OVA-IVF Kinderwunsch-Klinik Zürich
OVA-IVF Kinderwunsch-Klinik Zürich

Dapoxetine: The On-Demand Treatment Option

Other > premature ejaculation medicine


More recently, concern over the risk of an increased suicide rate in young men upon initiation of SSRIs has dampened enthusiasm.

  • Dapoxetine's side effects can include nausea, headache, and dizziness.
  • Topical anesthetics include lidocaine and prilocaine-based creams or sprays.
  • SSRIs like fluoxetine, sertraline, may also be used off-label for PE.
  • Opioid medications require careful medical oversight due to dependency potential.
  • Behavioral approaches are first-line treatment for many men with PE.
  • Regular exercise can improve overall sexual function and control.
  • Some innovations include vibration devices to delay ejaculation temporarily.
  • Medical tests may be recommended to exclude underlying causes.
  • Education about sexual response stages can improve control strategies.
  • Sex therapy often involves both partners to address relational issues.
  • Medications may take several weeks to show maximum benefit.
  • Lifestyle modifications, like reducing alcohol, can also help manage PE.

Recent experience with the use of Tramadol raises the hope that this might prove to be an agent as effective as SSRIs with less worrisome risk of side-effects.

Frequently asked questions

A retrospective review of peer reviewed publications relevant to the field of premature ejaculation and related medical therapies. Review of safety and efficacy of various medical therapies for premature ejaculation. Selective serotonin release inhibitors have been the most promising agents to date. The on-demand “PRN” use of these agents is more convenient, but its efficacy is less well established. Chronic use of this class of medications has been associated with minor, but bothersome side effects. New trials on novel formulations of topical solutions are currently underway in the United States.

  • Dapoxetine is taken as needed, usually 1-3 hours before sex for rapid action.
  • Topical anesthetics should be used sparingly to avoid numbness of partner.
  • SSRIs may cause side effects like nausea, dizziness, or decreased libido.
  • Tramadol carries potential for abuse and should only be used under medical supervision.
  • Daily use of certain medications may be recommended for persistent PE.
  • Psychological counseling helps address performance anxiety contributing to PE.
  • Pelvic floor exercises improve control and delay ejaculation naturally.
  • Partner involvement in therapy can improve treatment adherence.
  • Discontinuing medication abruptly may cause withdrawal symptoms or rebound.
  • For some men, combining therapy with lifestyle changes yields better results.
  • Over-the-counter remedies should be approached cautiously and discussed with a doctor.
  • Research continues into new pharmacological and non-pharmacological treatments.

Interest in medical therapy for PE is rapidly increasing and reflected in a disproportionate number of publications in this field in the past few years.

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Clinical research in this field is hampered by the complexity, variability among different men and cultures, and subjectivity of PE.

  • 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.

Reliable, appropriately controlled and assessed studies are generally lacking and carefully devised, methodically conducted research is much needed.

The bottom line

Oral ED drugs are part of a class of medications known as phosphodiesterase-5 (PDE-5) inhibitors. Again, the FDA has not approved these meds as PE treatments, though they are FDA-approved to treat erectile dysfunction. In some cases, premature ejaculation is a side effect of erectile dysfunction. When ED is the underlying cause of PE, your doctor will treat the erectile dysfunction first. For many patients, successfully treating ED will also solve the premature sex tablet 100mg ejaculation problem.

Behavioral Therapy and Techniques for Reducing Arousal Levels

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Medication Name Type Typical Dosage Onset Time Duration of Effect Common Side Effects Approval Status Available By Prescription Estimated Cost (USD)
Dapoxetine SSRI 30 mg 1-3 hours 12-24 hours Nausea, dizziness, headache Approved Yes 2-5
Paroxetine SSRI 20 mg/day 1-2 hours 24 hours Fatigue, dry mouth Approved Yes 1-4
Sertraline SSRI 50 mg/day 2-4 hours 24 hours Diarrhea, insomnia Approved Yes 2-4
Topical Anesthetics Local anesthetic Varies Immediate 30-60 minutes Loss of sensation in area Approved Yes 3-7

Premature ejaculation: Current medical treatment and new directions.

Cited sources

BSc (Hons) MBBS MRCGP AFHEA MA (Hons) AFMCP I occasionally experienced premature ejaculation during sex. Not every time, but enough that it became something that was weighing on my mind whenever I got intimate with a girl. My life is so much better now that it seems silly to have wasted so much time not being satisfied. The service is accessible and easily takes away the embarrassment factor. Answer a few simple questions to get the treatment you need.

Symptoms of Premature Ejaculation

Hossein Sadeghi-Nejad, MD, FACS, and Richard Watson, MD, FACS A B S T R A C TIntroduction. Premature ejaculation (PE) is the most common form of male sexual dysfunction. Until very recently, scientific investigation of PE has been hampered by a lack of standardized lovegra tablet definitions and objective, validated questionnaires. Small numbers of randomized controlled studies evaluating various treatment options have also added to the challenges facing the clinicians who manage PE. This article provides a summary of some of the more relevant the peer-reviewed literature pertaining to the medical therapy of premature ejaculation. Interest in premature ejaculation (PE) has been increasing rapidly among all healthcare professionals.

Drug Name Approval Year Primary Use Recommended Dosage Prescription Needed Monitor Required Typical Side Effects
Dapoxetine 2009 Premature ejaculation 30 mg before sex Yes Yes Nausea, dizziness
Paroxetine Approved for other uses, off-label for PE 20 mg/day Yes Yes Yes Fatigue, sexual dysfunction
Sertraline Approved for depression, off-label for PE 50 mg/day Yes Yes Yes Insomnia, digestive issues

A recent Medline search (January 2008) for articles related to PE, from 1949 to the present, uncovered a total of 589 references of which 160 articles (27%) had been published within the past 2 years.

What causes premature ejaculation?

There are 2 main classes of oral premature ejaculation medicine available by prescription: antidepressants, especially SSRIs, and PDE5 inhibitors. Though these oral meds are currently prescribed as a treatment for premature ejaculation, the FDA hasn’t approved any oral medication specifically for PE. As a result, any premature ejaculation pills you’re prescribed are being used off-label. Certain antidepressants have the side effect of delaying orgasm. Since the chemical serotonin can help delay ejaculation, antidepressants that increase serotonin levels in your brain may be used to treat PE.

Therapy and stress reduction

This class of antidepressants is called selective serotonin reuptake inhibitors (SSRIs). Sertraline is a common SSRI that may be prescribed off-label as a PE treatment. Research shows that this med often works well, whether it’s used daily or on an as-needed basis. Take this medication as your doctor prescribes it, either each day or as needed before sexual intercourse. When used daily, this med takes 5-10 days to start working, and it will be 2-3 weeks before you see its full effects. Much of this recent surge in interest has focused on new and promising medical relief for men who are troubled by this vexing condition.

  • Dapoxetine's fast action makes it convenient for on-demand use.
  • Topical anesthetics should be used with caution to avoid partner discomfort.
  • SSRIs are not approved solely for PE but are widely prescribed off-label.
  • Tramadol can interact with other medications, requiring caution.
  • Behavioral techniques teach ejaculation control through practice.
  • Pelvic exercises improve muscular control over ejaculation.
  • Psychological interventions target mental aspects of PE.
  • Combining therapies offers the best chance for success.
  • Regular monitoring helps track side effects and effectiveness.
  • Lifestyle choices, such as diet and exercise, impact sexual health.
  • Open dialogue with healthcare providers ensures safe treatment.
  • Ongoing research explores novel pharmacological options.

This review, while recognizing the critical importance of an integrated approach to the evaluation and management of PE—coordinating participation on the part of urologists, mental health professionals, endocrinologists, primary care physicians, and other interested healthcare professionals—is directed primarily at providing an update on recent developments in the medical treatment of PE.

This article is cited by

Use a PDE5 inhibitor in patients with ED or subclinical ED and PE (LCEE). Consider on-demand use of an SSRI (paroxetine or fluoxetine) for PE refractory to first-line treatments and in the absence of psychiatric contraindications, as confirmed by a psychiatric consultation and psychometry. Consider daily use of clomipramine or an SSRI (paroxetine or fluoxetine) for PE refractory to first line-treatments or to on-demand SSRI use, in the absence of psychiatric contraindications, as confirmed by a psychiatric consultation and psychometry. Prescription of an antidepressant without a careful screening for depression and determination of the endogenous or reactive nature of the depression Use of alpha-1 adrenergic receptor blockers as second-line therapy in men with PE/lower urinary tract symptoms (LUTS) How does treatment for premature ejaculation work? All treatments focus on the same thing: how to delay ejaculation.

Early and Delayed Ejaculation: Psychological Considerations

There are several treatments available that work well for PE, especially when used in combination. They include psychological approaches, behavioral techniques to control ejaculation during sex, condom use, topical anesthetics applied directly to the penis, and oral medications. Many men combine 2 or more of these therapies for the best all-around treatment. For the time being, we’ll focus on the 2 most common types of premature ejaculation pills available by prescription, SSRIs and PDE5 inhibitors. Certain prescription meds that can help delay ejaculation are prescribed off-label as premature ejaculation pills. The definition of PE is still evolving, but the classic triad involved in the definition includes (i) short intravaginal ejaculatory latency time (IELT), (ii) lack of control, and (iii) sexual dissatisfaction [1].

What are Premature Ejaculation Pills?

Treatments for premature ejaculation can take as little as 10 seconds to start working, and usually last long enough for satisfying sex. Premature ejaculation is a common sexual dysfunction where an individual ejaculates earlier than they’d like during sexual activity. It can cause distress and frustration and can occur for a variety of reasons. Psychological contributors may include anxiety, stress, or relationship issues, while physical factors can range from hormonal imbalances to certain neurological conditions. There are simple ways to treat premature ejaculation and medical intervention can provide individuals with tailored strategies that help solve the issue.

Lifestyle changes

Treatment for premature ejaculation often involves a combination of techniques. Behavioural strategies like the stop-start or squeeze techniques can be helpful. Medications such as selective serotonin reuptake inhibitors (SSRIs) or topical anaesthetics may be prescribed. Counselling or therapy can also be beneficial when psychological factors are involved. Specialists in medicine, nutrition, performance, and diagnostics. The World Health Organization (WHO) 1994 International Classification of Diseases defines PE as “an inability to delay ejaculation sufficiently to enjoy lovemaking, manifest as either of the following: occurrence of ejaculation before or very soon after the beginning of intercourse (if a time limit is required: before or within 15 seconds of the beginning of intercourse); occurrence of ejaculation in the absence of sufficient erection to make intercourse possible. The problem is not the result of prolonged absence from sexual activity” [1].

Further information

All content on this page has been medically reviewed by: Hassan Thwaini, Clinical Pharmacist and Copywriter, Master of Pharmacy (MPharm) on 30 March, 2026. 4.6* from over 33,000 people like you. You’ll be assessed by our UK-based clinicians via a simple online consultation. Your medication will be delivered swiftly in unmarked packaging. Repeat prescriptions keep you topped up, and you can switch any time if you wish to try alternative treatments.

Paroxetine (Paxil, Pexeva)

We’re with you throughout your journey. You can access your medical team whenever you need to, via phone and email. How we make it possible for you to have longer-lasting sex. Innovative methods of delaying ejaculation enable longer-lasting sex without compromising on pleasure. Some treatments delay premature ejaculation by boosting serotonin levels in the body, and others work by gently reducing sensitivity in the penis. Furthermore, the WHO definition excludes men whose PE is predominately attributed to (i) alcohol, substance abuse, and/or medications; (ii) a sexual context that has led to very high levels of arousal because of the novelty of partner or situation; and (iii) a low frequency of sexual activity [1]. Others have based their diagnosis on the number of penile thrusts occurring before ejaculation, considering less than 8–15 thrusts as the criterion for PE [2,3].

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