tramadol can cause addiction problems if misused. These are aside from the other side effects mentioned above. 

This risk is real, although it’s less severe than for other opioids. According to the FDA, the rate of addiction for tramadol was one in every 100,000 people during the latest 18-month period of surveillance.

As such, tramadol is largely thought of as having a low abuse potential compared to most other opioids, although it can still function as an addictive, harmful medication when misused.

Put simply, “low risk” compared to other opioid medications doesn’t mean that using tramadol is risk free, or that it’s a medication that can be taken without any consideration for your wellbeing and safety. 

Because of its potential for abuse and addiction, some healthcare providers may hesitate to try tramadol as a treatment for premature ejaculation, particularly when other medications are also available for increasing intra-vaginal ejaculatory latency time and improving sexual stamina.

This means that it’s generally rare for tramadol to be prescribed -- at least as a first-line form of treatment -- if you have PE.

If you are prescribed this medication for PE, your healthcare provider will usually only make this decision if other medications aren’t effective, or if they cause too many unwanted side effects to be suitable for you. 

In this case, it’s important to be vigilant about signs of addiction, such as a feeling that you need to take tramadol in order to feel “normal” or “yourself.”

Your healthcare provider may also suggest making changes to your habits and lifestyle so that you can use tramadol appropriately, such as limiting your alcohol consumption and avoiding all illicit or recreational drugs.

This is because consuming alcohol or using illicit drugs with tramadol can increase your risk of harmful side effects or life-threatening overdose. 

Make sure to closely follow your healthcare provider’s instructions and, if needed, inform them as soon as possible if you have concerns about tramadol dependence.  

Should You Use Tramadol for Premature Ejaculation?

So, is tramadol for PE worth it? That depends on your personal medical situation, what else you have already tried for your PE, what other medications you're on, and other considerations. This should be a joint decision between you and your health provider. 

Right now, research into the effectiveness of a daily dose of tramadol for premature ejaculation is promising but limited. We have a few previous studies that suggest it offers benefits, but the total level of evidence isn’t yet as strong as it needs to be to recommend it as a treatment.

Put simply, we still don’t know enough to carry out a totally thorough evaluation of tramadol for PE right now. As such, the role of tramadol as a potential option for treating PE and improving your sex life still isn’t fully known. 

As such, we don’t believe that tramadol should be a first-line treatment for premature ejaculation just yet, at least not based on the current evidence base.

For now, it seems better to stick with the existing proven treatments and wait for more research before making a firm decision on whether or not to use tramadol as a PE treatment. 

Other, Non-Tramadol Treatments for Premature Ejaculation

So, if tramadol isn’t a recommended first-line treatment for premature ejaculation, what type of treatment will work for you? This is a good question, and it’s one that the medical community is still working to answer. 

Premature ejaculation isn’t yet considered curable, but there are numerous options available to help you deal with PE symptoms, improve your sexual stamina and enjoy a more satisfying sex life, even if you’re normally affected by PE. 

Better yet, many of these treatments are backed up by large amounts of scientific research that show that they’re effective for most men.

If you’d like to try treating premature ejaculation without using medication, you may benefit from behavioral approaches such as the stop-start and squeeze techniques. 

The stop-start (or start-stop) technique involves simply taking a break from movement when you feel yourself approaching orgasm sooner than you’d like it to, then continuing with intercourse if the urge has faded.

We like to make fun of the ridiculously named “squeeze technique,” in part because it is slightly ridiculous in its own right -- you squeeze the tip of your penis when you feel like you’re about to reach orgasm to help the urge subside.

However, it’s been shown effective in some extremely small studies. As such, we think it’s best viewed as a last-ditch effort.

You might also start doing kegel exercises to strengthen the pelvic floor muscles that you use to pee. Training these muscles can help you control ejaculation urges more effectively while you’re in the act.

For example, some research suggests that pelvic floor muscle training can increase ejaculation time from 30 seconds to more than two minutes.

If behavioral techniques don’t seem to work for you, or if they only produce small improvements in your ejaculatory dysfunction symptoms, you might want to consider taking part in talk therapy or using medication to improve your sexual stamina.

Talk therapy is typically used to treat mental disorders, such as depression and anxiety. If you’re concerned that your PE symptoms could be caused by negative feelings or sexual performance anxiety, meeting with a therapist might improve your confidence and sexual function.

We offer therapy online, allowing you to easily talk to a licensed counselor from the comfort and privacy of your home. 

As for medication, there are several over-the-counter and prescription options available to help you slow down ejaculation and make sexual behavior more satisfying.

Over-the-counter options include wipes and sprays that reduce sensitivity around the tip of your penis, allowing you to avoid feeling overly stimulated during sex. These can be applied several minutes before sex, letting you prepare ahead of time for a longer-lasting encounter.

Our Clockstopper Climax Delay Wipes and Delay Spray for Men both contain topical anesthetic ingredients that reduce sensitivity and extend lovemaking, all without making your penis feel too numb or uncomfortable. 

As for prescription PE medications, the most common options are selective serotonin re-uptake inhibitors, or SSRIs. 

Approved by the FDA as medications for depression, these prescription medications cause the inhibition of serotonin, a neurotransmitter. This helps to increase serotonin levels in your brain and body, improving some of your moods and feelings.

Many SSRIs can slow down orgasm and ejaculation, allowing you to last for longer in bed with no need for specific techniques or other behavioral modification. 

Two SSRIs that are typically prescribed for premature ejaculation include sertraline (the active ingredient in Zoloft®) and paroxetine (Paxil®). We offer both of these medications online after an evaluation with a licensed healthcare provider. 

For many people, the most effective approach to dealing with PE is a bit of both worlds -- a mix of medication and behavioral therapy. Your healthcare provider will let you know what’s best for you and work with you to help you find the most effective treatment for your needs. 

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The Bottom Line on Tramadol and Premature Ejaculation

Premature ejaculation is a common problem that can have a debilitating impact on your sexual wellbeing. When it’s severe, it can cause everything from stress to major interpersonal difficulty between you and your sexual partner. 

Although tramadol does show some promise as a treatment for premature ejaculation, it usually isn’t recommended as a first-line treatment due to the harmful effects of tramadol misuse.

Instead, if you have PE, your healthcare provider will likely recommend talk therapy, behavioral techniques, medication, or a mix of different approaches to improve your sexual function.

Interested in learning more about treating PE? We offer a large range of premature ejaculation treatments online, including wipes, topical sprays and prescription medications for dealing with early ejaculation. 

You can get started by participating in an online premature ejaculation consultation and talking to a licensed healthcare provider, who will determine if medication is appropriate. 

8 Sources

  1. Tramadol. (2022, January 15). Retrieved from https://medlineplus.gov/druginfo/meds/a695011.html
  2. Dhesi, M., Maldonado, K.A. & Maani, C.V. (2022, June 6). Tramadol. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK537060/
  3. Dhesi, M., Maldonado, K.A. & Maani, C.V. (2022, June 6). Tramadol. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK537060/
  4. Khan, A.H. & Rasaily, D. (2013). Tramadol Use in Premature Ejaculation: Daily Versus Sporadic Treatment. Indian Journal of Psychological Medicine. 35 (3), 256-259. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3821202/
  5. Martyn-St James, M., et al. (2015). Tramadol for premature ejaculation: a systematic review and meta-analysis. BMC Urology. 15, 6. Retrieved from https://pubmed.ncbi.nlm.nih.gov/25636495/
  6. Eassa, B.I. & El-Shazly, M.A. (2013, January). Safety and efficacy of tramadol hydrochloride on treatment of premature ejaculation. Asian Journal of Andrology. 15 (1), 138-142. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3739134/
  7. Premature ejaculation: What can I do on my own? (2019, September 12). InformedHealth.org. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK547551/
  8. Chu, A. & Wadhwa, R. (2022, May 8). Selective Serotonin Reuptake Inhibitors. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK554406/
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.

Vicky Davis, FNP

Dr. Vicky Davis is a board-certified Family Nurse Practitioner with over 20 years of experience in clinical practice, leadership and education. 

Dr. Davis' expertise include direct patient care and many years working in clinical research to bring evidence-based care to patients and their families. 

She is a Florida native who obtained her master’s degree from the University of Florida and completed her Doctor of Nursing Practice in 2020 from Chamberlain College of Nursing

She is also an active member of the American Academy of Nurse Practitioners.

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