Medically reviewed by Kristin Hall, FNP
Written by Our Editorial Team
Last updated 1/31/2022
Premature ejaculation (PE) is one of the most common forms of sexual dysfunction in men, with research suggesting that up to 39 percent of men are affected. If you’re dealing with premature ejaculation, you’re most certainly not alone.
Sertraline is an antidepressant. As you’d expect, it’s usually prescribed to treat depression and other psychiatric disorders. But did you know that it’s also used off-label to treat sexual function and performance issues like premature ejaculation?
Sertraline for premature ejaculation isn’t generally something most people think about, but the supporting evidence is there, and you should be aware of it.
If you’re one of the tens of millions of men in the United States affected by PE, using sertraline may help you to improve your sexual function and get greater control over your ability to reach orgasm and ejaculate.
Below, we’ve explained what premature ejaculation is, as well as what you might experience if you’re affected by PE. We’ve also explained what sertraline is, how it works as a PE treatment and how you can use it for better sexual performance and enjoyment.
Finally, we’ve shared a few other treatments for PE that you might want to consider, either with sertraline or on their own.
Premature ejaculation, or rapid ejaculation, is a common sexual disorder in men. Although it’s normal to reach orgasm a little earlier than you’d like to sometimes, men affected by PE find it difficult to have sex for a normal amount of time without ejaculating.
For the most part, PE is defined as an intravaginal ejaculatory latency time (IELT) of one minute or less, although some definitions view ejaculation within 60 to 90 seconds as “probable” PE.
In comparison, research suggests that the median intravaginal ejaculatory latency time is about five minutes.
In addition to short ejaculation time, premature ejaculation involves ejaculation before a person or their partner would like it to happen, with symptoms that persist for six months or longer and cause significant distress.
Premature ejaculation ranges from mild to severe. Mild PE is ejaculation that happens 30 to 60 seconds after penetration, while moderate PE occurs within 15 to 30 seconds of penetration. In cases of severe PE, ejaculation might occur almost immediately, or even before penetration.
Like other forms of sexual dysfunction, PE can be a lifelong problem that affects someone from their first sexual experience, or a situational issue that only occurs with certain partners or types of sexual stimulation.
Although the exact cause of premature ejaculation isn’t yet known, experts believe that a variety of factors may play a role. These include:
Abnormal levels of serotonin
Abnormal hormone levels
Mental disorders, such as depression or anxiety
Feelings of guilt or stress about sexual activity
Lack of confidence or poor body image
Unrealistic sexual expectations or sexual performance anxiety
A history of sexual repression or sexual abuse
Our guide to premature ejaculation goes into more detail about what PE is, how it might develop and the symptoms you may notice if you’re affected.
Sertraline is an antidepressant. You might have heard of it before as Zoloft®, the original brand name used by Pfizer to market this medication.
Sertraline belongs to a class of antidepressants called selective serotonin reuptake inhibitors, or SSRIs. It’s one of the most widely used antidepressants in the world, with millions of users in the United States and many more in other countries.
As an antidepressant, sertraline works by increasing levels of the neurotransmitter serotonin in the brain and body. Serotonin is involved in controlling certain aspects of your personality and mood, with research suggesting that it plays a role in the development of depression.
By boosting serotonin levels, SSRIs like sertraline can help to treat the symptoms of depression and other mood disorders.
Although it was originally developed as an antidepressant, sertraline is used to treat a variety of medical conditions. Today, it’s a common medication for treating obsessive-compulsive disorder (OCD) social anxiety disorder (SAD), posttraumatic stress disorder (PTSD) and panic disorder.
Sertraline is also prescribed off-label as a treatment for premature ejaculation. In fact, it’s one of the most widely used premature ejaculation pills on the market today.
Despite being best known for its antidepressant effects, sertraline works surprisingly effectively as a treatment for premature ejaculation.
In fact, over the years, numerous studies of sertraline have shown that it can extend intravaginal ejaculation latency time (IELT, or the average time during sexual intercourse that passes prior to a man reaching orgasm and ejaculating).
Some of these studies show significant increases in IELT in men with premature ejaculation who use sertraline.
For example, in one 1998 study published in the International Journal of Impotence Research, a group of men aged between 22 and 63 with premature ejaculation were treated with sertraline to assess its effects on sexual performance.
The men were given oral sertraline tablets and started the study at a dose of 25mg per day. By week three, the dosage was increased to 50mg of sertraline per day. At week six, it was further increased to 100mg of sertraline per day.
None of the men received any formal psychosexual therapy -- the only form of treatment was a daily dose of sertraline.
At the start of the study, the men had a mean ejaculatory interval of one minute, with a range of zero to five minutes.
With a 25mg daily dose of sertraline, the average ejaculatory interval of the men increased from one minute to 7.6 minutes, with a range of zero to 20 minutes. With a 50mg dose, the average ejaculatory interval increased to 13.1 minutes.
At a daily dose of 100mg of sertraline, the men’s average ejaculatory time was 16.4 minutes. In addition to the significant increase in average ejaculation time, the minimum ejaculation interval also increased, with a total range of seven minutes to anejaculation (inability to ejaculate).
During the study, side effects were limited. At the full dose of 100mg per day, the most common side effects were dyspepsia (indigestion), feelings of anxiety, transient drowsiness and anorexia, as well as erectile dysfunction and reduced libido.
These issues were reported by fewer than 10% of the men who took part in the study, with most participants reporting no side effects from sertraline.
Other studies of sertraline for premature ejaculation have produced similar results, with notable improvements ejaculation time and general sexual function.
In a study published in the journal Urology in 1999, men affected by premature ejaculaton who used sertraline were able to significantly increase their average ejaculation latency.
Before treatment, the men had an average ejaculation time of 23 +/- 19 seconds. After taking sertraline for two weeks at a daily dose of 50mg, the men’s average ejaculation time increased to 5.9 +/- 4.2 minutes.
This same study also found that sertraline works as a treatment for premature ejaculation when used on an as-needed basis.
When the men used sertraline as needed on the day of intercouse at a dose of 50 to 100mg, the average ejaculation time of the men rose from 23 +/- 19 seconds to 5.1 +/- 3.8 minutes after two weeks, and 4.5 +/- 2.7 minutes after four weeks.
Not only were the men involved in the study able to have sex for a longer amount of time before reaching orgasm and ejaculating -- both they and their partners reported higher levels of sexual satisfaction after the men started treatment with sertraline.
At the beginning of the study, the men’s partners recorded an average sexual satisfaction score of 1.1 +/- 0.7 (zero meaning extremely unsatisfied and five meaning extremely satisfied).
After four weeks of treatment with sertraline, the men’s partners had an average score of 3.3 +/- 1.2.
The men’s satisfaction scores increased from an average of 0.8 +/- 0.8 prior to treatment to 3.4 +/- 1.0 after two weeks of treatment with 50 or 100mg of sertraline as needed. After four weeks, the men reported a similar average satisfaction score of 3.2 +/- 0.7.
Just like in the 1998 study, side effects were rare. One study participant experienced excessive delay of ejaculation, with another reporting numbness and two experiencing fatigue.
In short, studies show that using sertraline for premature ejaculation works, and that the results are significant. Not only were men with PE able to increase their time to ejaculation through use of sertraline -- they also reported higher levels of sexual satisfaction.
Sertraline can be used to treat premature ejaculation in two different ways. The first way to use sertraline is as a daily-use medication, meaning you’ll take a dose of sertraline every day, even if you don’t always expect to have sex on that day.
The second is as an as-needed medication for premature ejaculation. In this case, you’ll take a sertraline tablet only on the days when you plan to have sex.
There’s no “ideal” way to use sertraline for PE for everyone. The most effective approach is to follow your healthcare provider’s instructions and take your prescribed sertraline dosage either as needed or on a daily basis.
Although sertraline is effective, results aren’t always immediate. It may take several weeks for sertraline to become completely effective as a treatment for PE. In the studies above, most of the men experienced the largest improvements after using sertraline for four weeks.
Currently, sertraline is only approved by the FDA as a treatment for major depressive disorder, obsessive-compulsive disorder, panic disorder and several other mental health conditions.
When sertraline is prescribed to treat premature ejaculation, it’s considered an off-label use of the medication. This means that the FDA does not provide a specific recommended dosage of sertraline for treating PE as it does for depression and anxiety disorders.
Most studies of sertraline as a premature ejaculation treatment involve a daily dose of between 25mg and 100mg.
We offer sertraline for premature ejaculation as a 50mg tablet, available following a consultation with a licensed healthcare provider who will determine if a prescription is appropriate.
Sertraline is a safe and effective medication for most people. However, like other SSRIs, it can potentially cause side effects. Most side effects of sertraline are mild and only occur in a small percentage of users, especially at the low dose that’s generally used to treat PE.
In rare cases, sertraline may cause more serious side effects. It’s also possible for sertraline to interact with other medications and cause adverse effects and allergic reactions.
Common side effects of sertraline include:
Difficulty falling asleep or staying asleep
Loss of appetite
Nausea and/or vomiting
Changes in sex drive and sexual desire
Changes in sexual function or performance
However, it’s important to note that most scientific research on sexual side effects from SSRIs involves people who take these medications to treat depression and anxiety disorders, not as off-label treatments for premature ejaculation.
Overall, only a tiny percentage of men who use sertraline -- just four percent in clinical trials of Zoloft, a popular branded version of sertraline -- experience erectile dysfunction.
Our detailed guide to sertraline’s sexual side effects goes into more detail about the risk of ED while using sertraline to treat premature ejaculation, as well as the steps that you can take with your healthcare provider to avoid it.
Although most side effects from sertraline are mild, there are some safety risks and interactions that you should be aware of before using sertraline to treat PE.
The first of these is that sertraline can cause an issue called serotonin syndrome when it’s used at the same time as serotonergic medications, meaning other drugs that also cause an increase in your body’s levels of serotonin.
Other medications that can cause serotonin syndrome when used with sertraline include opioid pain medications, triptans, amphetamines and supplements such as St. John’s wort.
Serotonin syndrome can cause a range of serious symptoms, including delirium, hallucinations and other changes in your mental state. In some cases, it may be life-threatening.
To avoid drug interactions while using sertraline for PE, it’s important to inform your healthcare provider about any medications, both prescription and over the counter, you currently use or have recently used, including medications you have taken during the previous two weeks.
While sertraline is safe, convenient and highly effective, it’s not the only treatment available for premature ejaculation.
Other options for treating PE include topical sprays, behavioral therapy, sexual techniques and even medications like sildenafil (the active ingredient in Viagra®).
We’ve listed these options below -- including several effective home remedies for dealing with premature ejaculation -- as well as other resources to help you learn more about successfully treating premature ejaculation.
If you want to treat premature ejaculation without using oral medication, you may want to try a topical spray.
Topical sprays containing lidocaine are a popular, effective treatment for increasing ejaculation latency and stopping premature ejaculation. They’re applied to your penis before sex and work by reducing its sensitivity level to stop you from reaching orgasm too quickly.
Lidocaine is a safe, widely used local anesthetic. If you’ve ever gotten dental surgery, there’s a good chance your dentist used lidocaine or a similar local anesthetic to desensitize your gums before the procedure.
Used topically, lidocaine works by making your penis less sensitive to touch. During sex, you’ll feel slightly less, stopping you from ejaculating early due to physical stimulation. You’ll still stay hard and enjoy the experience, just with a slightly reduced level of sensation.
Our Delay Spray for Men contains lidocaine to reduce sensitivity and help you last longer while you have sex, all without overly numbing.
Studies show that lidocaine sprays work well as a treatment for premature ejaculation. In a 2003 study, a topical lidocaine spray increased average intravaginal ejaculation latency time from just 84 seconds to 11 minutes and 21 seconds for men with premature ejaculation.
Our full guide to lidocaine and premature ejaculation goes into more detail about how lidocaine works as a treatment for PE, as well as how you can use it to increase your ejaculation latency and enjoy longer, more satisfying sex.
Interestingly, some medications used to treat erectile dysfunction, such as sildenafil (the active ingredient in Viagra) and tadalafil (Cialis®) may also offer benefits as treatments for premature ejaculation.
The precise mechanism by which erectile dysfunction drugs treat premature ejaculation isn’t known. However, several studies show that men with premature ejaculation who use erectile dysfunction drugs tend to have longer ejaculation times than their peers.
In a 2007 study, researchers found that sildenafil was more effective at treating symptoms of premature ejaculation than paroxetine, a commonly used SSRI. The researchers concluded that sildenafil is “very effective and safe to treat PE.”
Sildenafil, tadalafil and other erectile dysfunction drugs can also shorten the refractory period, which is the amount of time that’s required for you to recover your normal sexual function after you have sex and ejaculate.
This means that you may be able to enjoy round two earlier than you would without the use of medication.
We offer several ED treatments online, following a consultation with a healthcare provider who will determine if a prescription is appropriate.
Our guide to premature ejaculation pills goes into more detail on how ED medications such as sildenafil can be used to treat premature ejaculation and improve sexual performance.
When your premature ejaculation is caused by a psychological issue, taking part in therapy is often a helpful way to change your thought patterns and improve your sexual function.
In fact, research shows that a mix of medication and sexual behavioral treatment works better than medication alone for many men with premature ejaculation.
Several different forms of therapy may be used to treat premature ejaculation and other sexual performance issues, including sex therapy, couples therapy and others.
Our full guide to premature ejaculation therapy goes into more detail about the mix of cognitive and behavioral approaches used to treat PE.
While medications are usually the most effective way to increase ejaculation time and treat PE, they’re far from the only option.
If you have mild premature ejaculation, you might be able to increase your ejaculation time by practicing the “stop-start” strategy or “squeeze” technique.
Both of these techniques are easy but effective when used properly. The stop-start strategy is exactly what it sounds like -- during sex, when you feel yourself about to orgasm, slow down or stop moving completely and give yourself some time to recover, then continue.
The squeeze technique is equally simple -- when you feel that you’re approaching orgasm, use your thumb and finger to gently squeeze the area between the shaft and glans of your penis for about 30 seconds. Once you feel relaxed, go back to having sex as normal.
These techniques are associated with short-term benefits, but their long-term effectiveness isn’t very well studied.
As simple as it might sound, masturbating shortly before you have sex can be a good way to increase your ejaculation latency and avoid ejaculating too early.
The idea behind this technique, which is referred to as precoitus masturbation, is simple. After you orgasm, you’ll start your refractory period -- a recovery phase in which you’ll usually find it more difficult to orgasm again.
This means you’ll find it easier to last longer during sex, potentially improving your sexual performance and satisfaction.
The effectiveness of precoitus masturbation isn’t well studied, although it’s often suggested as an option for younger men with PE. Just be aware that it’s important to get the timing right, as masturbating too close to sex could have a negative effect on your sexual performance.
Our guide to stopping premature ejaculation goes into more detail about this technique, as well as other options for avoiding PE and improving your sexual function.
Premature ejaculation is a common sexual health issue that affects tens of millions of men every year in the United States alone. It occurs in men of all ages and backgrounds, and it can vary in severity from mild and occasional to severe and persistent.
The good news is that premature ejaculation is usually easily treatable with medication, therapy, behavioral techniques or a mix of different approaches.
Tired of dealing with PE? We offer a range of premature ejaculation treatments online, including prescription medications such as sertraline and paroxetine and over-the-counter treatments like our Delay Spray for Men and Clockstopper Climax Delay Wipes.
You can also find out more about PE, from its causes and symptoms to treatment options, in our premature ejaculation guide.