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Premature ejaculation (PE) is one of the most common forms of sexual dysfunction, with up to 39 percent of men affected at some point in life.
If you have premature ejaculation, you may find it difficult to control your ability to reach orgasm and ejaculate during sex. You may also find that this causes or contributes to other sex-related issues, such as sexual performance anxiety.
Premature ejaculation can be a tough problem to deal with, and it can potentially take a serious toll on your level of interest in sex. However, it can often be treated using medication, including selective serotonin reuptake inhibitors (SSRIs) and drugs for erectile dysfunction (ED).
One such potential treatment is sildenafil, the active ingredient in Viagra®. Although there aren’t yet any large-scale studies that conclusively show that sildenafil treats PE, some research does suggest that sildenafil may offer benefits for slowing down orgasm and ejaculation.
Below, we’ve explained how and why premature ejaculation occurs, as well as what sildenafil is as a medication.
We’ve also discussed the existing research on sildenafil and certain aspects of sexual function, including the amount of time that passes before orgasm and ejaculation.
Finally, we’ve shared other treatment options that you might want to consider if you’re prone to PE and want to increase your time to ejaculation, improve your overall sexual performance and enjoy more satisfying sex.
Before we get into the specific details of sildenafil and premature ejaculation, we need to quickly go over what premature ejaculation actually is.
Premature ejaculation is ejaculation that occurs within one minute of vaginal penetration, before you wish it, during all or almost all sexual activity. It’s sometimes called “rapid ejaculation,” as it can often occur with little or no warning after you penetrate your partner.
It’s common and normal to occasionally reach orgasm and ejaculate faster than you’d like when you have sex, and doing so isn’t necessarily an indicator that you have premature ejaculation.
To be diagnosed with premature ejaculation, you’ll usually need to have symptoms that last for a period of at least six months, cause you some degree of clinical distress and aren’t caused by a non-sexual factor, such as a mental health disorder or the use of medication.
Like many other forms of male sexual dysfunction, premature ejaculation can vary significantly in severity.
If you have mild PE, you may be able to have sex for one minute before you reach orgasm and ejaculate. If you have severe PE, you may find it difficult to avoid ejaculation at any time during sexual activity, even before penetration.
PE can be lifelong (meaning it has happened since your first sexual experience) or acquired. It can also happen generally (meaning you experience PE in all sexual activity), or only affect you during certain types of sexual activity or with specific partners.
Our guide to premature ejaculation goes into more detail about what PE is, the factors that can cause it, common symptoms and more.
So, what exactly is sildenafil? Sildenafil is the active ingredient in Viagra, a popular medication for treating erectile dysfunction. It belongs to a class of drugs called PDE5 inhibitors and works by increasing blood flow to your penis, making it easier for you to get an erection.
More specifically, sildenafil inhibits the effects of an enzyme called phosphodiesterase-5, which is involved in controlling the diameter of the blood vessels that supply your penis.
Erections are all about blood flow. When you’re aroused, blood flows into the tissue inside your penis, causing it to become larger and firmer. Drugs like sildenafil increase the ability of blood to flow into your penis, which can help you to get and stay hard.
Sildenafil is one of several PDE5 inhibitors used to treat erectile dysfunction. Other medications for erectile dysfunction include tadalafil (Cialis®), vardenafil (Levitra®) and avanafil (available as Stendra®).
Contrary to popular belief, medications like sildenafil don’t cause random erections or make you more interested in sex -- instead, you’ll only get erections when you feel sexually aroused, such as during sexual encounters.
Sildenafil was originally developed as a medication for certain heart conditions, such as angina (a form of chest pain caused by reduced blood flow to the heart). However, it’s best known as an erectile dysfunction medication due to its widespread use in Viagra.
Because sildenafil is approved by the FDA as a treatment for erectile dysfunction, almost all of the scientific research on its effects focuses on its use for improving erections.
However, over the decades, researchers have looked into several other potential uses for drugs like sildenafil, including answering one question: Does Viagra help premature ejaculation?
As such, there are a few studies that look at the potential effects of sildenafil as a treatment for premature ejaculation.
In one study published in the International Journal of Urology in 2007, 180 men with premature ejaculation were divided into three groups.
The first group (Group A) was treated with 50mg of sildenafil, while people in Group B received a 20mg daily dose of paroxetine (commonly sold as Paxil®), an SSRI that’s often used off-label to treat PE.
People in the third group (Group C) were not given any medication, but were instructed to apply the squeeze technique (a technique that involves squeezing the penis before orgasm) to reduce sensitivity during sex.
The researchers followed up with study participants after six months. Men in Group A (the group given sildenafil) experienced improvements in intravaginal ejaculatory latency time (IELT, or time to ejaculation after penetration), sexual satisfaction and the general severity of their PE.
Members of the sildenafil group also reported having sex more often, suggesting that sildenafil’s effects on erections and sexual stamina may also increase general sexual confidence.
The study concluded that sildenafil is “very effective and safe to treat PE” and noted that it had a higher degree of efficacy than paroxetine and the squeeze technique.
In an older clinical trial published in the Journal of Sexual Medicine in 2005, researchers looked at the effects of sildenafil as a treatment option for men diagnosed with premature ejaculation.
For this study, men between the ages of 18 and 65 with diagnosed premature ejaculation were given sildenafil in a placebo-controlled, double-blind environment. The men who used sildenafil were instructed to take the medication over the course of eight weeks.
After the trial period, men in the sildenafil group experienced an increase in IELT (intervaginal ejaculation latency time) and an improvement in VTS-ELT (vibrotactile stimulation ejaculatory latency time) compared to the placebo group.
However, while these scores increased, the improvements in ejaculation latency time weren’t statistically significant.
Men in the sildenafil group also reported significant increases in their level of control regarding ejaculation ejaculatory control, confidence about ejaculation and sexual satisfaction. They also had a shorter refractory period — the time required to recover sexually after ejaculating.
Overall, the study concluded that sildenafil “increased confidence, the perception of ejaculatory control and overall sexual satisfaction” compared to the placebo treatment, although it did note that the increase in ejaculation latency time caused by sildenafil wasn’t significant.
In other words, the “little blue pill” appears to provide real benefits to men affected by premature ejaculation, although the actual increase in time to ejaculation isn’t always significant and varies from study to study.
Several other studies have also looked into the effects of sildenafil for men with PE, including as adjuvant therapy (a medication given in addition to another form of treatment).
In one study published in the journal Urology, researchers found that sildenafil worked well when it was taken in combination with the SSRI paroxetine and forms of psychological and behavioral therapy, including in men with PE who failed to respond to other treatments.
A more recent study from 2019 found that men with a combination of premature ejaculation and erectile dysfunction responded well to treatment with sildenafil and dapoxetine, a new drug that is currently in development as a PE medication.
Currently, healthcare professionals aren’t aware of how or why medications for ED like sildenafil increase the time required for men with premature ejaculation to reach orgasm and ejaculate.
One common theory regarding sildenafil’s effects on premature ejaculation is that it could inhibit neurotransmission in your urogenital system.
Experts also believe that sildenafil and other PDE5 inhibitors may dilate the smooth muscle near the vas deferens and seminal vesicles, which are responsible for transporting semen and sperm into the penis during orgasm and ejaculation.
Finally, some of the effects of sildenafil may simply be the result of a confidence boost, as many medications for ED are linked to reduced levels of sexual performance anxiety.
Sildenafil is a safe and effective medication for most men. However, it can potentially cause side effects. It may also cause drug interactions when used with certain medications, including drugs for common medical conditions such as hypertension (high blood pressure).
Common side effects of sildenafil include:
Headache
Flushing
Dyspepsia (indigestion)
Changes in vision (blurred vision or changes in color vision)
Nasal congestion
Back pain
Myalgia (muscle pain)
Nausea
Dizziness
Skin rash
Most of the time, sildenafil only causes mild side effects. It’s important to talk to your healthcare provider if you develop side effects from sildenafil that are severe, or adverse effects that persist after sildenafil stops working.
Sildenafil and other PDE5 inhibitors can interact with some other medications, including nitrates and alpha-blockers used to treat hypertension. Recreational drugs that contain nitrates, such as poppers, can also interact with sildenafil.
When used with sildenafil, these substances can produce a sudden, dangerous decline in blood pressure that may cause you to feel dizzy, faint or suffer a severe cardiovascular event.
To keep yourself safe, it’s important to inform your healthcare provider about all medications you currently use or have recently used before starting treatment with sildenafil.
It’s also important to inform your healthcare provider if you have a medical history that involves any cardiovascular issues, such as a heart attack, heart failure or heart surgery.
Our guide to Viagra side effects goes into more detail about the potential side effects and drug interactions that can occur with Viagra or generic sildenafil.
In addition to ED medications such as sildenafil, there are numerous other effective treatments available for premature ejaculation.
These include topical creams and sprays that lower sensitivity and make controlling ejaculation easier, as well as prescription medications such as antidepressants.
If you have mild or moderate premature ejaculation, you may be able to slow down ejaculation and gain more control over your orgasms by using a topical treatment that lowers sensitivity in your penis.
For example, our Clockstopper Climax Delay Wipes and Delay Spray for Men are made using the topical anesthetics benzocaine and lidocaine to control sensitivity without reducing sexual pleasure.
Although the FDA has yet to approve any specific premature ejaculation pills, a range of existing medications are prescribed off-label to treat PE, including the SSRIs sertraline (the generic form of Zoloft®) and paroxetine (Paxil®).
These medications, which require a prescription, can help to increase ejaculation time and give you more control over your orgasms during sexual activity.
We offer sertraline and paroxetine for premature ejaculation online, following a consultation with a healthcare provider who will determine if a prescription is appropriate.
In addition to using medication, performing certain exercises and techniques -- or simply making a few changes to your habits and daily lifestyle -- may help to improve your sexual performance and reduce the severity of PE. These include:
Performing pelvic floor exercises to strengthen the muscles that control ejaculation
Using approaches like the squeeze technique to delay ejaculation during sex
Masturbating before you have sex to take advantage of your refractory time
Switching to a thicker condom that reduces sensitivity when you have sex
Distracting yourself or using relaxation techniques to avoid reaching orgasm
Our guide to stopping premature ejaculation goes into more detail about these tactics and how you can use them to improve your stamina and sexual function.
While there isn’t a wealth of scientific research into sildenafil as a treatment for PE, the studies that are currently available show promising results.
Sildenafil increases intervaginal ejaculation latency time and sexual satisfaction, meaning it can potentially help you last longer in bed and enjoy sex more. It also appears to offer a confidence boost in bed, which may help if you’re prone to sexual performance anxiety.
However, it’s also worth noting that much more research needs to be done before anything can be said definitively.
We offer sildenafil online as part of our range of medications for erectile dysfunction, following a consultation with a physician who will determine if a prescription is appropriate.
We also offer a range of evidence-based treatments for premature ejaculation, including sprays, wipes and oral medications that you can use as needed to improve your sexual stamina.
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