Medication for PE: what works and how to use it
Premature ejaculation (PE) can feel embarrassing, but there are real treatment options that work. This page explains the main medications used, how they help, typical doses, and common safety issues so you can talk to your doctor with confidence.
Most used medicines
Dapoxetine (on-demand SSRI) — Dapoxetine is a short-acting SSRI made for PE. Typical dose is 30 mg taken 1–3 hours before sex; some men increase to 60 mg if 30 mg isn’t enough. Side effects: nausea, dizziness, headache. Don’t mix with MAOIs or certain antidepressants.
Daily SSRIs (sertraline, paroxetine, fluoxetine) — These are taken every day and can delay ejaculation over time. Example doses: sertraline 50–100 mg/day, paroxetine 10–40 mg/day, fluoxetine 20 mg/day. They may take 1–3 weeks to help. Side effects can include lowered libido, tiredness, and sometimes erectile issues.
Topical anesthetics (lidocaine/prilocaine creams or sprays) — Applied to the penis 5–15 minutes before sex, then wiped off or allowed to absorb depending on product. They numb sensation and often work within one use. Watch for transfer to partner (use a condom if concerned) and brief local numbness.
PDE5 inhibitors (sildenafil, tadalafil) — Mainly used for erectile dysfunction, but they can help men who have both ED and PE. Doses follow ED guidance (e.g., sildenafil 25–100 mg before sex). They’re less reliable for PE alone but useful when anxiety or erection problems play a role.
Tramadol (off-label) — An opioid that can delay ejaculation at low doses. It carries risks—drowsiness, dependence, and interactions with SSRIs (serotonin syndrome). Use only under strong medical supervision.
How to use medicines safely
Always check with a doctor before starting any drug. Tell them about other medicines you take, especially MAOIs, other antidepressants, or nitrates (which shouldn’t be mixed with PDE5 inhibitors). Expect a short trial to see if a med works and what side effects appear.
Combine medication with behavioral methods like the stop-start or squeeze technique and consider sex therapy or couples counseling for longer-term improvement. If you plan to buy meds online, use licensed pharmacies that require a prescription and avoid suspiciously cheap or unregulated sites.
If a treatment causes severe side effects—fainting, chest pain, signs of serotonin syndrome (high fever, confusion, muscle stiffness)—stop the drug and seek emergency care. For most men, the right medicine plus a few practical changes bring real improvement in control and confidence.