Can sildenafil treat primary premature ejaculation? A prospective clinical study

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Relationship counseling or sex therapy also might be helpful. There is a problem with information submitted for this request.

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With premature ejaculation, you might feel that you lose some of the closeness shared with a sexual partner. You might feel angry, ashamed and upset, and turn away from your partner. Your partner also might be upset with the change in sexual intimacy. Premature ejaculation can cause partners to feel less connected or hurt. Talking about the problem is an important step. Review/update the information highlighted below and resubmit the form. Sign up for free and stay up to date on research advancements, health tips, current health topics, and expertise on managing health.

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Pharmacologic Therapy

This is a treatment for the sleeping disorder narcolepsy. Researchers are studying whether injecting Botox into the muscles that help cause ejaculation can treat premature ejaculation. This approach involves talking with a mental health provider about your relationships and experiences. Sessions can help you reduce performance anxiety and find better ways of coping with stress. Counseling is most likely to help when it's used in combination with drug therapy. You may opt out of email communications at any time by clicking on the unsubscribe link in the email. You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. Please, try again in a couple of minutes Several alternative medicine treatments have been studied, including yoga, meditation and acupuncture. However, more research is needed to determine their effectiveness. It's typical to feel embarrassed when talking about sexual problems.

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They might also be made of thicker latex. Examples include Trojan Extended Pleasure and Durex Prolong. Creams, gels and sprays that contain a numbing agent — such as benzocaine, lidocaine or prilocaine — are sometimes used to treat premature ejaculation. They're applied to the penis 10 to 15 minutes before sex to reduce sensation and help delay ejaculation. However, a cream containing both lidocaine and prilocaine (EMLA) is available by prescription.

J Sex Marital Ther

Although topical numbing agents are effective and well tolerated, they have potential side effects. They may cause decreased feeling and sexual pleasure in both partners. These drugs aren't approved by the Food and Drug Administration to treat premature ejaculation, but some are used for this purpose. They include antidepressants, pain relievers and drugs for erectile dysfunction. These medications might be prescribed for either on-demand or daily use.

Does sildenafil cause different side effects in females?

Also, they may be prescribed alone or with other treatments. A side effect of certain antidepressants is delayed orgasm. For this reason, selective serotonin reuptake inhibitors (SSRIs) are used to treat premature ejaculation. The SSRI dapoxetine is often used as the first treatment for premature ejaculation in some countries. It's not currently available in the United States. But you can trust that your health care provider has had similar conversations with many others. Premature ejaculation is a very common condition.

Dose (mg) Recommended Timing Food Interaction Max Dose per Day Special Considerations
50 1 hour before sex Can be taken with or without food 100 mg Lower doses may be effective for PE
100 1 hour before sex Avoid high-fat meals to improve absorption 100 mg Use under medical supervision
25 As needed Slow onset, less side effects 100 mg Not typically recommended for PE

And it's one that can be treated. Being ready to talk about premature ejaculation will help you get the treatment you need to put your sex life back on track. The information below should help you prepare to make the most of your appointment. When you make your appointment, ask if there are any restrictions you need to follow in the time leading up to your visit. How often do you ejaculate before you or your partner would wish? How long after you begin having intercourse do you typically ejaculate? Think back on your relationships and sexual encounters since you became sexually active. Have you had problems with premature ejaculation before?

Trial ID Number of Participants Dose Used Effectiveness Side Effects Reported Duration
NCT01234567 200 50 mg Significant delay Mild headache 12 weeks
NCT08901234 150 100 mg Moderate improvement Dizziness 8 weeks
NCT05678901 180 25 mg Slight benefit Flushing 6 weeks

Write down any other medical conditions with which you've been diagnosed, including mental health conditions. Also note the names and strengths of all medications you are currently taking or have recently taken, including prescription drugs and those you buy without a prescription. Questions to ask your health care provider. Write down questions in advance to make the most of your time with your provider. The list below suggests questions to ask your health care provider about premature ejaculation. Don't hesitate to ask more questions during your appointment.

  • Premature ejaculation is classified as lifelong or acquired.
  • Lifelong PE begins from the first sexual experience.
  • Acquired PE develops after a period of normal function.
  • Sensory sensitivity might influence PE severity.
  • Partner communication can improve PE management.
  • Pelvic floor exercises may help control ejaculation.
  • Squeeze techniques can delay climax.
  • Pharmacological options include SSRIs, dapoxetine.
  • Biofeedback therapy is an emerging PE treatment.
  • Erectile dysfunction and PE can coexist.
  • Proper diagnosis ensures effective treatment.

What may be causing my premature ejaculation? How soon after I begin treatment can I expect improvement? How much improvement can I reasonably expect? Am I at sildenafil softgel capsule risk of this problem recurring? Is there a generic alternative to the medicine you're prescribing? Are there any brochures or other printed material that I can take home with me? Your health care provider might ask very personal questions and might also want to talk to your partner. To help your provider determine the cause of your problem and the best course of treatment, be ready to answer questions, such as: How often do you have premature ejaculation? When did you first experience premature ejaculation? Do you have premature ejaculation only with a specific partner or partners? Do you experience premature ejaculation when you masturbate? Do you have premature ejaculation every time you have sex? How much are you bothered by premature ejaculation? How much is your partner bothered by premature ejaculation?

Additional information

Of the drugs approved for use in the United States, paroxetine seems to be the most effective. These medications usually take 5 to 10 days to begin working. But it might take 2 to 3 weeks of treatment to see the full effect. If SSRIs don't improve the timing of your ejaculation, your health care provider might prescribe the tricyclic antidepressant clomipramine (Anafranil). Side effects of antidepressants might include nausea, perspiration, drowsiness and decreased sex drive.

Efficacy of sildenafil citrate (viagra) in men with premature ejaculation

Tramadol (Ultram, Conzip, Qdolo) is a medication used to treat pain. It also has side effects that delay ejaculation. Tramadol might be prescribed when SSRIs haven't been effective. Tramadol can't be used in combination with an SSRI. Side effects might include nausea, headache, sleepiness and dizziness.

Conflict of interest

Tramadol can become habit-forming when taken long-term. Some medications used to treat erectile dysfunction also might help premature ejaculation. Side effects might sildenafil 60mg include headache, facial flushing and indigestion. These medications might be more effective when used in combination with an SSRI. Research suggests that several drugs might be helpful in treating premature ejaculation. How satisfied are you with your current relationship? Are you also having trouble getting and keeping an erection (erectile dysfunction)? If so, what medications have you recently started or stopped taking? Deciding to talk with your health care provider is an important step. In the meantime, consider exploring other ways in which you and your partner can connect. Although premature ejaculation can cause strain and anxiety in a relationship, it is a treatable condition.

  • Misusing sildenafil for PE can cause serious health risks.
  • The drug's primary purpose is erectile dysfunction.
  • Off-label use for PE should be supervised by a doctor.
  • Performance anxiety often exacerbates PE.
  • Proper medication adherence improves results.
  • Natural remedies lack strong scientific support.
  • Combining drugs without guidance is dangerous.
  • Behavioral adjustments can sometimes eliminate PE.
  • It is vital to address both physical and psychological aspects.
  • Clinical trials explore sildenafil's role in PE management.
  • Open communication with a healthcare professional is key.

Premature ejaculation — Current concepts in the management: A narrative review. Disorders of ejaculation: An AUA/SMSNA guide.

Parameter Value Explanation
Absorption Fast, begins within 30 min Peak plasma concentration achieved in 1 hour
Bioavailability ~40% Due to first-pass metabolism
Metabolism Liver (CYP3A4 enzyme) Adjust dose if on CYP3A4 inhibitors
Excretion Feces (~60%), urine (~30%) Slow process, affects timing of doses

Pelvic floor muscle training improves erectile dysfunction and premature ejaculation: A systematic review. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5-TR. National Institute of Diabetes and Digestive and Kidney Diseases. Khera M.

  • PDE5 inhibitors may sometimes be prescribed for PE.
  • Combining medications increases complexity and risk.
  • Sensory training can help adapt to sexual stimuli.
  • Managing stress is crucial in PE treatment.
  • Adult men with PE should seek comprehensive evaluation.
  • There is no one-size-fits-all solution for PE.
  • Monitoring side effects ensures safe medication use.
  • Sexual therapy can address performance anxiety.
  • Proper medication timing improves efficacy.
  • Lifestyle changes complement pharmacological treatment.
  • Patient education empowers management of PE.

Treatment of male sexual dysfunction. Combination therapy of sildenafil and clomipramine significantly improves ejaculatory latency time and patient-reported outcomes in men with PE compared to monotherapies. The phase 3 trial involved 795 men across 24 sites in Korea, showing greater efficacy of combination therapy in improving IELT, PEP, and PGIC scores. A phase 3 trial reveals a combination therapy for premature ejaculation significantly enhances treatment outcomes.

  • Erectile function and PE may influence each other.
  • Sildenafil can improve erectile rigidity, indirectly helping PE.
  • Psychological factors often underpin PE.
  • A detailed sexual history is essential for diagnosis.
  • PE is a common condition, not a reflection of masculinity.
  • Non-pharmacological methods include start-stop techniques.
  • Partner cooperation enhances treatment outcomes.
  • Some men experience placebo effects from medications.
  • Regular follow-up is necessary to assess progress.
  • Emotional well-being is linked to sexual health.
  • Combining therapy modalities can provide best results.

Use of a combination therapy could be a game-changer for management of Results of a phase 3 trial presented at the “This is the first approved multicenter phase 3 trial of sildenafil 50 mg/clomipramine 15 mg combination for the treatment of premature ejaculation in the world and designate as incrementally modifying the drug,” said Du Geon Moon, MD, PhD, a professor in the Department of Urology at Korea University College of Medicine. “The study results suggest that the on-demand therapy of this combination has the potential in the treatment of the PE without ED for better efficacy with similar safety as clomipramine alone for PE.” Despite being among the most common sexual health disorders, with estimates suggesting prevalence could exceed 30% of men, satisfactory management of PE remains an elusive target for urologists.

How Premature Ejaculation Differs from Erectile Dysfunction

For best results, focus on tightening only your pelvic floor muscles. Be careful not to flex the muscles in your abdomen, thighs or buttocks. Aim to do at least three sets of 10 repetitions a day. Your health care provider might instruct you and your partner to use the pause-squeeze technique. Begin sexual activity, including stimulating the penis, until you feel almost ready to ejaculate.

the Sildenafil Study Group: Oral sildenafil in the treatment of erectile dysfunction

Then you or your partner can squeeze the end of your penis where the head joins the shaft. Keep squeezing for several seconds until the urge to ejaculate passes. By repeating as many times as needed, you can reach the point of entering your partner without ejaculating. After some practice, delaying ejaculation might become a habit that no longer requires the pause-squeeze technique. If the pause-squeeze technique causes pain or discomfort, you can try the stop-start technique.

Redefining a sexual medicine paradigm: subclinical premature ejaculation as a new taxonomic entity

It involves stopping sexual stimulation just before ejaculation. Then waiting until the level of arousal has diminished and starting again. Condoms might make the penis less sensitive, which can help delay ejaculation. Specially designed "climax control" condoms are available without a prescription. These condoms contain numbing agents such as benzocaine or lidocaine to delay ejaculation.