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Premature Ejaculation is a common disorder affecting men where one ejaculates 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. Rapid ejaculation may not be a problem if it occurs infrequently, but may seriously affect intimacy in relationships if both the partners are not satisfied. Fortunately, there are many treatment options available in the market now to choose from, even if your PE is diagnosed as lifelong or severe.

Why Does It Happen?

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.

Psychological Factors:

Psychological Factor
  • Anxiety and/or Depression 
  • Body image issues
  • Feelings of guilt, worry, and nervousness 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?

Treatment for Premature ejaculation

The most effective treatment according to the experts is the combination of medications and behavioral therapy. Other treatment options include counseling. 

Behavioral Therapy

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: Here 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 that are used for voluntarily halting the flow of urine. 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.[4]
  • Masturbating Before Sex: Some people admit that masturbating 1-2 hours before involving 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 

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 

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:

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 the physicians to delay the ejaculation time – Sertraline, Dapoxetine, 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.[1]
    • 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 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 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.[2
  • These drugs work by increasing the flow of blood to the penis, which makes you secure a firm erection that stays for 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).
  • Side Effects: dizziness, reduced appetite, panic attacks, paranoia, anxiety, confusion, hallucinations.

Combination of SSRIs and PDE-5 Inhibitors 

These drugs offer the best treatment by combining the effects of firm erection with controlled ejaculation time. 

  • Tadapox 20 mg has 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 for 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.[3
  • 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, 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 moderately improve the ejaculation time in men diagnosed with PE.[9]
  • Silodosin
    • The treatment drug for prostate cancer showed improvement in IELT as per a study.[10]

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.

  1. 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.[5]
    1. The Ayurvedic herbal medications have been around since forever, to tackle almost every type of condition. Medicines with yauvanamrit vati, kamini vidrawan ras, are believed to be effective when taken twice a day.
    2. Chinese herbal pills such as Qilin pills or Yimusake tablets boost stamina and energy resulting in increased time for ejaculation. 
    3. 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.[6,7]

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.

  1. Topical Cream: These over-the-counter treatment options provide an on-demand solution, and contain a chemical that has a numbing effect on 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.
    1. These topical products can cause temporary loss of sensitivity, burning sensation, and mild pain. Regular use may lead to a decrease in libido. 
    2. Some women also complain of decreased sensation when it is administered and not washed off properly before the actual activity.
  1. Zinc & Magnesium Supplements: Zinc & Magnesium are an important part of your diet that offer various benefits including an increase of testosterone levels that enhance your energy and sexual drive. Taking the required dose of the minerals daily has shown to improve testosterone levels in the body and help with premature ejaculation.[8]
    1. However, increased levels of zinc may lead to vomiting, diarrhea, nausea, damage to the kidney & stomach.

The Internet is filled with a myriad of herbal as well as topical cures which claim to fix your problem. Although it may seem tempting to try something convenient to order, you should be aware that usually the herbal supplements are not regulated by any authorities, thus, increasing the chances of you getting scammed. 

Do PE Pills Work?

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.

Final Verdict 

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 the 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. But 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 that may result in serious health effects. 

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