Premature ejaculation pills: benefits, how they work, & where to get them

Premature ejaculation (PE) pills are prescription medications used off-label to help delay climax. Common options include selective serotonin reuptake inhibitors (SSRIs) such as sertraline and erectile dysfunction (ED) drugs like sildenafil or tadalafil. These medications may improve control, increase satisfaction, and extend time to ejaculation.

But an important distinction is that these medications are not actually designed, or approved by the US Food and Drug Administration (FDA), to treat PE, and studies on these medications are relatively small. While a provider may decide to prescribe them off-label to prolong erections with the goal of improving your sex life, individual results may vary.   

These medications are generally safe but can cause side effects like headaches or reduced libido. Here’s a detailed guide on how they work and what you can expect.

Off-label PE treatments or “last longer in bed pills” include SSRIs or erectile dysfunction medications. Sildenafil (Viagra) and tadalafil (Cialis) are two examples. Some small studies have shown these pills can help delay ejaculation, improve control, and increase sexual satisfaction, though results may vary depending on the individual. 

Some over-the-counter options, like benzocaine wipes, are not pills but can also reduce sensitivity to help prolong sex.

A healthcare provider can help choose the right treatment based on your needs.

While premature ejaculation pills are medications that may help you last longer in bed, this isn’t in the way you might expect. None of them are officially FDA-approved for treating PE, but some are prescribed off-label because they’ve been shown to delay ejaculation in clinical studies.

Thus, PE pills are actually medications designed for entirely different conditions. They include antidepressants and ED treatments, two drug categories that just happen to share a helpful side effect: for some people, they can make it easier to control when you climax.

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For PE, there are two main types of off-label medicines that might help you last longer in bed:

1. SSRIs (selective serotonin reuptake inhibitors)

SSRIs like sertraline (Zoloft), paroxetine (Paxil), and fluoxetine (Prozac) are best known for treating depression and anxiety. But one of their common side effects — delayed ejaculation — has made them a go-to off-label option for managing PE. For most people, ongoing use is necessary to maintain their benefits.

2. PDE5 inhibitors (ED medications)

Medications like sildenafil (Viagra), tadalafil (Cialis), and other PDE5 inhibitors are sometimes prescribed off-label for PE. While they were originally developed to treat ED, smaller trials suggest they may also help with PE.

Research looking at multiple clinical trials found that PDE5 inhibitors like sildenafil and tadalafil can help people last longer during sex compared to a placebo.

PDE5 inhibitors like sildenafil or tadalafil have been shown to help people last longer during sex compared to a placebo. When combined with an SSRI, the results may be even better, with studies showing greater improvements in timing and overall effectiveness.

Remember, these medications are not specifically FDA-approved to treat PE. Talk to your healthcare provider to see if they might be a good fit for you.

Pills that may help with PE are prescription medications, so you’ll need to speak with a licensed healthcare provider to get them. You can do this by talking to one in person or through an online telehealth service.

If you’re not sure where to start, online platforms like Ro offer access to licensed providers who can evaluate your symptoms and determine if treatment is appropriate.

Premature ejaculation pill options

Although not FDA-approved for PE, here are some of the most commonly prescribed off-label options:

Sertraline (generic Zoloft)

Sertraline is a type of SSRI often prescribed off-label to treat PE. It’s taken daily as an oral tablet. This medication is not FDA-approved specifically for PE, but several studies support its use for this purpose. While results will be different for everyone, some patients report lasting six to 20 times longer, with improvements starting as early as one week.

However, sertraline also carries an FDA black box warning due to the potential for increased risk of suicidal thoughts or behaviors in some individuals, particularly young adults.

A healthcare provider can help determine if it’s a safe option for you.

Sildenafil (generic Viagra)

Sildenafil is commonly prescribed for ED, but it may also help with PE, especially in people who experience both conditions.

In an eight-week clinical study, people who took sildenafil reported feeling more in control of when they climaxed, greater sexual confidence, and higher satisfaction during sex compared to those who took a placebo.

The medication also helped shorten the refractory period, meaning people were able to get another erection faster after ejaculating.

These effects make sildenafil a potentially useful option for people whose PE symptoms are tied to anxiety, erection concerns, or difficulty maintaining arousal after climax. Sildenafil is taken on demand, usually 30 to 60 minutes before sex.

Topical benzocaine (Roman Swipes)

Topical anesthetics like benzocaine offer an over-the-counter alternative to oral treatments for PE. They work by numbing the skin slightly, which helps reduce sensitivity and delay climax.

Roman Swipes contain 4% benzocaine and are applied directly to the penis a few minutes before sex.  Clinical studies of topical anesthetics, including benzocaine sprays and gels, have found that they can significantly increase the time to ejaculation compared to a placebo.

Topical options don’t require a prescription, but they’re not risk-free. They may not be appropriate for everyone, especially if you or your partner have a history of sensitivity to anesthetics. A healthcare provider can help you understand whether they’re a good fit for your needs.

Premature ejaculation isn’t just about finishing too fast. Stress, nerves, and how your body works all play a part. The off-label medicines used for PE help in different ways: some calm the nerves, others balance brain chemicals, and some steady the body’s signals so you can last longer.

SSRIs: it’s about brain chemistry

SSRIs change the way the brain handles serotonin, a neurotransmitter involved in mood regulation, arousal, and orgasm. When serotonin levels are higher in certain parts of the brain, it can slow down the signal that makes ejaculation happen.

This is why some SSRIs are prescribed off-label to manage PE. The goal isn’t sedation or numbing; it’s rebalancing a system that may be triggering ejaculation too quickly.

Their impact varies from person to person. Some people experience a significant delay in ejaculation, while others may have minimal changes or unwanted side effects like reduced libido.

PDE5 inhibitors: it’s about physical response and psychological ease

PDE5 inhibitors, like sildenafil or tadalafil, work by relaxing blood vessels and improving blood flow to the penis. While this primarily helps with erectile function, the effects can ripple outward.

For some, feeling more physically prepared can mentally reduce performance anxiety, which is one of the major psychological drivers of PE.

In some cases, providers may recommend combining the two approaches—treating both the physical and neurological sides of PE at once.

“Climax control pills” can delay ejaculation, but the time to climax varies by person. These PE pills are often antidepressants or ED medications prescribed off-label to last longer. SSRIs like sertraline and ED drugs like sildenafil can improve control and sexual confidence. However, they can cause side effects, so consult a healthcare provider before starting treatment.

The effectiveness of pills that make you last longer depends on the medication and individual response.

In a review of 14 clinical studies, sertraline was found to help people with PE last longer in bed. The most significant improvement was seen after four weeks of daily use, with continued benefits at six and eight weeks. The same research also showed that people taking sertraline and their partners felt more satisfied with their sex lives during treatment.

It's important to note that individual results may vary, and these treatments are not FDA-approved for PE. You should discuss them with a healthcare provider to determine the most appropriate option.

How well do SSRI pills work for premature ejaculation?

In a major review of 31 clinical trials involving over 8,200 people, SSRIs were found to improve several outcomes for people with PE.

• Improved control over ejaculation: Those taking SSRIs were almost twice as likely to report better ejaculatory control compared to those taking a placebo.

• Greater satisfaction during sex: Participants were more likely to rate their sexual experience as “good” or “very good” while on SSRIs.

• Less distress: SSRIs also helped reduce emotional distress about PE, which can affect both individuals and their relationships.

• Longer time to ejaculation: On average, SSRIs increased IELT by about three minutes compared to placebo.

How well do PDE5 inhibitor pills work for PE?

In a review of 15 randomized controlled trials, PDE5 inhibitors were found to significantly improve IELT compared to a placebo. They also improved ejaculatory control and sexual satisfaction, though results varied from study to study.

That said, PDE5 inhibitors didn’t perform better than SSRIs when used alone. But when combined with an SSRI, they were significantly more effective than SSRIs alone, offering a potential additive benefit for people with PE.

Another study focused on people using both a PDE5 inhibitor and an SSRI found that the combination led to longer-lasting results compared to taking an SSRI by itself.

The two together may improve both ejaculatory timing and sexual confidence, especially in people dealing with both PE and erection concerns.

Like any other medication, pills that help you last longer, such as those prescribed for PE, can cause side effects—some mild, others more disruptive. 

While these treatments are generally well-tolerated, it’s important to know what to expect and when to speak with a healthcare provider. They can help you try different options and determine what works best for you over continued discussions.

SSRIs: sertraline and other antidepressants

SSRIs such as sertraline are among the most common medications prescribed off-label for PE. Although they can be effective, they also come with a list of potential side effects, some of which are common across many types of antidepressants.

Reported SSRI side effects include:

• Nausea, diarrhea, or other stomach issues

• Headache

• Dizziness or shakiness

• Dry mouth

• Trouble sleeping or daytime fatigue

• Weight or appetite changes

• Anxiety

• Reduced libido or difficulty with sexual performance

Most of these are mild and may fade as your body adjusts, but sexual side effects like low libido or delayed orgasm can persist in some people, even if the medication is helping with PE. If you are experiencing these types of issues, be sure to talk to your healthcare provider to figure out your next steps. 

PDE5 inhibitors: sildenafil, tadalafil, and similar medications

PDE5 inhibitors like sildenafil tend to produce short-term, mild side effects that appear while the medication is active in your system. Serious side effects are also possible but are much less frequent.  

The most common PDE5 inhibitor side effects are mild and usually resolve within a few hours. These include:

• Headaches

• Facial flushing (warmth or redness in your face)

• Upset stomach or indigestion

• Stuffy or runny nose

• Back pain

• Muscle aches

• Dizziness

• Changes in vision, such as seeing a blue tinge or increased light sensitivity

• Rash

Since these effects can vary from person to person, it’s important to try different options and figure out the one that works best for you by continuing to discuss with your healthcare provider. 

Not everyone with PE wants (or needs) prescription medication. For some, behavioral strategies and physical exercises can make a meaningful difference in timing, control, and confidence during sex. These non-drug options are often used alone or alongside medical treatment.

Here are the most researched and commonly recommended natural and behavioral approaches:

Pelvic floor exercises (Kegels)

Strengthening the muscles that control ejaculation can improve performance over time. The pelvic floor muscles play a key role in ejaculation, and Kegel exercises have been shown to help with PE by improving muscular control.

Stop-start and squeeze techniques

These techniques are designed to help you learn how to delay ejaculation during sexual activity.

• Stop-start: Pause stimulation just before the point of no return, wait until arousal decreases, then resume.

• Squeeze technique: Apply firm pressure to the head or base of the penis until the urge to ejaculate passes, then continue stimulation.

With repetition, these strategies can help some people build more control during sex. They may feel awkward at first, but can be effective with consistent use.

Masturbation before sex

Some people find that masturbating an hour or two before intercourse can help delay climax during partnered sex. While the evidence here is mostly anecdotal, it may reduce sensitivity by moving you into the post-orgasm refractory period.

Condoms and climax control condoms

Condoms can reduce sensitivity during sex, which may help some people delay ejaculation. Thicker condoms, in particular, have been found to prolong erection time, increase pre-ejaculatory latency, and improve ejaculatory control compared to standard condoms.

Some people even use two standard condoms to mimic the effect of a single, thicker one, though this may affect comfort or fit. (If you are using condoms as your only measure of contraception, you should be careful and this approach may not be recommended for you.)

There are also climax control condoms, which contain a small amount of benzocaine or lidocaine on the inside. These numbing agents further minimize stimulation and may help delay climax.

All of these options are available without a prescription and may be useful for people looking for a non-pill, over-the-counter way to manage PE.

Therapy and counseling

PE isn’t always about physical function. Psychological or emotional factors like performance anxiety, low sexual confidence, relationship tension, and past experiences can all play a role. When this happens, therapy can be an important part of treatment, and in some cases, the first line of care.

Short-term psychotherapy, especially approaches like cognitive behavioral therapy or sex therapy, focuses on helping people reduce anxiety about sexual performance, address negative patterns, and strengthen communication and intimacy with a partner.

Avoiding penetration-focused sex

When performance anxiety plays a role in PE, intercourse itself can become a source of stress. To relieve that pressure, sex therapists often recommend temporarily shifting focus away from penetrative sex and toward other forms of intimacy like touching, kissing, or non-penetrative sexual activity.

This change can reduce the sense of urgency and help partners reconnect without the weight of performance expectations.

Over time, this low-pressure approach can build confidence, improve communication, and create a stronger emotional connection. As control improves, penetrative intercourse can be gradually reintroduced at a pace that feels comfortable.

Though it may feel unfamiliar at first, this kind of reset can be a helpful step in breaking the cycle of anxiety that often keeps PE going.

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Figuring out what pills make you last longer in bed often depends on the underlying cause of PE. However, off-label options like SSRIs and certain ED medications have been shown to help improve control and delay climax in some people.

• Multiple treatments can help, even if none are FDA-approved: Medications like SSRIs and PDE5 inhibitors are commonly prescribed off-label for PE and could improve control and satisfaction, as seen in small clinical studies.

• Some options work best when combined: Using a PDE5 inhibitor alongside an SSRI may offer greater benefits than taking either alone, particularly in people with both PE and ED symptoms.

• You may need to stay on treatment long-term: SSRIs often require daily use and can take several weeks to become effective. If you notice unwanted side effects or feel the medication is not working after a long enough trial period, speak with your healthcare provider. 

• Topical products and condoms can offer short-term help: Benzocaine wipes, lidocaine creams, and climax control condoms can reduce sensitivity and help delay climax. These products usually don’t require a prescription.

• Psychological support makes a difference: Performance anxiety and stress can worsen PE. Therapy, especially when paired with physical treatments, can help reduce any shame associated with sexual issues, improve confidence, and strengthen intimacy.

Pills for premature ejaculation aren’t one-size-fits-all, but with the right treatment plan, many people see meaningful improvements in both timing and overall sexual satisfaction.