Premature Ejaculation is a common disorder affecting men where one ejaculate within a minute of penetration or, in severe cases, even before penetration. Nearly 1 in 3 men admit to having encountered it at some point in their life.[1] Rapid ejaculation may not be a problem if it occurs infrequently but may seriously affect intimacy in relationships if both partners are not satisfied. Fortunately, many treatment options are available in the market now. Even if your PE is diagnosed as lifelong or severe, take control of your sexual health with the best Premature Ejaculation pills.
Table of Contents
Why Does It Happen?
Although it is usually believed to be the result of psychological factors, some physical factors may also play a role in it.[1]
Psychological Factors:
Anxiety and/or Depression
Body image issues
Feelings of guilt, worry, and nervousness are associated with pressure to perform.
Turbulent relationship
Any abusive memory or experience associated with sex
In cases of Erectile Dysfunction, men climax early due to anxiousness about maintaining an erection
Biological Factors:
Prostrate or urethral infection and/or inflammation
Genetically inherited
Hormonal Imbalance
Decreased serotonin levels.
What Are The Treatment Options?
The most effective treatment, according to the experts, is the combination of medications and behavioral therapy. Other treatment options include counseling.
Behavioral Therapy
This therapy makes use of certain exercises to develop endurance to prolong internal ejaculatory latency time (IELT), such as
The Stop-Start Method: You, or your partner, stimulate the penis and stop just before ejaculation. You get time to take hold of your senses and start again. This method needs to be repeated 3-4 times for your tolerance to develop.
The Squeeze Method: In this method, you or your partner should stimulate the penis and stop just before you sense ejaculation. Then squeeze the penis firmly to make the erection go away. Repeat it thrice before climaxing to last longer.
Kegel Exercises: For this, you need to clench the muscles used for voluntarily halting the urine flow. Hold this position for up to 5 seconds, and repeat the steps 10 times. This exercise strengthens the muscles and prolongs the ejaculation period in people suffering from PE, as per the findings of one study.[2]
Masturbating Before Sex: Some people admit that masturbating 1-2 hours before being involved in a sexual activity helps you to delay the ejaculatory reflex.
Using Condoms: Condoms desensitize the penis for some time, thus increasing the time it takes to reach orgasm.
Counseling
In this method, you take on the challenge by taking care of your psychological needs. It usually works better in combination with drug treatment. Communication is the basis of any strong relationship. Articulating how this problem is affecting you, your mental status, and your partner and his/her mental status eases the associated anxiety.
Medications
From over-the-counter herbal treatment options to prescription medications, there are different options for you to choose from to help you last longer in bed.
Prescription Medications:
Currently, there is no drug specifically designed to treat PE. Many medications are prescribed for ‘off-label’ use as treatment. A medication may delay an orgasm due to the multiple physiological effects the drugs usually have, resulting in side effects. The usual medications that are prescribed are antidepressants such as Selective Serotonin Reuptake Inhibitors (SSRIs), erectile dysfunction medications such as PDE5 inhibitors, and certain anxiolytics.
Selective Serotonin Reuptake Inhibitors (SSRIs)
This drug was designed for the treatment of depression.
It works by boosting the duration of the active state of serotonin, a neurotransmitter responsible for stabilizing the mood, thus assuaging depression.
However, this drug has a side effect – prolongation of the time needed to attain orgasm.
Many drugs belonging to this category are prescribed by physicians to delay ejaculation time – Sertraline, Dapoxetine, and Escitalopram.
Sertraline: A study conducted in 1998 showed promising improvement in men with premature ejaculation with daily administration. However, with increased dosages, some men reported an inability to climax at all.[3]
Side Effects: insomnia, anxiety, restlessness, and diarrhea.
Dapoxetine: This drug, licensed for the occasional treatment of PE, became a perfect choice because it starts working quickly and leaves the system quickly as well. The effects of an orally administered dose of Dapoxetine 30 mg may last 3-4 hours. Similarly, Poxet 60 mg may start working in 1-2 hours, and the effects may last up to 4 hours.
Side Effects: dryness of mouth, dizziness, nausea, diarrhea, headaches, insomnia.
Escitalopram: Even though this drug has been proven effective by some studies, it takes time to show its effects, making it a routine medication.
Side Effects: reduced libido, withdrawal symptoms, anorgasmia.
You are required to take these medications 1-2 hours before you plan on getting intimate.
Phosphodiesterase-5 Inhibitors
The drugs belonging to this class are authorized for the treatment of erectile dysfunction. However, they are also known to lengthen the time taken to achieve orgasm.[4]
These drugs work by increasing the flow of blood to the penis, which makes you secure a firm erection that stays for a long.
The drugs belonging to this category are Sildenafil (the active ingredient in Viagra), Tadalafil (the active ingredient in Cialis), and Vardenafil (the active ingredient in Levitra).
These drugs offer the best treatment by combining the effects of a firm erection with controlled ejaculation time.
Tadapox 20 mg is a combination of two medications – Tadalafil and Dapoxetine. The effects of this medication can stay for up to 36 hours and significantly prolong the ejaculation time.
Super P Force is another such combination that has Dapoxetine and Sildenafil Citrate as its active ingredients. It starts working within an hour of administration, and the effects last 4-5 hours.
In short, you can stay hard longer with these pills and extend your ejaculation time.
Analgesics
The pain medications such as Tramadol are formulated for the treatment of pain but have a side effect whereby the ejaculation time gets delayed.
Studies support the safety and efficacy of its use in the treatment of PE. However, the exact mode of action is not yet fully comprehended.[5]
It is usually prescribed when SSRIs fail to exhibit any improvement.
Other Drugs With Potential For Treatment
These drugs have been recently studied for their role in the treatment of PE, and even though the results were on the positive side, more intensive research is required to establish their effectiveness in the long run.
Modafinil
This medication is used in the treatment of narcolepsy. However, a study shows it to improve the ejaculation time in men diagnosed with PE moderately.[6]
Silodosin
The treatment drug for prostate cancer showed improvement in IELT as per a study.[7]
Over The Counter Medications
There are considerable options available for you to try. From over-the-counter premature ejaculation pills to topical application products, there are considerable options accessible to anyone who knows where to look for them.
Herbal Pills: These delayed ejaculation supplements are easy to find and may offer many other benefits as well. A study shows that herbal medications with roots in Ayurveda and Chinese herbs may significantly help in extending the ejaculation time in those who suffer from PE, however, more research is required for stronger evidence.[8]
Ayurvedic herbal medications have been around forever to tackle almost every type of condition. Medicines with Yauvanamrit Vati, and Kamini Vidrawan Ras, are believed to be effective when taken twice a day.
Chinese herbal pills such as Qilin pills or Yimusake tablets boost stamina and energy, resulting in increased time for ejaculation.
St. John’s Wort: It is used as an ingredient in many supplements that are available as longer-duration sex pills. Studies show promising results in the treatment of PE.[9][10]
The herbal supplements, however, are also known to cause certain side effects such as dizziness, mild pain, and stomachache. Their overuse may also result in a decrease in sexual drive.
Topical Cream: These over-the-counter treatment options provide an on-demand solution and contain a chemical that numbs the penis. This means decreased sensation and delayed orgasm. For effective results, the cream needs to be applied at least 15 minutes prior to the activity and washed off before the actual use.
These topical products can cause temporary loss of sensitivity, burning sensation, and mild pain. Regular use may lead to a decrease in libido.
Some women also complain of decreased sensation when it is administered and not washed off properly before the actual activity.
Zinc & Magnesium Supplements: Zinc and magnesium are an important part of your diet that offer various benefits, including an increase in testosterone levels that enhance your energy and sexual drive. Taking the required dose of the minerals daily has been shown to improve testosterone levels in the body and help with premature ejaculation. However, increased levels of zinc may lead to vomiting, diarrhea, nausea, and damage to the kidneys & stomach.
The Internet is filled with a myriad of herbal as well as topical cures that claim to fix your problem. Although it may seem tempting to try something convenient to order, you should be aware that usually, herbal supplements are not regulated by any authorities, thus, increasing the chances of you getting scammed.
Do PE Pills Work?
While some pills have substantial amounts of scientific data supporting their effectiveness, others still require more comprehensive research to understand their scope in the treatment of PE. However, favorable results don’t imply an elixir that may fix the condition overnight. You need to take medications diligently to maintain the positive effects. Plus, the action of any medication, whether it is synthetic drugs or herbal supplements, depends on the biochemistry of the body. Therefore, how a PE pill affects you will vary from another person. For some people, they work perfectly, while some need to try different types of PE treatment pills to find the one that suits them the best.
The Final Thought
Premature Ejaculation is a common issue affecting men that may seriously strain relationships and mental health. Fortunately, plenty of over-the-counter treatment options are available, along with prescription medications. Usually, SSRIs or PDE5 inhibitors are advised by doctors for treating PE-related symptoms. Deciding which one would be best depends on the biochemistry of the user. The various pre-existing conditions also act as a contributing factor to finding a suitable medication for you. Consult with your physician to discuss the option you can try by evaluating your health conditions.
Frequently Asked Questions
Q. Are there any PE pills that do not have side effects?
Unfortunately, no. Every drug that you consume will have some effect on other physiological functions as the medications pass through different organs in the body.
Q. Do I need to consult a doctor for OTC medications?
No, you don’t. However, it is recommended to consult a doctor as even herbal supplements are known to interact with many medications to cause adverse effects.
Q. Can I take herbal supplements along with prescribed medication for premature ejaculation?
It is not recommended to mix medications unless advised by a doctor. Herbal ingredients are known to interact with prescription medications, which may result in serious health effects.
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McMahon CG. Treatment of premature ejaculation with sertraline hydrochloride. Int J Impot Res. 1998 Sep;10(3):181-4; discussion 185. doi: 10.1038/sj.ijir.3900344. PMID: 9788108. https://pubmed.ncbi.nlm.nih.gov/9788108/
Wang, W.-F. et al. (2007) “Can sildenafil treat primary premature ejaculation? A prospective clinical study,” International Journal of Urology, 14(4), pp. 331–335.
Eassa BI, El-Shazly MA. Safety and efficacy of tramadol hydrochloride on treatment of premature ejaculation. Asian J Androl. 2013 Jan;15(1):138-42. doi: 10.1038/aja.2012.96. Epub 2012 Oct 29. PMID: 23103596; PMCID: PMC3739134.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3739134/
Tuken, M., Kiremit, M.C. and Serefoglu, E.C. (2016) “On-demand modafinil improves ejaculation time and patient-reported outcomes in men with lifelong premature ejaculation,” Urology, 94, pp. 139–142. https://doi.org/10.1016/j.urology.2016.04.036.
Sato, Y. et al. (2017) “Silodosin versus Naftopidil in the treatment of premature ejaculation: A prospective multicenter trial,” International Journal of Urology, 24(8), pp. 626–631.
Cooper, K. et al. (2016) “Complementary and alternative medicine for the management of premature ejaculation: A systematic review,” Sexual Medicine, 5(1). https://doi.org/10.1016/j.esxm.2016.08.002.
Capasso R, Borrelli F, Montanaro V, Altieri V, Capasso F, Izzo AA. Effects of the antidepressant St. John’s wort (Hypericum perforatum) on rat and human vas deferens contractility. J Urol. 2005 Jun;173(6):2194-7. doi: 10.1097/01.ju.0000158132.31157.01. PMID: 15879886. https://pubmed.ncbi.nlm.nih.gov/15879886/
Asgari, S.A. et al. (2010) “Safety and efficacy of the herbal drug Hypericum perforatum for the treatment of premature ejaculation,” UroToday International Journal, 03(03).
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