Premature ejaculation

Common questions

Roman is a telemedicine company that provides a discreet, convenient, and affordable way for you to receive premature ejaculation (PE) treatment from a doctor or nurse practitioner—all without leaving the couch. Roman Swipes are available for purchase directly from the website as an over-the-counter (OTC) product that does not require a prescription. If you are interested in prescription treatment, it starts with an online visit. The online visit will ask you about your symptoms, your medical history, and other basic information. You’ll also be asked to upload a photo of your ID to verify your identity. Once you have done all of this, a doctor or nurse practitioner will review everything, determine if you’re a candidate for PE treatment through telemedicine, and craft a personalized treatment plan for you.

According to the World Health Organization (WHO), premature ejaculation (PE) is defined as “recurrent ejaculation that occurs with minimal stimulation and earlier than desired, before or soon after penetration, which causes bother or distress, and upon which the sufferer has little or no control.”

One of the problems with the diagnosis and treatment of PE is that, until recently, there has not been agreement on its definition. Many men believe they ejaculate more quickly than they should, only to discover that their time to ejaculation is well within the average range. Other men might ejaculate in two minutes but find it is neither a cause for concern for them or their partner. If you feel that you ejaculate too quickly during sex, treatment may be appropriate for you.

Although no single treatment works for everyone, most men can be treated successfully. There are multiple oral medications, topical therapies, and other techniques that can be used alone or in combination with one another. Some people see immediate results, but for many men it takes some time before results are apparent. Some may find they need to try a few different methods before finding the right solution. If things don’t go as planned or if you experience an adverse side effect, don’t give up. You have options and we are here to help you find the best solution.

There are three prescription-strength medications for premature ejaculation (PE) available on the Roman platform: sildenafil citrate (the active ingredient in Viagra) (see important safety information), tadalafil (the active ingredient in Cialis) (see important safety information), and sertraline (a type of medication known as a selective serotonin reuptake inhibitor, or SSRI) (see important safety information). Your doctor or nurse practitioner will decide which treatment option is most appropriate for you after reviewing the information you provide in your online visit. While one medication may be better for one person, a different medication may be better for another person. It all depends on your specific medical history, symptoms, and preferences. Of note, there is no medication that is specifically FDA-approved for the treatment of PE. However, sildenafil citrate, tadalafil, and sertraline can be prescribed off-label for this purpose, if appropriate.

In addition to these three prescription medications, Roman Swipes is an over-the-counter treatment for PE that you can purchase directly from the website without going through an online visit.

Off-label usage of a medication refers to using the medication for purposes that have not specifically been approved by the FDA. Healthcare professionals have the discretion to prescribe medications off label if they believe it is an appropriate course of treatment for a particular patient.

There are many possible causes of premature ejaculation (PE), ranging from physical causes to psychological causes. Although it may seem odd to get prescribed erectile dysfunction (ED) medication for PE, numerous studies have shown that it can be effective. There are a few reasons ED medication might help:

  • ED medication can help relax the smooth muscles of organs involved in ejaculation

  • ED medication can affect the nervous system in ways that may delay ejaculation

  • ED medication may decrease the sensitivity of the penis

  • ED medication can prolong the duration of an erection, increasing confidence, the perception of ejaculatory control, and overall sexual satisfaction

  • ED medication can make it easier to get a second erection after ejaculation

Some patients may also have coexisting ED and PE. For these patients, it is recommended ED get treated first, to see if it has beneficial effects on PE.

The medications available for treating PE work for the vast majority of patients and they usually do so without causing side effects. However, just as no drug works on everyone, no drug is 100% safe—and these treatments are no exception. The potential side effects depend on which medication you use, so be sure to check out each medication’s important safety information for specifics. To reduce the risk of side effects, your doctor or nurse practitioner will work with you to find the lowest effective dose of the medication. This is the dose at which the medication still works but is least likely to have any adverse effects.

If you’re allergic to benzocaine (the active ingredient in Roman Swipes), you might experience an allergic reaction on the skin, including redness and swelling. Contact your primary healthcare provider if you notice any reactions.

Your doctor or nurse practitioner may recommend a combination of medication and behavioral therapy tips to deal with premature ejaculation (PE). No two people are alike, and it may take time and experimentation to find the methods that work best for you. Some recommended non-prescription techniques include:

  • Topical anesthetics: Topical anesthetics can be applied to the penis just before sexual activity. They come as creams, lotions, or sprays and are available over-the-counter. The advantage of topical applications is that the side effect rate is low.

  • Condoms: Condoms can help with PE by decreasing penile sensitivity. They also have the added benefit of reducing the risk of sexually transmitted infections and unwanted pregnancy.

  • Behavioral modification: The squeeze and stop-start techniques are two different strategies that can be practiced during masturbation or sexual activity, and—over time—they can improve control over the timing of ejaculation.

  • Psychotherapy: Counseling, whether in person, by telephone, or by text messaging, may increase the likelihood of success for some patients.

Your online visit is free.

Services, products, and medications offered through Roman are not covered by insurance.

If prescribed, the cost of treatment depends on the type of medication and the number of doses you receive. Check out the current Roman Pharmacy Network prices. Prices at your local pharmacy may vary.

You’re only charged for the medication after a doctor or nurse practitioner has approved a personalized treatment plan.

Important safety information

What you should know before taking sildenafil.

Important safety information

What you should know before taking Viagra.

Important safety information

What you should know before taking Cialis

Important safety information

What you should know before taking sertraline.