How to Use Lexapro for Premature Ejaculation

Vicky Davis

Medically reviewed by Vicky Davis, FNP

Written by Our Editorial Team

Last updated 4/23/2022

Premature ejaculation, or PE, is one of the most common male sexual dysfunctions. In fact, it’s estimated that as many as 39 percent of all adult men are affected by premature ejaculation to some degree.

A variety of treatments are available for PE, including topical sprays and prescription drugs that delay orgasm and ejaculation.

One such medication is Lexapro®, which contains the active ingredient escitalopram. Originally designed to treat depression, some research suggests that escitalopram can also improve male sexual function and slow down ejaculation.

Below, we’ve talked about what Lexapro is, how it works as a medication and how you can use Lexapro for premature ejaculation. 

We’ve also discussed other treatment options that you may want to consider if you’re one of the tens of millions of men affected by PE.


What Is Lexapro?

Lexapro is a common brand name for escitalopram, an antidepressant that’s currently approved by the Food and Drug Administration (FDA) to treat major depressive disorder (MDD) and generalized anxiety disorder (GAD) in adults.

Escitalopram belongs to a class of medications called selective serotonin reuptake inhibitors, or SSRIs. It works by increasing the levels of serotonin — an important neurotransmitter — in your brain and body.

Serotonin is involved in many of your body’s internal processes. In the brain, it’s thought to play a major role in regulating your moods, happiness and levels of anxiety. It’s also involved in the regulation of your sleep-wake cycle, digestive function and other important processes.

Low levels of serotonin are linked with several mental disorders, including depression. Experts think that medications such as escitalopram treat depression and anxiety by bringing your levels of serotonin back up to normal.

High levels of serotonin are associated with reduced levels of arousal. Research also shows a clear link between serotonin and inhibition of ejaculation — a finding that suggests that boosting serotonin levels may be helpful for men with PE.

What is Premature Ejaculation?

Premature ejaculation is a common form of sexual dysfunction in which orgasm and ejaculation occur sooner than you or your partner would like. It’s an extremely prevalent issue that affects men of all ages and backgrounds.

Definitions of premature ejaculation vary. The DSM-5 — a classification of mental disorders used by mental health professionals — defines PE as follows:

  • Ejaculation during partnered sexual activity that occurs within one minute after vaginal penetration, before a person wishes it, all or almost all the time.

  • Symptoms that continue for at least six months and cause clinical distress, without any clear explanation, such as a nonsexual mental disorder, medical condition, relationship distress or the use of medication.


Premature ejaculation can vary in severity. If you have mild PE, you may be able to have sex for 30 seconds to one minute before reaching orgasm and ejaculating. If you have severe PE, you may ejaculate almost immediately after penetration, or even before penetrative sex occurs.

Although many people think of PE as a purely sexual problem, it can have negative effects on a range of aspects of your life.

Premature ejaculation can have an enormous impact on self-esteem and make sexual intimacy more difficult to maintain. In addition to affecting your confidence, it can also potentially take a toll on your sexual partner.

Our detailed guide to premature ejaculation provides more information about the most common symptoms of PE, as well as causes and treatment options.

delay spray for men

longer sex is yours for the taking

Does Lexapro Treat Premature Ejaculation?

Over the years, researchers have studied several SSRIs and other prescription antidepressants as potential treatments for premature ejaculation.

Although escitalopram — the active ingredient in Lexapro — isn’t quite as well studied as certain other SSRIs, several studies have looked at its effects as a prescription medication for delaying orgasm and treating PE. 

In one study published in the journal Therapeutics and Clinical Risk Management in 2007, men with premature ejaculation were randomized into three groups, with one receiving fluoxetine (an SSRI sold as Prozac®), one receiving paroxetine (Paxil®) and the other escitalopram.

The men took the medication in the morning for four weeks. At the end of the treatment period, the researchers surveyed the men using a questionnaire to determine the effects of each SSRI on their intravaginal ejaculatory latency time and other aspects of sexual function.

All of the men that participated in the study showed improvements in ejaculation time, including the men that received escitalopram. All three of the medications displayed similar efficacy and were well tolerated.

In a different study published in the International Journal of Impotence Research in 2011, a team of researchers looked at the effects of escitalopram on men with PE.

The men, who all had lifelong premature ejaculation, were asked to record their ejaculation time for one month. After this, they started treatment with 10mg of escitalopram daily for 12 weeks in total.

By the third month of treatment, the men showed a significant increase in mean ejaculation time and decreased scores in a Premature Ejaculation Diagnostic Tool (PEDT) questionnaire.

However, they also displayed decreased sperm concentration, motility and size, suggesting that escitalopram may have a negative effect on sperm health and fertility.

Overall, most scientific evidence suggests that escitalopram helps to slow down ejaculation and improve sexual function in men with PE.

How to Use Lexapro for Premature Ejaculation

Brand name Lexapro and generic escitalopram are available in tablet form and as a solution for us by mouth. Your healthcare provider will likely recommend using this medication one time a day, either with or without a meal.

Since escitalopram is used off-label to treat PE, there isn’t a recommended dosage provided by the FDA. If you’re prescribed escitalopram, your healthcare provider will choose a dosage that’s appropriate for you based on your needs and medical history.

It can take several weeks for escitalopram to start working. Make sure to continue taking your medication even if you don’t notice improvements right away. Talk to your healthcare provider if you still have PE symptoms after using escitalopram for four weeks of treatment or longer. 

Can Lexapro Cause Side Effects?

As an SSRI, Lexapro and generic escitalopram are less likely to cause side effects than older antidepressants, such as tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs). However, like all medications, Lexapro can potentially cause some side effects.

Common side effects of escitalopram, the active ingredient in Lexapro, include:

  • Insomnia

  • Nausea

  • Increased sweating

  • Fatigue

  • Somnolence (drowsiness)

Like other SSRIs, escitalopram can cause potentially sexual side effects in addition to delayed orgasm and ejaculation. While using escitalopram, you may have a weak sex drive and a lower general level of interest in sexual activity than normal.

Lexapro and generic escitalopram can also interact with other medications, including those that increase serotonin levels. Make sure to let your healthcare provider know about all medications you currently use or have recently used before taking escitalopram.

Our full guide to SSRI side effects goes into more detail about potential adverse effects that you should be aware of before using escitalopram for premature ejaculation.

Other Treatments for Premature Ejaculation

Escitalopram is one of several medications used to treat premature ejaculation. Others include similar SSRIs, over-the-counter anesthetic products and even medications originally designed for treating erectile dysfunction. 

Some treatments for premature ejaculation are non-pharmacological. For example, PE is often treated with sexual behavior exercises and psychotherapy. You can learn more about the best treatment options for stopping premature ejaculation below.

Other SSRIs

Several other SSRIs are prescribed as off-label treatments for premature ejaculation, including sertraline (Zoloft®) and paroxetine (Paxil).

Like the escitalopram in Lexapro, these medications work by increasing serotonin levels in your brain and body. Research shows that they’re effective — for example, a 2019 systematic review found that sertraline delays ejaculation and improves sexual satisfaction in men with PE.

Like escitalopram, sertraline and paroxetine are prescription medications, meaning you’ll need to talk to your healthcare provider in order to use them. We offer both medications online in our range of premature ejaculation treatments

Our guide to sertraline for premature ejaculation and paroxetine for premature ejaculation offer more information about how these medications work as PE treatments. 

Over-the-Counter PE Treatments

If your premature ejaculation is mild, or if you’d prefer not to begin with prescription medication, you may want to try an over-the-counter treatment for PE.

Several over-the-counter PE treatments are available, including anesthetic creams and sprays that reduce sensitivity in your penis. These products can be applied before sex to improve your stamina and prevent you from reaching orgasm and ejaculating too early.

Our Delay Spray for Men and Clockstopper Climax Delay Wipes are formulated using lidocaine and benzocaine respectively to reduce sensitivity and help you last for longer in bed, all without overly numbing your penis.

You can learn more about how topical treatments for PE work in our guide to lidocaine spray for premature ejaculation

ED Medications

Some medications used to treat erectile dysfunction, including PDE5 inhibitors such as sildenafil (the active ingredient in Viagra®) have been found to slow down orgasm and ejaculation in men affected by PE.

For example, one study published in the International Journal of Urology in 2007 found that men with PE who used sildenafil experienced bigger improvements in sexual performance and fewer side effects than men who used the SSRI paroxetine.

Other medications for ED include tadalafil (the active ingredient in Cialis®), vardenafil (Levitra®) and avanafil (Stendra®). 

These medications work by increasing blood flow to the tissue inside your penis, helping you to get and maintain an erection. Our guide to PDE5 inhibitors goes into greater detail about how they work and how you can use them for better sexual performance.

We offer sildenafil for PE online, following a private consultation with a healthcare provider who will determine if a prescription is appropriate.

Behavioral Techniques

Some forms of behavioral therapy, including techniques that you can use during sex, may help to slow down orgasm and treat PE.

Two of the most common behavioral approaches for dealing with premature ejaculation are the stop-start technique and squeeze technique

The stop-start technique involves having sex as normal until you feel ejaculation approaching, then stopping to relax and allow the sensation to pass.

The squeeze technique is similar. It involves having sex until you’re close to reaching orgasm and ejaculating, then firmly squeezing the area just between the glans (head) and the shaft of your penis until you no longer feel stimulated and ready to ejaculate.

Both of these techniques can be repeated during sex, allowing you to delay orgasm and have sex for longer. However, research isn’t clear about their long-term effectiveness.

Our list of ways to last longer in bed shares other behavioral techniques and at-home methods that may help to improve your stamina and sexual function.

Psychotherapy

Premature ejaculation is at least partly psychological in nature, and research suggests that talk therapy, or psychotherapy, is often helpful for reducing its severity.

Psychotherapy can help to address the negative feelings and thoughts that may be involved in the development of PE. For example, you might take part in therapy to address specific issues such as sexual performance anxiety or a lack of confidence in the bedroom.

We offer individual therapy with licensed counselors as part of our range of online mental health services

premature ejaculation treatment

improve performance with doctor-trusted treatments

Learn More About Dealing With PE

Premature ejaculation is a common problem for men, and research shows that antidepressant medications like Lexapro are often effective at treating it.

If you’re one of the tens of millions of men in the United States affected by PE, don’t hesitate to ask your healthcare provider for help. PE is treatable, and reaching out for expert help is a vital first step toward overcoming premature ejaculation and improving your sexual function.

Want to get started right away? We offer a range of premature ejaculation treatments, including over-the-counter products and oral medications similar to Lexapro. 

You can also learn more about your options for dealing with PE in our guides to home remedies for PE and premature ejaculation pills.

11 Sources

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.

  1. McMahon, C.G. (2007, April-June). Premature ejaculation. Indian Journal of Urology. 23 (2), 97-108. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2721550/
  2. Lexapro® (escitalopram oxalate) Tablets. (2017, January). Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/021323s047lbl.pdf
  3. Escitalopram. (2022, January 15). Retrieved from https://medlineplus.gov/druginfo/meds/a603005.html
  4. Brain Hormones. (2022, January 23). Retrieved from https://www.endocrine.org/patient-engagement/endocrine-library/hormones-and-endocrine-function/brain-hormones
  5. Giuliano, F. & Clément, P. (2006, September). Serotonin and premature ejaculation: from physiology to patient management. European Urology. 50 (3), 454-466. Retrieved from https://pubmed.ncbi.nlm.nih.gov/16844284/
  6. Crowdis, M. & Nazir, S. (2021, July 1). Premature Ejaculation. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK546701/
  7. Arafa, M. & Shamloul, R. (2007, August). A randomized study examining the effect of 3 SSRI on premature ejaculation using a validated questionnaire. Therapeutics and Clinical Risk Management. 3 (4), 527-531. Retrieved from https://pubmed.ncbi.nlm.nih.gov/18472973/
  8. Koyuncu, H., et al. (2011). Escitalopram treatment for premature ejaculation has a negative effect on semen parameters. International Journal of Impotence Research. 23, 257-261. Retrieved from https://www.nature.com/articles/ijir201135
  9. Yi, Z.-M., et al. (2019, June). Efficacy and safety of sertraline for the treatment of premature ejaculation Systematic review and meta-analysis. Medicine (Baltimore). 98 (23), e15989. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6571276/
  10. Wang, W.-F., Wang, Y., Mihnas, S. & Ralph, D.J. (2007, April). Can sildenafil treat primary premature ejaculation? A prospective clinical study. International Journal of Urology: Official Journal of the Japanese Urological Association. 14 (4), 331-335. Retrieved from https://pubmed.ncbi.nlm.nih.gov/17470165/
  11. Dhaliwal, A. & Gupta, M. (2021, June 25). PDE5 Inhibitors. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK549843/

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.