Potential increase in time-to-climax with sertraline for PE

Potential increase in time-to-climax with paroxetine for PE

Kick PE out of bed. PE is personal and through Hims, PE treatment can be, too. Our online consultations were designed with medical and urology experts, so you can find the right PE treatment for your body and your sex life.

Premature ejaculation pills proven to work—really

While no FDA-approved premature ejaculation pills exist today, medical providers can prescribe the following meds “off-label” when appropriate. These PE treatments are clinically proven to help men last longer in bed, no topical sprays or goopy gels required. We call that a win-win.

Daily

Sertraline for PE

From $24/month

Sertraline is a daily pill that can increase time to climax by up to 400%1 (seriously) and help keep you prepared for intimacy on your schedule. Being ready to go at any time? Hot.

As-needed

Sildenafil for PE

From $3/use

Sildenafil (the active ingredient in Viagra®) can be taken as needed to delay ejaculation and to treat erectile dysfunction. Plus, studies2 suggest it can help you get another erection more easily after orgasm. Round two?

Daily

Paroxetine for PE

From $24/month

Tried other PE treatments without mindblowing results? When prescribed for premature ejaculation, taking paroxetine daily can help you last 9-12x1 longer in bed. That’s time well spent.

Important Safety Information

WARNING: SUICIDALITY AND ANTIDEPRESSANT DRUGS
Sertraline and other antidepressant drugs may increase suicidal thoughts or actions in some people 24 years of age and younger, especially within the first few months of treatment or when the dose is changed. Watch for these changes and call your healthcare provider right away if you notice new or sudden changes in mood, behavior, actions, thoughts, or feelings, especially if severe. Pay particular attention to such changes when sertraline is started or when the dose is changed.
Who should not take sertraline?
Do not take sertraline if:
You take a Monoamine Oxidase Inhibitor (MAOI), including linezolid or methylene blue, or if you stopped taking an MAOI in the last 2 weeks. Do not take an MAOI within 2 weeks of stopping sertraline. Ask your healthcare provider or pharmacist if you are not sure if your medicine is an MAOI. People who take sertraline close in time to an MAOI may have serious or even life threatening side effects.
Get medical help right away if you have any of these symptoms:
  • high fever
  • uncontrolled muscle spasms
  • stiff muscles
  • rapid changes in heart rate or blood pressure
  • confusion
  • loss of consciousness (pass out)
Take Orap® (pimozide) because this can cause serious heart problems
Take MELLARIL® (thioridazine) because this can cause serious heart rhythm problems or sudden death.
Are allergic to sertraline or any of the ingredients in sertraline
Sertraline and other antidepressant medicines may cause serious side effects. Call a healthcare provider right away if you or a person you know who is taking sertraline has any of the following symptoms, especially if they are new, worse, or worry you:
  • Attempts to commit suicide
  • Acting aggressive or violent
  • New or worse depression
  • Feeling agitated, restless, angry, or irritable
  • An increase in activity or talking more than what is normal for you
  • Acting on dangerous impulses
  • Thoughts about suicide or dying
  • New or worse anxiety or panic attacks
  • Trouble sleeping
  • Other unusual changes in behavior or mood
  • Depression or other serious mental illnesses are the most important causes of suicidal thoughts or actions. Watch for these changes and call your healthcare provider right away if you notice new or sudden changes in mood, behavior, actions, thoughts, or feelings, especially if severe. Keep all follow-up visits with your healthcare provider and call between visits if you are worried about symptoms.
Depression or other serious mental illnesses are the most important causes of suicidal thoughts or actions. Watch for these changes and call your healthcare provider right away if you notice new or sudden changes in mood, behavior, actions, thoughts, or feelings, especially if severe. Keep all follow-up visits with your healthcare provider and call between visits if you are worried about symptoms.
What should I tell my healthcare provider before taking sertraline?
Before taking sertraline, tell your healthcare provider and pharmacist about all prescription and over-the-counter medications and supplements you take or plan to take including:
  • those to treat migraines
  • psychiatric disorders (including other antidepressants or amphetamines) to avoid a potentially life-threatening condition called serotonin syndrome
  • Aspirin
  • other NSAID pain relievers
  • other blood thinners because they may increase the risk of bleeding
  • drugs used to treat irregular heartbeat
  • drugs used to treat HIV infection
  • drugs used to treat epilepsy
Before taking sertraline, tell your healthcare provider your complete list of medical conditions, including if you have liver problems, kidney problems, heart problems, seizures or convulsions, psychiatric disorders including bipolar disorder or mania, low sodium levels in your blood, history of a stroke, high blood pressure, bleeding problems, or glaucoma (high pressure in the eye).
Tell your healthcare provider immediately if you
  • Become severely ill and have some or all of these symptoms: agitation, hallucinations, coma, or other changes in mental status; coordination problems or muscle twitching (overactive reflexes); racing heartbeat, high or low blood pressure; sweating or fever; nausea, vomiting, or diarrhea; muscle tightness, as these may be the symptoms of a life-threatening condition called Serotonin Syndrome
  • Have a rash, hives, swelling, or trouble breathing as these may be the symptoms of an allergic reaction
  • Have seizures or convulsions
  • Have any increased or unusual bruising or bleeding, especially if you take the blood thinner warfarin (Coumadin®, Jantoven®), a non-steroidal anti-inflammatory drug (NSAID), or aspirin
  • Have a headache; weakness or feeling unsteady; confusion, problems concentrating, thinking, or remembering, as these may be the symptoms of low salt (sodium) levels in the blood (hyponatremia). Elderly people may be at greater risk for this
Do not stop sertraline without first talking to your healthcare provider. Stopping sertraline may cause serious symptoms, including anxiety, irritability, high or low mood, feeling restless or sleepy; headache, sweating, nausea, dizziness; electric shock-like sensations, shaking, and confusion.
Some people are at risk for visual problems such as eye pain, changes in vision, or swelling or redness around the eye. You may want to undergo an eye examination to see if you are at risk and get preventative treatment if you are.
Should I avoid any activities while taking sertraline?
Sertraline can cause sleepiness or may affect your ability to make decisions, think clearly, or react quickly. You should not drive, operate heavy machinery, or do other dangerous activities until you know how sertraline affects you.
Drinking alcohol while taking sertraline is not recommended.
What are the possible side effects of sertraline in adults?
The most common side effects in adults treated with sertraline include:
  • Nausea, loss of appetite, diarrhea, or indigestion
  • Increased sweating
  • Tremor or shaking
  • Agitation
  • Change in sleep habits including increased sleepiness or insomnia
  • Sexual problems including decreased libido and ejaculation failure
  • Feeling tired or fatigued
  • Weakness
  • Dizziness
  • Sexual problems
  • Dry mouth
  • Constipation
  • Infection
  • Feeling anxious or trouble sleeping
Contact your healthcare provider if you have any side effect that continues or bothers you. These are not all the possible side effects of sertraline. Contact your healthcare provider or pharmacist if you need more information.
For medical advice on side effects, contact your healthcare provider. You can also report side effects to the FDA at 1-800-FDA-1088.
Your healthcare provider or pharmacist can tell you if it is safe to take sertraline with your other medicines. Do not start or stop any medicine while taking sertraline without talking to your healthcare provider first.

Important Safety Information

WARNING: SUICIDALITY AND ANTIDEPRESSANT DRUGS
Paroxetine and other antidepressant drugs may increase suicidal thoughts or actions in some people 24 years of age and younger, especially within the first few months of treatment or when the dose is changed. Watch for these changes and call your healthcare provider right away if you notice new or sudden changes in mood, behavior, actions, thoughts, or feelings, especially if severe. Pay particular attention to such changes when paroxetine is started or when the dose is changed.
Do not take paroxetine if:
You take a Monoamine Oxidase Inhibitor (MAOI), including linezolid or methylene blue, or if you stopped taking an MAOI in the last 2 weeks. Do not take an MAOI within 2 weeks of stopping paroxetine. Ask your healthcare provider or pharmacist if you are not sure if your medicine is an MAOI. People who take paroxetine close in time to an MAOI may have serious or even life threatening side effects.
Get medical help right away if you have any of these symptoms:
  • high fever
  • uncontrolled muscle spasms
  • stiff muscles
  • rapid changes in heart rate or blood pressure
  • confusion
  • loss of consciousness (pass out)
Take Orap® (pimozide) because this can cause serious heart problems
Take MELLARIL® (thioridazine) because this can cause serious heart rhythm problems or sudden death.
Are allergic to paroxetine or any of the inactive ingredients in paroxetine
Paroxetine and other antidepressant medicines may cause serious side effects. Call a healthcare provider right away if you or a person you know who is taking paroxetine has any of the following symptoms, especially if they are new, worse, or worry you:
  • Attempts to commit suicide
  • Acting aggressive or violent
  • New or worse depression
  • Feeling agitated, restless, angry, or irritable
  • An increase in activity or talking more than what is normal for you
  • Acting on dangerous impulses
  • Thoughts about suicide or dying
  • New or worse anxiety or panic attacks
  • Trouble sleeping
  • Other unusual changes in behavior or mood
Depression or other serious mental illnesses are the most important causes of suicidal thoughts or actions. Watch for these changes and call your healthcare provider right away if you notice new or sudden changes in mood, behavior, actions, thoughts, or feelings, especially if severe. Keep all follow-up visits with your healthcare provider and call between visits if you are worried about symptoms.
Before taking paroxetine, tell your healthcare provider and pharmacist about all prescription and over-the-counter medications and supplements you take or plan to take including:
  • those to treat migraines
  • psychiatric disorders (including other antidepressants or amphetamines) to avoid a potentially life-threatening condition called serotonin syndrome
  • Aspirin
  • other NSAID pain relievers
  • other blood thinners because they may increase the risk of bleeding
  • drugs used to treat irregular heartbeat
  • drugs used to treat HIV infection
  • drugs used to treat epilepsy
Before taking paroxetine, tell your healthcare provider your complete list of medical conditions, including if you have liver problems, kidney problems, heart problems, seizures or convulsions, psychiatric disorders including bipolar disorder or mania, low sodium levels in your blood, history of a stroke, high blood pressure, bleeding problems, or glaucoma (high pressure in the eye).
Tell your healthcare provider immediately if you
  • Become severely ill and have some or all of these symptoms: agitation, hallucinations, coma, or other changes in mental status; coordination problems or muscle twitching (overactive reflexes); racing heartbeat, high or low blood pressure; sweating or fever; nausea, vomiting, or diarrhea; muscle tightness, as these may be the symptoms of a life-threatening condition called Serotonin Syndrome
  • Have a rash, hives, swelling, or trouble breathing as these may be the symptoms of an allergic reaction
  • Have seizures or convulsions
  • Have any increased or unusual bruising or bleeding, especially if you take the blood thinner warfarin (Coumadin®, Jantoven®), a non-steroidal anti-inflammatory drug (NSAID), or aspirin
  • Have a headache; weakness or feeling unsteady; confusion, problems concentrating, thinking, or remembering, as these may be the symptoms of low salt (sodium) levels in the blood (hyponatremia). Elderly people may be at greater risk for this
Do not stop paroxetine without first talking to your healthcare provider. Stopping paroxetine may cause serious symptoms, including anxiety, irritability, high or low mood, feeling restless or sleepy; headache, sweating, nausea, dizziness; electric shock-like sensations, shaking, and confusion.
Some people are at risk for visual problems such as eye pain, changes in vision, or swelling or redness around the eye. You may want to undergo an eye examination to see if you are at risk and get preventative treatment if you are.
Should I avoid any activities while taking paroxetine?
Paroxetine can cause sleepiness or may affect your ability to make decisions, think clearly, or react quickly. You should not drive, operate heavy machinery, or do other dangerous activities until you know how paroxetine affects you.
Drinking alcohol while taking paroxetine is not recommended.
What are the possible side effects of paroxetine in adults?
The most common side effects in adults treated with paroxetine include:
  • Nausea, loss of appetite, diarrhea, or indigestion
  • Increased sweating
  • Tremor or shaking
  • Agitation
  • Change in sleep habits including increased sleepiness or insomnia
  • Sexual problems including decreased libido and ejaculation failure
  • Feeling tired or fatigued
  • Weakness
  • Dizziness
  • Sexual problems
  • Dry mouth
  • Constipation
  • Infection
  • Feeling anxious or trouble sleeping
Contact your healthcare provider if you have any side effect that continues or bothers you. These are not all the possible side effects of paroxetine. Contact your healthcare provider or pharmacist if you need more information.
For medical advice on side effects, contact your healthcare provider. You can also report side effects to the FDA at 1-800-FDA-1088.
Your healthcare provider or pharmacist can tell you if it is safe to take paroxetine with your other medicines. Do not start or stop any medicine while taking paroxetine without talking to your healthcare provider first.

Important Safety Information

Do not take Sildenafil (generic Viagra) if you:
  • take any medicines called nitrates, often prescribed for chest pain, or guanylate cyclase stimulators like Adempas (riociguat) for pulmonary hypertension. Your blood pressure could drop to an unsafe level
  • are allergic to Sildenafil, as contained in Sildenafil and REVATIO, or any of the ingredients in Sildenafil
Discuss your health with your doctor to ensure that you are healthy enough for sex. If you experience chest pain, dizziness, or nausea during sex, seek immediate medical help
Sildenafil can cause serious side effects. Rarely reported side effects include:
  • an erection that will not go away (priapism). If you have an erection that lasts more than 4 hours, get medical help right away. If it is not treated right away, priapism can permanently damage your penis
  • sudden vision loss in one or both eyes. Sudden vision loss in one or both eyes can be a sign of a serious eye problem called non-arteritic anterior ischemic optic neuropathy (NAION). Stop taking Sildenafil and call your healthcare provider right away if you have any sudden vision loss
  • sudden hearing decrease or hearing loss. Some people may also have ringing in their ears (tinnitus) or dizziness. If you have these symptoms, stop taking Sildenafil and contact a doctor right away
Before you take Sildenafil, tell your healthcare provider if you:
  • have or have had heart problems such as a heart attack, irregular heartbeat, angina, chest pain, narrowing of the aortic valve, or heart failure
  • have had heart surgery within the last 6 months
  • have pulmonary hypertension
  • have had a stroke
  • have low blood pressure, or high blood pressure that is not controlled
  • have a deformed penis shape
  • have had an erection that lasted for more than 4 hours
  • have problems with your blood cells such as sickle call anemia, multiple myeloma, or leukemia
  • have retinitis pigmentosa, a rare genetic (runs in families) eye disease
  • have ever had severe vision loss, including an eye problem called NAION
  • have bleeding problems
  • have or have had stomach ulcers
  • have liver problems
  • have kidney problems or are having kidney dialysis have any other medical conditions
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
Sildenafil may affect the way other medicines work, and other medicines may affect the way Sildenafil works, causing side effects. Especially tell your healthcare provider if you take any of the following:
  • medicines called nitrates
  • medicines called guanylate cyclase stimulators such as Adempas (riociguat)
  • medicines called alpha-blockers such as Hytrin (terazosin HCl), Flomax (tamsulosin HCl), Cardura (doxazosinmesylate), Minipress (prazosin HCl), Uroxatral (alfuzosin HCl), Jalyn (dutasteride and tamsulosin HCl), or Rapaflo (silodosin). Alpha-blockers are sometimes prescribed for prostate problems or high blood pressure. In some patients, the use of Sildenafil with alpha-blockers can lead to a drop in blood pressure or to fainting
  • medicines called HIV protease inhibitors, such as ritonavir (Norvir), indinavir sulfate (Crixivan), saquinavir (Fortovase or Invirase), or atazanavir sulfate (Reyataz)
  • some types of oral antifungal medicines, such as ketoconazole (Nizoral) and itraconazole (Sporanox)
  • some types of antibiotics, such as clarithromycin (Biaxin), telithromycin (Ketek), or erythromycin
  • other medicines that treat high blood pressure
  • other medicines or treatments for ED
  • Sildenafil contains Sildenafil, which is the same medicine found in another drug called REVATIO. REVATIO is used to treat a rare disease called pulmonary arterial hypertension (PAH). Sildenafil should not be used with REVATIO or with other PAH treatments containing Sildenafil or any other PDE5 inhibitors (such as Adcirca [tadalafil])
Sildenafil does not protect against sexually transmitted diseases, including HIV.
The most common side effects of Sildenafil: headache; flushing; upset stomach; abnormal vision, such as changes in color vision (such as having a blue color tinge) and blurred vision; stuffy or runny nose; back pain; muscle pain; nausea; dizziness; rash.
Sildenafil (generic Viagra) is prescription medicine used to treat erectile dysfunction (ED).
Sildenafil is not for women or children.

Climax delay on-demand

Last longer with these easy-to-use, fast-acting sprays and wipes.

Clockstopper Climax
Delay Spray

$31

Last up to 64% longer with this flavorless spray that’s safe to use with condoms, lube, and your partner. The perfect accessory for your bedside table and your sex life.

Additional fees may apply

Clockstopper Climax
Delay Wipes

$19

Convenient, wallet-sized wipes to help you finish last. Discrete packaging, no-mess application.

Additional fees may apply

1. An Update of the International Society of Sexual Medicine's Guidelines for the Diagnosis and Treatment of Premature Ejaculation (PE); 2. Phosphodiesterase-5 Inhibitors for Premature Ejaculation, U.S. National Library of Medicine; Prescription products are not FDA-approved for the treatment of premature ejaculation and available only if prescribed by a healthcare provider after an online consultation. Learn about off-label uses. This page has been medically reviewed by Peter J. Stahl, MD.

Get PE meds from the privacy of home

Confidential communication with a licensed provider
Online prescription of the right PE treatment for you, if appropriate
Discreet, direct shipping—no pharmacy lines required

Got PE questions?
We’ve got answers.

What is premature ejaculation?

Technically, PE occurs when you ejaculate less than a few minutes after you start penetrative sex. More generally, PE is when you ejaculate much sooner than you or your partner wishes. In severe cases, it may even happen before sexual intercourse. PE can negatively affect one’s sex life and may be referred to as early ejaculation, rapid ejaculation or premature climax. PE is one of the most common sexual dysfunctions you may encounter.

What causes premature ejaculation?

Premature ejaculation has a number of different causes, including psychological factors like concern over your sexual performance (aka sexual performance anxiety), relationship problems, stress or depression, as well as some physical factors, like a hormonal imbalance or an infection in your urethra or prostate. In many cases, the cause cannot be determined. All of these factors can cause problems ejaculating, including premature or early ejaculation, which can impact your sexual relationships and encounters.

How can you fix premature ejaculation?

There are several prescription, over-the-counter and home remedies that all can be effective in treating PE. The best option for you depends on your specific situation, but these are a few of the most popular options:
  • SSRIs: Also known as selective serotonin reuptake inhibitors, prescription medications like paroxetine, sertraline, fluoxetine and dapoxetine have been shown to be effective in treating premature ejaculation.
  • PDE5 inhibitors: ED medications, such as sildenafil (generic for Viagra®) or tadalafil (generic for Cialis®), can be used to treat both premature ejaculation and erectile dysfunction. If you ejaculate too quickly, this may be the option for you, especially if you also struggle with getting erections, maintaining them, or achieving another one after your refractory period.
  • Anesthetic creams or sprays: Topical anesthetics are a popular choice for management of premature ejaculation because they are over-the-counter and since they aren’t ingested, they don’t have systemic effects on your body, which reduces the risk of experiencing systemic side effects
  • Stop-start or edging: This is a method of training your body to recognize when you are about to ejaculate during sexual stimulation, so that you can stop stimulation for a time to delay ejaculation for longer during sexual intercourse.
  • Sex therapy: Starting behavioral therapy with a licensed mental health provider, such as a psychiatrist or sex therapist, can help you to work through any psychological reasons that you might be experience premature ejaculation.
  • Squeeze technique: The squeeze method is simply putting pressure on your penis when you are close to ejaculating to decrease arousal.
  • Kegel exercises: Strengthening the pelvic floor muscles can help you to control the muscles around your urethra, which studies show can help with premature ejaculation.
  • Masturbation: Masturbating before sexual intercourse can help you to last longer during sexual activity

Why do I need a prescription for PE treatment?

There are non-prescription treatment options for PE, but to get a prescription treatment, you must first see a healthcare provider, who can determine if a prescription is appropriate for you. Discussing premature ejaculation with a healthcare provider can also help improve outcomes (especially if there are underlying medical conditions causing PE). Some medications available through our platform for the treatment of premature ejaculation, such as PDE5 inhibitors like sildenafil and antidepressants like sertraline, are only available with a prescription by a licensed healthcare provider.

Can PE treatment increase my sexual performance?

It depends. PE treatment can improve your sexual experiences if you have a sexual problem on the PE spectrum. Talk with a medical provider to find out if PE treatment could help improve your sexual function.

What are signs of lifelong premature ejaculation?

Lifelong PE is an innate, lifelong low threshold for orgasm that often results in a consistent very short time to ejaculation and a sense that you can’t control climax. This is on the serious end of the PE spectrum and typically will not subside without professional help. The signs include coming during early foreplay, with minimal sexual stimulation, or within the first 1-3 minutes of sexual intercourse. There are a range of interventions proven to help in management of premature ejaculation so it does not affect your sex life.