Comparing Over-the-Counter Supplements for PE

It is a very common condition, and one of the most common sexual dysfunctions.

Your UCLA Men’s Clinic provider will be understanding and likely have an effective treatment that will please you and your partner.

Why Choose RedBox Rx

Oral medications: Some men respond well to low doses of the antidepressants known as selective serotonin reuptake inhibitors (SSRIs), that block serotonin, one of the hormones important in ejaculation. These are prescribed off-label, with some side effects. These pills have been around for over 20 years, are relatively safe, but are not FDA approved for PE / RE. It is therefore up to the patient and his doctor to make the call to use this class of drugs off label. Don’t be afraid to seek treatment for premature or rapid ejaculation. Board-certified urologists staff The Men’s Clinic at UCLA and you can be assured you are getting an experienced physician performing your evaluation and procedure in a relaxed and comfortable environment.

For more information and to schedule an appointment, please call the UCLA Urology Appointment line at 310-794-7700.

• Pills may work by desensitizing penile nerves temporarily.
• Certain antidepressants are used off-label for PE.
• Not all pills are suitable for every age or health condition.
• Effectiveness varies among individuals; patience is necessary.
• Some formulations combine multiple ingredients for synergy.

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.

• Dapoxetine is a fast-acting medication approved for PE.
• Combining medications with therapy enhances results.
• Some pills contain PDE5 inhibitors, like sildenafil, for better control.
• Side effects of pills may include dizziness or nausea.
• Always check for drug interactions before taking PE pills.

A phase 3 trial reveals a combination therapy for premature ejaculation significantly enhances treatment outcomes.

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.

Oral Medications Sometimes Used for PE

doi:10.3390/medsci7110102. Behavioral Therapies for Management of Premature Ejaculation: A Systematic Review. Wang Z, Yu J. Efficacy evaluation of thickened condom in the treatment of premature ejaculation. Emerging and investigational drugs for premature ejaculation.

The Risks of Unregulated “Herbal” Pills

Choosing a selection results in a full page refresh. We provide men’s health care in one convenient clinic. To learn more about our services, call 310-794-7700. It can be either primary, meaning the man has always had the problem, or secondary, meaning the man has acquired the condition later in life. Premature ejaculation has various timing definitions ranging from ejaculating within one minute of penetration to ejaculating prior to a man's partner achieving orgasm. “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.

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Doğan K, Keçe C. Comparison of the results of stop-start technique with stop-start technique and sphincter control training applied in premature ejaculation treatment. Published 2023 Aug 10. doi:10.1371/journal.pone.0283091. Efficacy of Sphincter Control Training (SCT) in the treatment of premature ejaculation, a new cognitive behavioral approach: A parallel-group randomized, controlled trial.

What Causes Premature Ejaculation?

Published 2019 Feb 26. doi:10.1371/journal.pone.0212274. Gillman N, Gillman M. Premature Ejaculation: Aetiology and Treatment Strategies. Published 2019 Oct 25. With no agents sporting indications specific to PE, providers are left with the challenge of determining proper treatments, with common choices including selective serotonin reuptake inhibitors, topical anesthetics, and behavioral therapies. Sponsored by CTC Bio, the AUA 2025 study from NAME was a 3-arm, prospective, randomized, double-blind, active-controlled, multi-center trial.

Phosphodiesterase type 5 inhibitors (PDE5 inhibitors)

Serotonin, dopamine, prolactin, testosterone and oxytocin are all hormones that play a role in ejaculation. This is a very troubling condition for men as it compromises their sexual satisfaction and inhibits them in relationships. Some recent studies shed light on PE and RE but the exact causes are still not known. Psychological: Classic literature on RE suggests it is a trained sexual response fostered by men secretively masturbating as adolescents and trained to finish quickly. This behavior was then reinforced with early partner encounters where young couples engage in clandestine sexual activity in parents’ basements or car back seats.

“Climax Control” Condoms

There is no proof that this is a real thing, however, and physicians suggesting this as a cause of RE reinforces guilt associations with sexuality. Neurobiological: The neurotransmitter serotonin (5HT) plays a central role in the ejaculatory response. Low levels of serotonin in specific areas of the brain may lead premature ejaculation. Studies have shown that increases in serotonin levels can help delay ejaculation in some men. This provides the rationale for treating RE with anti-depressants in the selective serotonin reuptake inhibitor (SSRI) class. The trial enrolled 795 men with PE without erectile dysfunction across 24 sites in Korea between October 2019 and April 2022. For the purpose of analysis, PE was defined based on DSM-V criteria, a PEDT score of 11 or higher, and an intravaginal ejaculatory latency time (IELT) of less than 3 minutes. A total of 265 participants were randomized to clomipramine 15 mg (Group A), 266 were randomized to sildenafil 50 mg (Group B), and 264 were randomized to a combination of clomipramine 15 mg and sildenafil 50 mg (Group C).

The primary outcome of interest for the study were stopwatch-measured IELT at 12 weeks. Additional outcomes of interested included changes in Premature Ejaculation Profile (PEP) and Patient Global Impression of Change (PGIC).1 Results of the trial indicated all groups showed significant increases in IELT over 12 weeks: Group A: 191.72±12.72 seconds (P <.001) Group B: 168.35±12.29 seconds (P <.001) Group C: 279.41±20.06 seconds(P <.001) Further analysis demonstrated the increase in IELT was significantly greater in group C compared to either monotherapy group (each P <.001).

Premature Ejaculation Complications

They are effective, easy-to-use, low-cost and have a negligible risk of systemic side effects. Topical numbing sprays and creams are available with either a prescription or over the counter. They all work by gently numbing the sensitive areas of the penis so the nerves don’t fire so fast and the man can prolong intercourse. The agent must be washed off prior to intercourse or a condom must be worn to make sure the partner is not also desensitized. One option for patients is a new product, Promescent®, from Absorption Pharmaceuticals, which provides improved ejaculatory latency (the time from penetration to ejaculation) with minimal loss of sexual sensation. Improvements in PEP scores were 91.46%, 85.59%, and 96.10% for groups A, B, and C, respectively, with group C achieving significantly greater rates of improvement than groups A (P = .037) or B (P <.001).

What is Premature Ejaculation?

Essentially, a man or a couple can suffer from rapid ejaculation if one or both is unhappy with how rapidly the man ejaculates. For some couples, RE can occur 30 seconds into vaginal penetration. For others, RE may extend out to five or ten minutes. As long as one of the partners is dissatisfied, RE is a problem. A man doesn’t have much control over how quickly he ejaculates.

Treatment options

Ejaculation is mostly an event of the autonomic nervous system, the part of our nervous system we can’t fully control. Heartbeat, digestion, sweating are all examples of neurologic processes our autonomic nervous system controls. Therefore, when a man gets a signal to ejaculate, the point of no return, he’s going to go. The most sensitive part of the penis is the area around the frenulum, the skin flap on the underside of the penis just below the urethral meatus (where he urinates). There is a spinal cord pathway that connects there and rapidly sends signals to the ejaculation center of the spinal cord. Additionally, a consistent trend was observed for PGIC score improvements, with improvement rates of 41.87%, 34.50%, and 54.98%, respectively, again favoring group C relative to groups A (P = .004) and B (P <.001).1 Safety data suggested treatment-emergent adverse events occurred among 17.36%, 16.17%, and 25.00% of patients in groups A, B, and C, respectively, with no statistically significant differences between groups (P = .098).

Premature Ejaculation Treatment

Penile Sensitivity: The ejaculatory spinal cord pathway is located at the ventral tip lovegra tablet of the corona (if you’re standing up and looking down at your penis, the ventral side is on the bottom. The corona is the mushroom head of your penis.) If a man has increased sensitivity at that point, he will likely ejaculate too fast. Applying topical numbing agents, usually containing lidocaine, is an effective way to reduce penile sensitivity and prolong ejaculation. It is important to wash the penis prior to intercourse, or wear a condom, to avoid desensitizing the partner, however. At UCLA Health—The Men’s Clinic, physicians are trained to treat rapid ejaculation and have a number of methods available.

Ejaculation Problems: Too Fast, Too Slow or Not at All

Treatment for PE and RE centers around behavioral, neurologic and hormonal modifications. Behavioral Therapy: Some patients respond to techniques such as starting and stopping. This basically involves interrupting intercourse to decrease stimulation to the penis in hopes of cooling the nerves down. Although effective at times, most patients report limited sexual satisfaction with these methods. Topical medications: One of the simplest treatment option is to temporarily desensitize the head of the penis by using a topical anesthetic medications for premature ejaculation. The most common treatment-emergent adverse events in group C were headache (9.09%), nausea (7.58%), flushing (7.95%), and dizziness (3.41%).