Premature ejaculation is the expulsion of semen happening sooner than anticipated. Ejaculation occurs almost immediately or within a minute of vaginal penetration. It is the most prevalent sexual dysfunction among men irrespective of age and ethnicity.

PE is elucidated as one primary reason for couples lacking intimacy in their relationship. Dwindling frequency of sex triggers depression and deteriorates sexual health.

Ejaculation is a highly coordinated process that has two phases:

  • Emission- Semen crosses the bladder and reaches the urethra. At this stage, ejaculation becomes inevitable.
  • Expulsion- A’ Point of no return’ stage for semen where it is ejaculated out.

Orgasm is the most pleasurable sensation known to mankind. It remains unaffected by a minor glitch in sexual function. But sex is not a solo game. A partner’s satisfaction is equally important.

PE is a curable condition that requires the joint effort of lifestyle changes and medical therapy. There is no ‘one-pill-solution’ kind of medicine for curing PE, but few categories of drugs can permanently cure PE.

The commonly used medicines for the treatment of PE are:

Selective Serotonin Reuptake Inhibitors (SSRI’s): These are anti-depressants that induce a delay in ejaculation time. Yes, they are lifting your mood and enhancing your sexual function at the same time. The commonly used drugs are Sertraline, Paroxetine, Fluoxetine, etc.

These drugs take 5-10 days for their action and require an increment in the dosage after 2-3 weeks. The side-effects associated with these drugs are nausea, dizziness, headache, interference in sleep patterns, and decreased libido on prolonged usage. Increased suicidal tendencies are also seen with these drugs, so they are used in particular cases.

Dapoxetine is a newly added SSRI that is comparatively safe and can be used on-demand. There are no long term side-effects associated with it. The adverse effects seen with Dapoxetine are mild nausea and headache.

Phosphodiesterase 5 Inhibitors: PDE5 inhibitors are well-suited, and on-demand drugs for erectile dysfunction have also shown improvement in PE cases. They are ideal drugs for the comorbid state of ED and PE. These drugs improve the blood flow to delicate penile capillaries and relax the penile musculature.

They have more control over erection than ejaculation. The adverse effects seen are headache, flushing, running nose, stomach pain, and indigestion. Prolong use also causes visual problems like blurry vision and difficulty distinguishing between blue and green colors.

Analgesics: Tramadol is used to treat pain and causes a delay in ejaculation time. Tramadol is an opioid analgesic and is not recommended for long term treatment for PE. Withdrawal symptoms are exhibited on sudden discontinuation after prolonged usage.

Desensitizing Agents: Topical anesthetics like lidocaine, prilocaine reduces the sensitivity of the glans and delays ejaculation. They cause vaginal numbness upon penetration. Placement of the condom is often recommended.

The Right Pill

Seek medical advice before treating yourself with any pill. What suited your friend may show a different effect on your body. A doctor can prescribe you the right medicine based on your medical and sexual history. PE is curable, and a sedentary lifestyle is highly unfavorable for it.

Calm yourself down, indulge in some physical and mental exercise. See a therapist in the context of distress in your relationship. Talking about the problem is essential for you and your partner. Continuing with PE will aggravate the symptoms of sexual dysfunction, affects your mental health, and you may lose the connection with your partner.

Medically reviewed by Rishabh Verma, RP