Premature Ejaculation Treatment Selector
Which Premature Ejaculation Treatment is Right for You?
Answer a few questions to find the most suitable treatment option based on your needs and lifestyle.
Your Situation
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| Option | Cost | Onset Time | Best For |
|---|---|---|---|
| Dapoxetine | £45-£60 | 30-60 min | |
| Sertraline | £15-£20 | 1-2 weeks | |
| Lidocaine Spray | £8-£12 | 10-15 min | |
| Behavioral Therapy | Free | Weeks to months |
Ever wonder why some men swear by a single pill before bedtime while others prefer a spray or a daily antidepressant for premature ejaculation (PE)? The market is crowded, and choosing the right option feels like a gamble. This guide breaks down dapoxetine and its main rivals, so you can see which one fits your lifestyle, budget, and health profile.
Key Takeaways
- Dapoxetine is the only on‑demand oral drug approved specifically for PE.
- SSRIs such as sertraline and paroxetine work off‑label and require daily dosing.
- Topical anesthetic sprays act locally, have rapid onset, but can reduce sensation for both partners.
- Behavioral techniques involve no medication and are best as first‑line or adjunct therapy.
- Cost, side‑effect profile, and how often you need the medication are the biggest decision factors.
What Is Dapoxetine?
Dapoxetine is a short‑acting selective serotonin reuptake inhibitor (SSRI) that the European Medicines Agency approved in 2009 specifically for the treatment of premature ejaculation. Its trade name in the UK is Priligy. Unlike traditional SSRIs, dapoxetine’s half‑life is roughly 1.5hours, allowing it to be taken 1-3hours before sexual activity and cleared from the system by the next day.
How Dapoxetine Works
When you swallow a dapoxetine tablet, it boosts serotonin levels in the central nervous system. Higher serotonin delays the ejaculatory reflex, extending intravaginal ejaculation latency time (IELT) by an average of 2-3minutes compared with baseline. Because it clears quickly, the drug doesn’t accumulate, meaning the typical side‑effects of chronic SSRIs-like weight gain or emotional blunting-are minimal.
Common Alternatives
Below are the most frequently mentioned substitutes, each with a brief definition and key attributes.
- Sertraline is a long‑acting SSRI prescribed for depression and anxiety but often used off‑label for PE. The usual dose is 50mg daily, taken continuously.
- Paroxetine is another SSRI with the strongest ejaculation‑delaying effect among its class. Typical regimens start at 20mg once daily.
- Clomipramine is a tricyclic antidepressant that also raises serotonin. Doses range from 25‑50mg nightly.
- Lidocaine‑Prilocaine Spray (e.g., TEMPE) is a topical anesthetic applied to the penis 10‑15minutes before sex, numbing sensory nerves to reduce premature climax.
- Behavioral Therapy includes techniques like the "stop‑start" or "squeeze" methods. No drugs are involved; success depends on practice and communication.
Side‑Effect Snapshot
All medicines carry risks. Here’s what users typically report:
- Dapoxetine: nausea, headache, dizziness (usually mild, fade after a few doses).
- Sertraline & Paroxetine: sexual dysfunction (loss of libido), dry mouth, insomnia-often more pronounced because the drug stays in the system for days.
- Clomipramine: constipation, weight gain, occasional cardiac concerns (requires ECG monitoring for high‑risk patients).
- Topical Spray: temporary loss of sensation for both partners, rare allergic skin reactions.
- Behavioral Therapy: no pharmacologic side‑effects, but can cause frustration if partners are not on board.
Comparing the Options
| Attribute | Dapoxetine | Sertraline (off‑label) | Paroxetine (off‑label) | Clomipramine | Lidocaine‑Prilocaine Spray | Behavioral Therapy |
|---|---|---|---|---|---|---|
| Mechanism | Short‑acting SSRI | Long‑acting SSRI | Long‑acting SSRI | Tricyclic antidepressant | Local anesthetic | Psychological/physiological techniques |
| Dosage Regimen | 1tablet 1-3h before sex (30mg or 60mg) | 50mg daily | 20mg daily | 25-50mg nightly | 2-3 sprays 10-15min before sex | Practice sessions 2-3times per week |
| Onset of Action | 30-60min | 1-2weeks | 1-2weeks | 1-2weeks | 10-15min | Varies; weeks to months of training |
| Average IELT Increase | +2.5min (clinical trials) | +1.5min | +1.8min | +1.2min | +1min (depends on spray strength) | +0.5-1min (when combined with other methods) |
| Common Side Effects | Nausea, headache, dizziness | Sexual dysfunction, insomnia | Sexual dysfunction, weight gain | Constipation, dry mouth, ECG changes | Reduced penile sensation, skin irritation | Frustration, need for partner cooperation |
| Prescription Status (UK) | Prescription‑only medicine (POM) | POM (off‑label) | POM (off‑label) | POM | Over‑the‑counter (OTC) in many pharmacies | Non‑medical |
| Typical Cost per Month (GBP) | £45‑£60 (depending on dosage) | £15‑£20 | £12‑£18 | £10‑£15 | £8‑£12 | Free (time investment) |
Which Option Suits Your Situation?
Use the following guide to match your personal needs to a treatment.
- Occasional Sex, Need Flexibility: Dapoxetine shines when you can’t predict the timing of intimacy. Its on‑demand nature means you won’t be tied to a daily pill.
- Frequent Sex, Cost‑Sensitive: Daily SSRIs like sertraline or paroxetine are cheaper per dose and work well if you have sex several times a week. Expect a few weeks for the effect to build.
- Concerned About Systemic Side Effects: Topical lidocaine‑prilocaine spray limits drug exposure to the penis, making it a good choice if you have heart issues or are taking other meds that interact with SSRIs.
- Prefer No Medication: Behavioral therapy can be effective, especially when combined with a mild topical. It also improves communication with your partner.
- Already on Antidepressants: If you’re taking an SSRI for mood, your doctor may simply adjust the dose for PE rather than start a new drug.
Safety Tips & Practical Advice
Before you start any of these treatments, keep the following in mind:
- Always discuss with a GP or urologist, especially if you have heart disease, liver impairment, or are on other serotonergic meds (risk of serotonin syndrome).
- Dapoxetine should not be taken with alcohol in excess; it can heighten dizziness.
- If you experience persistent nausea with dapoxetine, try taking it with a light snack or switch to a lower 30mg dose.
- For topical sprays, apply exactly as directed-over‑application can numb the partner and lower pleasure.
- When using daily SSRIs, give the medication at least two weeks before judging effectiveness. Expect initial sexual side‑effects to wane after the first month.
- Behavioral techniques require patience. Set aside dedicated practice time, and be honest with your partner about progress.
Next Steps
1. Book a confidential appointment with your GP to discuss symptoms and get a prescription if needed.
2. Compare prices at local pharmacies (some offer discount cards for chronic prescriptions).
3. If you opt for a topical spray, purchase from a reputable pharmacy and read the leaflet for contraindications.
4. Consider pairing any medication with a brief behavioral session-many men see an extra 30‑seconds gain.
Frequently Asked Questions
Can I take dapoxetine with other antidepressants?
Mixing dapoxetine with other SSRIs or SNRIs can increase serotonin levels too much, raising the risk of serotonin syndrome. Your doctor may need to pause the other drug before starting dapoxetine.
How long does dapoxetine stay in my system?
Its half‑life is about 1.5hours, so most of the drug clears within 12hours. By the next morning you should feel normal, unlike longer‑acting SSRIs that linger for days.
Is the lidocaine‑prilocaine spray safe for daily use?
It’s safe for intermittent use, but daily application can cause skin irritation and may dull sensation for both partners. Rotate with other methods if you need frequent coverage.
Do behavioral techniques work without medication?
Yes, many men achieve modest gains (0.5‑1minute) using the stop‑start or squeeze method, especially when practiced consistently and combined with good communication.
Which treatment is cheapest in the long run?
If you have sex several times a week, a daily low‑dose SSRI (sertraline or paroxetine) usually costs less than buying dapoxetine tablets each time. Topical sprays are cheap per use but may need frequent re‑application.
13 Comments
Alright, let’s break this down, step by step, because the market is a mess, and you need clarity; dapoxetine is on‑demand, cheap enough for occasional use, but the side‑effects aren’t negligible, especially the nausea; if you can’t handle a little stomach upset, look elsewhere, maybe the spray is safer.
Wow, what a comprehensive guide! I love how you laid out the pros and cons so clearly, it really helps anyone feeling overwhelmed. Keep the drama low and the info high-great job!
For anyone still unsure, remember that consistency matters more than the brand name. If you’re on a tight budget, sertraline can be an effective starter while you test the waters. Also, the topical spray works best when applied exactly ten minutes before intimacy-no more, no less. Don’t forget to discuss any heart conditions with your GP before choosing a systemic SSRI. Lastly, combining a low‑dose medication with behavioral techniques often yields the best overall gain.
Dapoxetine is the only on‑demand oral option approved for PE.
Let me lay it out in full detail, because clarity is paramount and half‑answers only breed confusion; first, understand the pharmacokinetics of dapoxetine, which boasts a half‑life of roughly 1.5 hours, meaning it is cleared from your system by the next morning, unlike traditional SSRIs that linger for days and cause cumulative side effects, a fact that makes it uniquely suited for on‑demand use, especially for those whose sexual activity is unpredictable, and this rapid clearance also reduces the risk of serotonin syndrome when combined with other serotonergic agents, provided you follow proper washout periods; second, consider the dosage options-30 mg for beginners to gauge tolerance, and 60 mg for those who need a stronger effect, always taking the tablet 1–3 hours before intercourse, allowing sufficient plasma concentration to modulate the ejaculatory reflex without over‑sedation, which can be a pitfall with higher doses; third, compare the cost structure, as dapoxetine typically runs £45‑£60 per month, which, while higher than generic sertraline, may be justified by its on‑demand nature, saving you from daily pill fatigue and the associated weight gain and sexual dysfunction that patients often report with long‑acting SSRIs; fourth, evaluate side‑effects-common complaints include mild nausea, headache, and dizziness, which usually subside after a few doses, but if these become persistent, a lower dose or food intake can mitigate them; fifth, assess drug interactions-avoid concurrent use with MAO inhibitors or other serotonergic drugs, and be cautious with alcohol, as it can exacerbate dizziness; sixth, recognize patient‑specific factors such as cardiac issues, where a topical lidocaine‑prilocaine spray may be safer because it avoids systemic exposure, though it can reduce sensation for both partners; seventh, do not overlook the psychological component-behavioral therapy, when paired with pharmacotherapy, can extend the intravaginal ejaculation latency time (IELT) beyond the drug’s pharmacological ceiling, offering a more durable solution; eighth, remember that prescribing dapoxetine requires a legitimate medical indication, so a confidential discussion with your GP is essential to rule out underlying conditions; ninth, keep in mind the legal landscape-while dapoxetine is prescription‑only in the UK, some regions may have different access pathways, so verify local regulations; finally, plan for long‑term management-if you find dapoxetine effective, schedule periodic follow‑ups to monitor efficacy and any emerging side‑effects, adjusting the regimen as needed, and always stay informed about new studies that may refine dosing strategies or introduce alternative agents, ensuring you maintain the best possible sexual health outcomes.
Just a quick note: the word “effects” should be plural when you’re talking about multiple outcomes, and “its” is possessive, not a contraction of “it is” in the phrase “its onset”. Also, avoid double spaces after periods-keeps the text tidy. Other than that, great post!
Thanks for the thorough breakdown!!! It really helps anyone juggling budgets and health concerns-especially the tip about taking dapoxetine with a light snack to ease nausea!!! Keep the info coming, folks!!!
Oh wow, another “miracle pill”. Sure, if you like paying extra for a quick fix. 🙄
Life’s simple: you either grab the pill or you don’t. No drama, just choice.
Listen, the pharma giants definitely push dapoxetine as the “only solution” while keeping the cheaper sprays under the radar, because they want you dependent on pricey meds; the real truth is hidden in plain sight-your own body can be trained, but they don’t want that.
From a neuropharmacological perspective, dapoxetine’s rapid serotonin reuptake inhibition modulates the ejaculatory latency circuit in the spinal cord, effectively extending IELT without the neuroadaptive tolerance seen in chronic SSRIs; however, the clinical heterogeneity among patients necessitates a personalized approach, integrating both pharmacodynamic considerations and behavioral conditioning to optimize therapeutic outcomes.
Stop buying overpriced pills and get a cheap spray if you have a heart condition; the evidence is clear and the side‑effects are minimal, so why bother with the fancy brand?
Hey everyone, I just want to say that regardless of which option you pick, the most important thing is open communication with your partner and a willingness to experiment safely; try a low dose of dapoxetine first and see how you feel, then consider adding a few behavioral exercises like the stop‑start method to build confidence; remember that consistency beats perfection, and even small improvements in IELT can boost overall satisfaction; don’t get discouraged if you don’t see massive changes overnight-progress is gradual, and the combination of a modest pharmacologic aid plus steady practice often yields the best long‑term results.