Managing Side Effects of PE Medications
Oral medications can help men maintain an erection or delay climax. Two main categories used for premature ejaculation are selective serotonin reuptake inhibitors (SSRIs), which are a type of antidepressant, and PDE5 inhibitors, which are typically prescribed for erectile dysfunction. Topical treatments are applied directly to the genitals anywhere from five to 20 minutes before intercourse to reduce sensation and have been shown to delay orgasm in men by three to six minutes.2 However, for some users, topical treatments can cause loss of sexual desire or erectile disruption due to numbness.3 One risk of using topical treatments for PE is that the numbing ingredients can transfer to your partner, reducing sensation for them as well. Using a condom can mitigate the transfer of topical treatment to your partner during sexual contact. Lidocaine cream is a topical PE medication that numbs the application area with local anesthetics.
- Dapoxetine is contraindicated with certain medications and health conditions.
- Topical creams should be used sparingly to prevent partner numbness.
- SSRI treatment may cause emotional blunting or decreased libido.
- Tramadol's risk of dependency requires careful medical supervision.
- Mechanical devices can provide temporary ejaculation delay.
- Behavioral training involves specific sex exercises for control.
- Mindfulness and relaxation techniques benefit PE management.
- Proper diagnosis is essential to rule out underlying disorders.
- Incorporate partner feedback to improve treatment results.
- Avoid abrupt discontinuation of prescribed medication.
- Lifestyle modifications can include weight management.
- Ongoing research aims to develop more effective PE treatments.
When applied to male genitals, desensitization helps prolong an erection and prevent premature ejaculation.
Further reading
A double-blind trial of clomipramine in premature ejaculation. Clomipramine as a treatment for rapid ejaculation: A double-blind crossover trial of fifteen couples. Effective daily treatment with clomipramine in men with premature ejaculation when 25 mg (as required) is ineffective. Maier U, Koinig G. Andrological findings in young patients under long-term antidepressive therapy with clomipramine.
Lidocaine (4%) Cream for PE
Mousavizadeh K, Ghafourifar P, Sadeghi-Nejad H. Calcium channel blocking activity of thioridazine, clomipramine and fluoxetine in isolated rat vas deferens: A relative potency measurement study. Tramadol HCL has promise in on-demand use to treat premature ejaculation. J Sex Med 2008;5:188–93. Safety and efficacy of tramadol in the treatment of premature ejaculation: A double-blind, placebo-controlled, fixed-dose, randomized study.
Sertraline (Zoloft®) for PE
Laumann EO, Nicolosi A, Glasser DB, Paik A, Gingell C, Moreira E, Wang T. Sexual problems among women and men aged 40–80 y: Prevalence and correlates identified in the Global Study of Sexual Attitudes and Behaviors. Efficacy of type-5 phosphodiesterase inhibitors in the drug treatment of premature ejaculation: A systematic review. Ejaculatory abnormalities in mice lacking the gene for endothelial nitric oxide synthase (eNOS-/-). Abdel-Hamid IA ENE, El Gilani A-H. Lidocaine is available via a prescription or over the counter. RedBox Rx offers prescription-strength 4% lidocaine cream in a 15 gm tube for $30.
| Product | Dosage | Quantity + Bonus | Price | |
|---|---|---|---|---|
| Viagra Generic | 25mg | 270 + 8 Pills | 184.26€ 175.49€ | |
| Viagra Generic | 50mg | 270 + 8 Pills | 198.48€ 189.03€ | |
| Kamagra Oral Jelly | 100mg | 90 + 8 Sachets | 303.56€ 289.10€ | |
| Cialis Generic | 10mg | 120 + 6 Pills | 178.49€ 169.99€ | |
| Kamagra Gold | 50 mg | 20 Pills | 73.17€ 69.69€ | |
| Cialis Professional | 20mg | 30 Pills | 104.57€ 99.59€ | |
| Levitra Generic | 40mg | 360 + 10 Pills | 704.99€ 671.42€ | |
| Kamagra | 100mg | 60 + 4 Pills | 201.34€ 191.75€ | |
| Kamagra Oral Jelly | 100mg | 21 Sachets | 95.92€ 91.35€ | |
| Levitra Generic | 40mg | 180 + 10 Pills | 405.06€ 385.77€ | |
| Levitra Generic | 60mg | 360 + 10 Pills | 906.69€ 863.51€ | |
| Cialis Generic | 5mg | 30 + 4 Pills | 53.56€ 51.01€ | |
| Cialis Professional | 20mg | 270 + 6 Pills | 623.07€ 593.40€ |
Benzocaine is a mild anesthetic that is widely available in over-the-counter pain relief products.
Preparing for your appointment
The best PE treatment depends on your symptoms, preferences and any other health concerns. A licensed provider can help you choose the right option for safe and effective results. Premature ejaculation treatments are available in two main types: topical and oral medications. Topical treatments are applied directly to the genitals to reduce sensation and help delay ejaculation. Common options include desensitizing creams or sprays and benzocaine wipes. When used topically on the skin, it can create numbness and desensitizes the area.
- Dapoxetine is effective when taken 1-3 hours before intercourse.
- Topical anesthetics can reduce sensation but risk partner numbness.
- SSRIs may take several weeks to reach full efficacy for PE.
- Tramadol's use for PE is off-label; consult a doctor before use.
- Combining medication with therapy can optimize outcomes.
- Avoiding excessive alcohol and stress can improve sexual performance.
- Pelvic exercises increase muscle strength and ejaculatory control.
- Psychological support can address anxiety-related PE.
- Devices like constriction rings may be used as mechanical aids.
- Open communication with partner improves treatment success.
- Regular follow-up with healthcare provider is recommended.
- Natural remedies lack solid clinical proof but are popular.
Benzocaine wipes4 have been developed specifically for PE as a convenient method to apply anesthetic to the genitals. Its ability to help men with PE last longer during intercourse has shown promise in small studies. Benzocaine wipes for PE are available over the counter. The price for benzocaine wipes varies widely – averaging approximately $2 to $6 per wipe.5 Selective serotonin reuptake inhibitors (SSRIs) are medications generally prescribed for mental health conditions like depression and anxiety.
| Strategy | Description | Expected Outcome | Time Frame | Additional Notes |
|---|---|---|---|---|
| Mindfulness Meditation | Practice focusing on the present moment to reduce anxiety | Reduced performance anxiety | Weeks to months | Complements other treatments |
| Sensate Focus Exercises | Partner-based touching exercises to build comfort | Increased control and intimacy | Several weeks | Requires partner cooperation |
| Cognitive Behavioral Therapy | Therapy addressing thoughts and anxiety related to sex | Better sexual confidence | Several sessions | Often part of a comprehensive plan |
One of the side effects of SSRIs is delayed ejaculation and studies6 show this can help with PE symptoms. Because of this, medical providers often prescribe SSRIs for PE.
Author information
The condition is very common, even if it is not openly discussed, and is easily treatable. Premature ejaculation (PE) treatments include prescription pills, numbing creams and desensitizing wipes. Each works differently to help delay climax. Numbing creams and wipes contain local anesthetics such as lidocaine, which reduce sensation on the skin. Prescription pills – like SRIs (sertraline, paroxetine) and PDE5 inhibitors (sildenafil, tadalafil, vardenafil) – are often also used to treat PE by adjusting serotonin levels in the brain, which can help prolong intimacy. Sertraline (generic Zoloft) is part of the classification of drugs called SSRIs.
Expected duration
Modi NB, Dresser MJ, Simon M, Lin D, Desai D, Gupta S. Single- and multiple-dose pharmacokinetics of dapoxetine hydrochloride, a novel agent for the treatment of premature ejaculation. Pryor JL, Althof SE, Steidle C, Rosen RC, Hellstrom WJ, Shabsigh R, Miloslavsky M, Kell S. Efficacy and tolerability of dapoxetine in treatment of premature ejaculation: An integrated analysis of two double-blind, randomised controlled trials. McMahon CG, Touma K.
Diagnosis Procedure for Identifying Issues with Premature Ejaculation
Treatment of premature ejaculation with paroxetine hydrochloride as needed: 2 single-blind placebo controlled crossover studies. Salonia A, Maga T, Colombo R, Scattoni V, Briganti A, Cestari A, Guazzoni G, Rigatti P, Montorsi F. A prospective study comparing paroxetine alone versus paroxetine plus sildenafil in patients with premature ejaculation. FDA proposes new warnings about suicidal thinking, behavior in young adults who take antidepressant medications. Available at NEW01624.html (accessed March 24, 2008).
Basic questions to ask your doctor
Rosen RC, Casey R, Levine SB, Mudumbi R, Tesfaye F, Hasmonay R. Treatment of premature ejaculation (PE) with dapoxetine (DPX) is not associated with suicidality. Healy D, Whitaker C. Antidepressants and suicide: Risk-benefit conundrums. Girgis SM, El-Haggar S, El-Hermouzy S. It is used for the treatment of a wide range of conditions, including depression, anxiety, OCD, PTSD and PMS.7 Although it’s not known exactly how it works, studies8 have shown that sertraline does work for PE. The retail price for sertraline (without insurance) is around $37 for a one-month supply.9 At Redbox Rx it starts at $25 per month. Paroxetine (generic Paxil) is another SSRI that has shown promising study results for treating PE.10 Although it is difficult to prove, some researchers believe that SSRIs ability to reduce depression and anxiety could be the foundation for treating PE. PE is a condition that can be wholly psychological rather than fully biological.
What Are the Signs and Symptoms of Premature Ejaculation?
Aloosh M, Hassani M, Nikoobakht M. Seminal plasma magnesium and premature ejaculation: A case-control study. Premature ejaculation (PE)1 is the most common type of sexual dysfunction in men. It affects as many as 30% to 40% of all men at some point in their life. It can have a wide range of causes, from hypersensitivity to medical conditions to psychological factors.The critical thing to remember when treating PE is that you are not alone. Paroxetine for PE is available by prescription only and can cost upward of $28 per month without insurance coverage.
How RedBox Rx can help
Assessment of as needed use of pharmacotherapy and the pausesqueeze technique in premature ejaculation. Efficacy of sildenafil citrate in treatment of erectile dysfunction: Impact of associated premature ejaculation and low desire. Goldmeier D, Lamba H. Assessment of as needed use of pharmacotherapy and the pause-squeeze technique in premature ejaculation by Abdel-Hamid et al. Intracavernous medication for treatment of premature ejaculation.
More Information
Chen J, blue sex pills Mabjeesh NJ, Matzkin H, Greenstein A. Efficacy of sildenafil as adjuvant therapy to selective serotonin reuptake inhibitor in alleviating premature ejaculation. A new combination treatment for premature ejaculation: A sex therapist’s perspective. Symonds T, Perelman MA, Althof S, Giuliano F, Martin M, May K, Abraham L, Crossland A, Morris M. Development and validation of a premature ejaculation diagnostic tool.
Behavioral Therapy and Techniques for Reducing Arousal Levels
Azam U. Late-stage clinical development in lower urogenital targets: Sexual dysfunction. Taber MT, Wright RN, Molski TF, Clarke WJ, Brassil PJ, Denhart DJ, Mattson RJ, Lodge NJ. Neurochemical, pharmacokinetic, and behavioral effects of the novel selective serotonin reuptake inhibitor BMS-505130. Pharmacol Biochem Behav 2005;80:521–8. A RedBox Rx paroxetine prescription starts at $25 per month. All RedBox Rx PE prescription medication options are FDA-approved, competitively priced, and customized to your health needs by a licensed U.S. medical professional. PDE5 inhibitors are a classification of medications traditionally prescribed for erectile dysfunction. Additionally, research has shown that PDE5 inhibitors can have positive results when prescribed for premature ejaculation.
Selective Serotonin Reuptake Inhibitors
Relevance of an evidence-based ejaculation time cutoff point for neurobiological research of premature ejaculation. Animal models of premature and retarded ejaculation. Waldinger MD, Schweitzer DH, Olivier B. On-demand SSRI treatment of premature ejaculation: Pharmacodynamic limitations for relevant ejaculation delay and consequent solutions. J Sex Med 2005;2:121–31.
How does Premature Ejaculation Occur?
Peripheral and central neurochemical effects of the selective serotonin reuptake inhibitors (SSRIs) in humans and nonhuman primates: Assessing bioeffect and mechanisms of action. Sprouse J, Braselton J, Reynolds L, Clarke T, Rollema H. Activation of postsynaptic 5-HT(1A) receptors by fluoxetine despite the loss of firingdependent serotonergic input: Electrophysiologicaland neurochemical studies. Sprouse J, Clarke T, Reynolds L, Heym J, Rollema H. Comparison of the effects of sertraline and its metabolite desmethylsertraline on blockade of central 5-HT reuptake in vivo.
How can I prevent premature ejaculation?
Anderson GM, Barr CS, Lindell S, Durham AC, Shifrovich I, Higley JD. Time course of the effects of the serotonin-selective reuptake inhibitor sertraline on central and peripheral serotonin neurochemistry in the rhesus monkey. Waldinger MD, Zwinderman AH, Olivier B. On-demand treatment of premature ejaculation with clomipramine and paroxetine: A randomized, double-blind fixed-dose study with stopwatch assessment. Eur Urol 2004;46:510–5; discussion 516.
