What Happens When You Don't Last? Premature Ejaculation: Causes and Treatment

Published July 26th, 2021 by Chris Riley
Fact Checked by
Erik Rivera
Medically Reviewed:
Dr. Angel Rivera

If you are suffering from premature ejaculation, you may be feeling that your sex life has been reduced to a frustrating experience. You might even feel embarrassed and ashamed of your premature ejaculation, but this condition is not uncommon. Premature ejaculation, or PE, can be caused by many different factors including anxiety, stress, or even an inherited condition. We will discuss the causes and treatment for premature ejaculation so that you can get back to enjoying a healthy sex life. 

What are the causes for premature ejaculation?

The causes of premature ejaculation can be attributed to many different factors. For some men, it could be psychological factors like anxiety or stress levels, while others may have inherited the condition from their father or grandfathers.

Here is a list of potential contributing factors:

  • Anxiety and stress levels 
  • Inherited condition or genetics
  • Depression
  • Incorrect technique due to lack of experience 
  • Medical conditions that affect the parasympathetic nervous system 
  • Performance anxiety
  • Sensitivity to stimulation on your penis 

Finding out the source for your PE can help you and your physician figure out your best treatment options. If you are experiencing premature ejaculation, speak with your doctor who may conduct tests to find out what has caused this problem in order to make an accurate diagnosis. If premature ejaculation is found due to genetic reasons then there are several ways to treat this including pills. 

How do PE pills work?

There are two common types of PE pills, the ones that are over-the-counter and pills that can be prescribed to you by your doctor. Let's take a look at each of the options. 

The over-the-counter pills often are sold at vitamin stores, online, and sometimes even gas stations in the U.S. These pills make claims to help with your libido and are often herbal supplements that are said to help you last longer when having sex. An herbal supplement for premature ejaculation may be an herb that prevents premature ejaculation or one that delays it. There are many herbs that claim they can be used to treat premature ejaculation because they are natural and have fewer side effects than some prescribed medications. Some herbs may come from plants such as damiana, epimedium, saw palmetto, nettle root, or Devil's claw, which all have properties thought to prevent premature ejaculation or delay it. Although widely available and with fewer known side effects, these herbs are often not FDA approved to treat PE and there aren't enough studies linking them with the ability to help treat PE. 

Prescribed pills for PE are usually one of two types of medications. The first is selective serotonin reuptake inhibitors or SSRIs. These pills help treat the symptoms related to PE. Although SSRIs do not directly help with PE, doctors will often prescribe them for PE use, which is called going "off-label."

The other form of prescription pills that can be prescribed are phosphodiesterase type 5 inhibitors or PDE5s. These pills are most commonly used for erectile dysfunction or ED. 

Enjoy the Ride
Sertraline | Hims

Sertraline | Hims

Sertraline is a prescription medication that doctors can prescribe for the treatment of premature ejaculation, allowing you to control your climax and enjoy sex for longer. And because Sertraline is a pill taken ahead of time, whether on a daily or an as-needed basis, you won't have to halt the action to apply a topical product. Modern romance at its finest.

How do SSRIs treat premature ejaculation?

SSRIs are used to combat depression and anxiety which are two major causes of premature ejaculation. If you do not want to take premature ejaculation pills, then you could also try an SSRI to treat the symptoms. If your premature ejaculation is due to performance anxiety, antidepressants might be the best treatment option for you. These drugs will increase your serotonin levels and make it easier for you to get an erection when you want one. Increasing serotonin levels can also successfully alleviate premature ejaculation. These types of medicines work on the brain to block serotonin from getting too high or low. Sertraline, the generic form of the brand name Zoloft, and paroxetine, the generic form of the brand name Paxil, are two of the most common SSRI drugs, but there are also others available. 

Paroxetine | Hims

Paroxetine | Hims

  • Daily pill that can be taken for climax control
  • Helps you last 9-12x longer in bed
  • No doctor’s office visit required
  • Free, discreet delivery, if prescribed

How do PDE5s treat premature ejaculation?

PDE5s are prescription drugs that work by relaxing the muscles around your penis so you last longer during sex. They work as vasodilators, which means they widen the blood vessels, bringing more blood to your penis. This can help you stay harder longer. They're often used as a treatment for erectile dysfunction, but can be used for other health conditions. 

Here is a list of the most common drugs that are used for ED with their generic counterparts: 

  • Viagra or sildenafil citrate
  • Cialis or tadalafil 
  • Levitra or vardenafil
  • Stendra or avanafil 

All of these medications are available in their generic forms except for avanafil. However, if premature ejaculations are caused by performance anxiety or stress then SSRIs rather than PDE5s may be the best option for you. We always recommend you talk to your doctor to determine the right treatment for you. 

Where can I get premature ejaculation pills?

The only way to get FDA-approved premature ejaculation pills is through a prescription from your doctor. Both SSRIs and PDE5s require your doctor to write you a prescription for them. Please talk to your doctor or pharmacists about your condition so you can find the best treatment options and plans for you. 

Are there any other treatments for PE?

Yes! If you do not want to take these pills there are a couple of other options available to you. 

Besides herbal supplements, SSRIs, and PDE5 inhibitors, there is also the option of using products that have lidocaine in them. These products usually come in the form of a spray, wipe, or cream that you use before sexual intercourse to numb sensitive areas of your genitals. It is a local anesthetic that temporarily numbs the skin it comes in contact with, prolonging foreplay and penetration and making premature ejaculation less likely. Lidocaine is fast-acting at absorbing through your skin so there should not be a worry of it affecting your partner. It also should not affect any lubrication you use during sex. Just make sure to put the medicine with the lidocaine on first before the lube. 

Enjoy the Ride
Delay Spray | Hims

Delay Spray | Hims

Delay Spray is designed to help keep the lovemaking going longer and stronger. In a study, men reported lasting 64% longer when using this spray. It’s the perfect sidekick to boost sexy time, so you don’t have to hold back.

Condoms are also an option if your penis is extra sensitive. By using a condom the penis becomes less sensitive and there are even condoms available over the counter that use local anesthetics like lidocaine, which can help prevent PE.

Finally, practicing premature ejaculation techniques is another way to treat PE. There are many videos and testimonials across the internet for these techniques and some are very credible. We recommend looking at the techniques that involve muscle control around your genitals to prevent premature ejaculation, specifically the ones that focus on your pelvic floor muscles. There also is the pause-squeeze or just squeeze technique, featured by the Mayo Clinic as a way to prevent PE. This technique involves you or your partner squeezing the head of your penis where it meets the shaft when you are about to ejaculate until the feeling passes. The pause-squeeze can be used as many times as necessary to prevent premature ejaculation. 


Premature ejaculation is a premature sexual climax during intercourse, usually before the desired time. It can lead to embarrassing moments with your partner but it doesn't have to be that way. We provided information on the different pills available and other techniques used to prevent PE. Herbal supplements are available over-the-counter but are not as studied as prescribed pills such as  SSRIs or PDE5s, which are both used to treat other symptoms associated with PE. If these methods are not available to you or work for you, there is also the option of using a lidocaine solution to help numb your penis, exercises to strengthen certain muscles used during orgasm, and even a method that you and your partner can use during sex. Please talk to your doctor about your struggles with PE to find the right treatment plan for you so you can have confidence again in your sexual activity.


NIH – Premature ejaculation: Does medication work?

Harvard Health Publishing – Ask the doctor: What works best for premature ejaculation?