Premature Ejaculation Treatment Selector
Select your key criteria to find the most suitable treatment option for premature ejaculation:
Recommended Treatment:
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Treatment Details:
FDA-approved Dapoxetine
On-demand SSRI for premature ejaculation. Takes 1–2 hours to work. Dose: 30–60 mg. Side effects: Nausea, dizziness.
- Fast-acting
- Intended for on-demand use
- Short half-life (~1.5 hours)
Lidocaine Spray
Topical anesthetic. Works within 5–30 minutes. Apply to glans 5–10 minutes before. Side effects: Partner numbness.
- Cheap and over-the-counter
- Immediate effect
- Requires partner cooperation
Sertraline (Off-label)
Daily SSRI. Takes 2–4 weeks to see benefits. Dose: 50–100 mg daily. Side effects: Sexual dysfunction, GI upset.
- Effective for long-term management
- Requires daily compliance
- May affect libido
Paroxetine (Off-label)
Strongest IELT booster among SSRIs. Dose: 20–40 mg daily. Side effects: Weight gain, fatigue.
- High efficacy
- Higher risk of sexual side effects
- Requires daily use
Quick Takeaways
- Dapoxetine is the only FDA‑approved oral drug specifically for premature ejaculation (PE).
- Off‑label SSRIs such as sertraline and paroxetine work but need daily dosing.
- Topical anesthetics act fast but can numb the partner.
- Behavioral therapy tackles the psychological side without meds.
- Choose based on your timing needs, side‑effect tolerance, and whether you want on‑demand or daily use.
What is dapoxetine?
Dapoxetine is a short‑acting selective serotonin reuptake inhibitor (SSRI) licensed in many countries to treat PE. It’s taken 1-2hours before sexual activity, peaks in the bloodstream after about 1hour, and clears out within 5‑6hours, which makes it a true “on‑demand” option.
Key attributes:
- Usual dose: 30mg or 60mg per use.
- Time to effect: 1-2hours.
- Half‑life: ~1.5hours.
- Approved in: EU, Canada, Australia (not FDA‑approved yet).
How does Dapoxetine work?
It boosts serotonin levels in the synaptic cleft, which delays the ejaculatory reflex. Because it’s short‑acting, the serotonin surge only lasts long enough to cover one sexual encounter, unlike typical antidepressant SSRIs that stay in the system for weeks.
Common Alternatives to Dapoxetine
Below are the most frequently mentioned PE options. Each is introduced with microdata so search engines can pick them up.
Sertraline (off‑label)
Sertraline is a standard antidepressant SSRI. Doctors sometimes prescribe it off‑label for PE because it lengthens intravaginal ejaculatory latency time (IELT). The catch? You need to take it daily, and it can take 2-4 weeks to see a benefit.
Paroxetine (off‑label)
Another SSRI, paroxetine, has the strongest IELT‑boosting data among antidepressants, but it also carries a higher risk of sexual side effects (reduced libido, anorgasmia). Like sertraline, it requires daily dosing.
Lidocaine spray
Topical anesthetics such as lidocaine or benzocaine sprays desensitize the penis for 30‑60minutes. They’re cheap, work on demand, and don’t need a prescription. The downside is potential numbness for the partner and occasional allergic reactions.
Clomipramine
Clomipramine is a tricyclic antidepressant with strong serotonin‑reuptake inhibition. It’s effective for PE but, like other daily SSRIs, requires a prescription and has a broader side‑effect profile (dry mouth, constipation, weight gain).
Sildenafil (Viagra)
Although primarily for erectile dysfunction, sildenafil can improve ejaculatory control indirectly by reducing performance anxiety. It’s an on‑demand pill taken 30‑60minutes before sex. It doesn’t directly affect serotonin pathways, so its benefit for PE is modest.
Psychosexual counseling
Therapies like the “stop‑start” or “squeeze” techniques, delivered by a certified sex therapist, address the psychological component of PE. No medication, no side effects, but it demands time, effort, and often several sessions.
Tramadol
Tramadol is an opioid analgesic that also delays ejaculation by acting on the central nervous system. It’s sometimes prescribed off‑label for PE, but the risk of dependence and regulatory restrictions make it a last‑resort option.
Side‑by‑Side Comparison
| Treatment | Type | On‑demand? | Typical Dose | Time to Effect | Main Side Effects | Prescription Needed? |
|---|---|---|---|---|---|---|
| Dapoxetine | Short‑acting SSRI | Yes | 30‑60mg | 1‑2hr | Nausea, dizziness, insomnia | Yes (specialist) |
| Sertraline | SSRI (off‑label) | No | 50‑100mg daily | 2‑4weeks | Sexual dysfunction, GI upset | Yes |
| Paroxetine | SSRI (off‑label) | No | 20‑40mg daily | 2‑4weeks | Weight gain, fatigue | Yes |
| Lidocaine spray | Topical anesthetic | Yes | 2‑4 sprays, 5‑10min before | 5‑30min | Partner numbness, rare allergy | No |
| Clomipramine | Tricyclic antidepressant | No | 25‑50mg daily | 1‑2weeks | Dry mouth, constipation | Yes |
| Sildenafil | PDE5 inhibitor | Yes | 25‑100mg | 30‑60min | Headache, flushing | Yes |
| Psychosexual counseling | Therapeutic technique | Yes (in sessions) | Varies (weekly) | Immediate (technique practice) | None (time commitment) | No |
| Tramadol | Opioid analgesic | Yes (off‑label) | 50‑100mg | 30‑60min | Dependence, constipation | Yes (controlled) |
Deciding Which Option Fits You
- Do you need on‑demand control? If you only want a pill a couple of times a month, dapoxetine or lidocaine spray are the clear winners.
- Can you tolerate daily medication? If you’re comfortable taking a pill every day and want consistent latency improvement, sertraline, paroxetine, or clomipramine make sense.
- Are you worried about partner sensation? Topical anesthetics can numb your partner; you might prefer an oral option or counseling.
- Do you have any heart or liver issues? PDE5 inhibitors (sildenafil) require caution with cardiovascular meds, while SSRIs need liver function monitoring.
- Is dependence a concern? Opioid‑based tramadol carries a high dependence risk - reserve it for cases where other treatments failed.
In practice, many clinicians start with an on‑demand oral (dapoxetine) because it’s easy to test and stop. If it doesn’t meet your latency targets or side‑effects are intolerable, they move to daily SSRIs or add a topical spray.
Safety Tips & Common Pitfalls
- Never combine two serotonergic agents (e.g., dapoxetine with sertraline) - risk of serotonin syndrome.
- Take dapoxetine with a light snack; a heavy or high‑fat meal can delay absorption.
- For lidocaine spray, apply to the glans, wait the recommended 5‑10minutes, and wipe excess to avoid partner numbness.
- Monitor mood changes when using SSRIs daily; some men report increased anxiety at the start.
- If you’re on blood thinners, discuss sildenafil with your doctor because of rare bleeding risks.
How to Get the Most Out of Dapoxetine
- Start with the 30mg dose. If latency improves but side‑effects are mild, consider the 60mg version.
- Time the dose 1‑2hours before intercourse; you’ll notice peak effect at about the 90‑minute mark.
- Avoid alcohol or strong sedatives on the same night - they can amplify dizziness.
- Combine with psychological techniques (e.g., pause‑squeeze) for a synergistic boost.
- Keep a simple diary: date, dose, effect, any side‑effects. Bring it to your next appointment.
Frequently Asked Questions
Is dapoxetine safe for long‑term use?
Clinical trials up to 12months show dapoxetine is well‑tolerated. Because it’s taken intermittently, cumulative toxicity is low. Still, anyone with liver disease or taking other serotonergic drugs should stay under medical supervision.
Clinical trials up to 12months show dapoxetine is well‑tolerated. Because it’s taken intermittently, cumulative toxicity is low. Still, anyone with liver disease or taking other serotonergic drugs should stay under medical supervision.
Can I use dapoxetine with alcohol?
Mixing alcohol with dapoxetine isn’t forbidden, but alcohol can increase dizziness and nausea. Most doctors advise limiting intake on the night you plan to use the drug.
Mixing alcohol with dapoxetine isn’t forbidden, but alcohol can increase dizziness and nausea. Most doctors advise limiting intake on the night you plan to use the drug.
How does dapoxetine compare to sertraline in terms of effectiveness?
Both increase IELT, but sertraline usually adds 2‑3minutes after weeks of daily use, while a single 60mg dose of dapoxetine can give a 1‑2minute boost within hours. The choice hinges on whether you prefer a quick, on‑demand pill or a steady daily regimen.
Both increase IELT, but sertraline usually adds 2‑3minutes after weeks of daily use, while a single 60mg dose of dapoxetine can give a 1‑2minute boost within hours. The choice hinges on whether you prefer a quick, on‑demand pill or a steady daily regimen.
Are there any men who should avoid dapoxetine?
Yes. Men with severe liver impairment, uncontrolled depression, or those already on MAO‑inhibitors should not take dapoxetine. It’s also contraindicated in patients with a history of cardiac arrhythmias when combined with certain PDE5 inhibitors.
Yes. Men with severe liver impairment, uncontrolled depression, or those already on MAO‑inhibitors should not take dapoxetine. It’s also contraindicated in patients with a history of cardiac arrhythmias when combined with certain PDE5 inhibitors.
Can I combine a topical anesthetic with dapoxetine?
Combining them is generally safe because they work via different mechanisms. Some men find the combo gives the longest latency, but be sure the anesthetic isn’t over‑applied to avoid partner numbness.
Combining them is generally safe because they work via different mechanisms. Some men find the combo gives the longest latency, but be sure the anesthetic isn’t over‑applied to avoid partner numbness.
Next Steps & Troubleshooting
If you’ve tried dapoxetine and still feel unsatisfied, consider these pathways:
- Switch to a daily SSRI - ask your GP about sertraline or paroxetine.
- Add a topical spray - the combination often pushes IELT beyond 5minutes.
- Book a session with a certified sex therapist - behavioral techniques can solve the anxiety component that meds alone don’t address.
- Review other health factors - thyroid issues, diabetes, or low testosterone can influence ejaculation speed.
Remember, the best choice is the one that fits your lifestyle, health profile, and partner preferences. Keep the conversation open with your healthcare provider - treatment for premature ejaculation is highly individualized.
10 Comments
Mandie Scrivens
Wow, another half‑page pharmaceutical brochure – riveting.
Natasha Beynon
Thanks for the thorough breakdown, it really clarifies the choices. I appreciate how you listed the side‑effects alongside the dosing schedule. The on‑demand vs daily distinction is especially useful for people with irregular intimacy patterns. Keeping the language clear makes it easy for anyone to follow, even if they aren’t familiar with medical jargon.
Cinder Rothschild
The table you provided is a solid starting point for anyone looking into premature ejaculation treatments. It shows that dapoxetine offers an on‑demand solution with a relatively short half‑life. That can be a game changer for couples who want flexibility without daily pills. On the other hand, daily SSRIs like sertraline and paroxetine build up over weeks but can provide steadier control. Lidocaine spray works fast but you have to coordinate with your partner to avoid unwanted numbness. Clomipramine, being a tricyclic, brings more side‑effects such as dry mouth and constipation. Sildenafil primarily helps erectile function yet may indirectly improve ejaculatory latency. Psychosexual counseling tackles the psychological components and costs nothing in terms of medication side‑effects. Tramadol is an opioid option and should only be considered when all other avenues have failed due to its dependence risk. The safety tips you listed are spot on, especially the warning against mixing serotonergic agents. It’s also wise to take dapoxetine with a light snack to avoid delayed absorption. Monitoring mood changes when using daily SSRIs is essential because anxiety can creep in at the start. The diary suggestion is practical and gives the physician concrete data. Overall, the guide balances medical facts with practical advice in a reader‑friendly way. I hope more people discover this resource and feel empowered to discuss options with their providers.
Oscar Brown
One must acknowledge the epistemic rigor inherent in the comparative analysis presented herein. The dichotomy between on‑demand pharmacodynamics and chronic serotonergic modulation is articulated with commendable precision. Moreover, the author prudently delineates the pharmacokinetic parameters, such as half‑life and time to peak plasma concentration, thereby furnishing the reader with a quantitative framework. The inclusion of contraindications, especially concerning serotonergic synergy, evinces a responsible approach to clinical safety. It is also noteworthy that the discourse traverses beyond mere pharmacotherapy to encompass behavioral modalities, enriching the therapeutic armamentarium. The tabular synthesis, while succinct, encapsulates a plethora of variables that would otherwise necessitate voluminous exposition. In summation, the treatise serves as an exemplar of balanced medical communication, deftly navigating the interstice between lay readability and scholarly exactitude.
Tommy Mains
Here’s the quick take: if you want something you can pop before sex, dapoxetine is the go‑to. If you don’t mind taking a pill every day, sertraline or paroxetine can give steadier results. Lidocaine spray works fast but watch out for partner numbness. And don’t forget the non‑drug options – the squeeze‑stop technique can really help on its own.
Alex Feseto
Whilst the exposition is exhaustive, one must contemplate the ontological implications of medicating intimacy. Nevertheless, the data presented is undeniably erudite.
vedant menghare
Esteemed readers, the compendium you have encountered is both comprehensive and graciously structured. It pays homage to the intricate balance between efficacy and tolerability, particularly with dapoxetine’s succinct half‑life. The author’s counsel to avoid co‑administration of serotonergic agents reflects a sagacious adherence to pharmacovigilance. May you all navigate these therapeutic avenues with both wisdom and compassion, ever mindful of the shared journey with your partners.
Kevin Cahuana
Nice rundown! Just a heads‑up: if you’re trying dapoxetine, grab a light snack so it absorbs better. Also, keep a simple log of when you take it and how it feels – it helps your doctor fine‑tune the dose. And remember, combining it with a topical spray can boost results, just wipe off any excess to keep your partner comfy.
Danielle Ryan
Are you serious???!! The pharma giants are definitely hiding the REAL cure!!??!! It’s all a massive ploy to keep us dependent!!!
Robyn Chowdhury
While I concur with the practical suggestions above, it would be remiss not to acknowledge the psychological dimension of sexual health. 😊 Your insights on combining behavioral techniques with pharmacotherapy are particularly valuable. 👍