Medically reviewed by Mary Lucas, MSCIS, MPhil, RN
Written by Our Editorial Team
Last updated 11/4/2021
Can a prescription painkiller kill the pain of premature ejaculation issues?
The medical community is working long and hard to keep you harder longer, but where erectile dysfunction has a bevvy of treatments available to its sufferers, premature ejaculation is still an area of sexual dysfunction where options are lacking.
Premature ejaculation is a major concern for men suffering from it — control over ejaculation may be an intimate issue, but difficulty in ejaculation can lead to intimacy issues and confidence issues that can have lasting effects if left unaddressed.
Part of the concern is that quick or rapid ejaculation has many potential causes, and the scientific community is still on the hunt for a root cause.
But the science is catching up, and clinical trials are looking into the potential role of drugs like tramadol in increasing the quality of life for people currently struggling with maintaining control over ejaculation.
Still, the results already showing for tramadol are surprising, if only for the fact that this type of medication wouldn’t seem to effectively qualify for premature ejaculation treatment.
Tramadol is a prescription strength pain relief medication designed to combat the effects of moderate to moderately severe pain.
It's a pain reliever in the class of narcotic analgesics, or alternatively, opiates, which is a complicated way of saying that it changes the way your brain and nervous system respond to pain signals.
It’s used for a variety of relief situations, typically for pain experienced outside of a hospital.
Tramadol comes in many forms, including liquid solutions and tablets, as well as long-acting capsules and extended-release tablets.
It’s a flexible medication, too. It can be delivered to treat immediate pain quickly, or designed to treat pain that is experienced ‘round-the-clock with extended relief delivery methods.
It can be taken with or without food in some cases, but should be taken exactly as directed by a healthcare professional, for your particular needs.
It’s important to not just stop taking tramadol abruptly without the guidance and direction of a health professional as it can cause withdrawal symptoms.
In addition to opioid-related concerns about addiction and dependency (more on that below!), tramadol may cause muscle tightness, headaches, sleepiness, difficulty falling asleep, dry mouth, heartburn or indigestion, nervousness, uncontrollable shaking of a body part and changes in mood.
Serious side effects should be brought immediately to the attention of a healthcare professional, and these include hives, seizures, blisters, rash, difficulty swallowing or breathing, swelling of the eyes, face, tongue, lips, hands, feet, ankles or other body part, hoarseness, decreased sexual desire, inability to keep or get an erection, nausea and vomiting or seizures.
A review of efficacy found that a daily dose of tramadol did offer some benefits.
One evaluation of tramadol published in 2013 sought to define the efficacy of tramadol for premature ejaculation sufferers with a test group of 60 healthy study participants between ages 28 to 45, who were not taking certain other types of medications.
The group was divided into a 100mg therapeutic group and a placebo group for four weeks. After four weeks of treatment, the tramadol medicated group saw their time to orgasm or intra-vaginal ejaculatory latency time more than tripled (and they saw increase in baseline satisfaction too), with the placebo group not experiencing the same effects on ejaculation time.
What’s more interesting, though, is that the study did not conclude that any difference was found between regular or daily treatment with tramadol and sporadic treatment or as-needed treatment with tramadol.
In other words, tramadol for premature ejaculation can theoretically be taken either as needed or daily, which would offer patients a larger variety of treatment options to employ based on their individual needs.
The study in question concluded that, while SSRIs (another frequently prescribed, off-label PE treatment) were also effective, the long-term risk of adverse effects and psychiatric issues was worthy of concern.
This is perhaps ironic, given that tramadol could be considered a habit-forming pain relief medication with prolonged use.
This is a concern we need to address — it’s the largest single concern associated with the safety of tramadol for premature ejaculation. That concern is addiction potential.
Chances are, if you’re even the most occasional national and world news consumer, you know opioids cause significant community problems for addiction and overdose every year, across the U.S. and the world.
While other opioids may get most of the headlines, even a lesser known medication like tramadol can cause addiction problems if misused.
That’s aside from the other side effects mentioned above.
If you’re prescribed this medication for PE, it will be the best option according to your chosen healthcare professional, but that doesn’t mean you shouldn’t remain vigilant of signs of addiction.
Likewise, you may have to make lifestyle changes including adjustments to your alcohol consumption and to your consumption of any recreational drugs, as these can quickly increase your risk of life-threatening overdose effects.
So, is tramadol for PE worth it? That depends on your personal health situation, what else you have tried for your PE, what other medications you're on, and other considerations. This should be a joint decision between you and your health provider.
Understanding the long-term effects of tramadol use for premature ejaculation are still somewhat unknown, as far as studies go, and a systematic review is still necessary to see what the best delivery method might be. Frankly, more placebo-controlled studies are necessary, as well.
Point being, this shouldn’t be your frontline treatment. A higher level of evidence than the current evidence base is needed for that level of confidence, and in the meantime there are other options available to start with.
So, what treatment modality will work for you? It’s a good question — one the medical community is still working to answer.
Premature ejaculation is not yet considered curable, but there are options available to help you cope with PE symptoms, and many of them are offered with support from research.
Your most effective treatment may focus on physiological strategies. This could include the well-known start-stop technique, which is employed while in the act of intercourse.
The start-stop (or stop-start technique) is simply taking a break when you feel yourself approaching orgasm sooner than you’d like, and only continuing with intercouse once the urge has faded.
We like to make fun of the ridiculously named “squeeze technique,” in part because it’s ridiculous in its own right — you squeeze the tip of your penis when you’re getting close to orgasm to help the urge subside.
It’s been shown effective in some limited studies, but we would consider it a last-ditch effort.
Topical medications in the form of gels, sprays and creams may also help you with your PE problem by reducing sensitivity — learn more about those here.
You might also benefit from antidepressants — Selective Serotonin Reuptake Inhibitors (SSRIs) can help you delay your ejaculatory response in certain circumstances.
Actually, SSRIs have a side effect of “difficulty with orgasms” listed in their adverse effects, but that isn’t so adverse of an effect if you’re struggling to get more difficulty into your sex life. all — literally all — of the participating men in one study saw stamina improvement.
The most effective treatment option for you may be one or a combination of these things we’ve listed — likewise your best solution may be tramadol or other treatments for PE.
As much as we’d like to give you reassurance, there’s a person you need to speak with after reading this story, and that person is a healthcare professional.
A healthcare professional will be able to look at your sexual dysfunction symptoms and give you the big picture on what might be going wrong — they may even diagnose a completely unexpected root cause of your premature ejaculation issues.
The sooner you do this, the sooner you can take your sex life a short film to a director’s cut.
Sexual dysfunction needs this kind of approach — there is no little blue pill yet for having a hair trigger in the bedroom. But just because it’s an issue for your sex life doesn’t mean it has to run your life.
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