Premature ejaculation (PE) is one of the most common forms of sexual dysfunction. 39 percent of men suffer from it at some point.
If you have premature ejaculation, you may have trouble controlling your ability to reach orgasm and ejaculate during sex. You notice that this causes or contributes to other sex-related problems, such as fear of sexual performance.
Premature ejaculation can be a difficult problem to deal with and can take a serious toll on your interest in sex. However, it can often be treated with medications, including selective serotonin reuptake inhibitors (SSRIs) and erectile dysfunction (ED) medications.
One such possible treatment is sildenafil, the active ingredient in Viagra®. While there are still no large-scale studies that conclusively prove that sildenafil treats PE, some studies suggest that sildenafil may offer benefits in delaying orgasm and ejaculation.
Below, we've explained how and why premature ejaculation occurs and what sildenafil is as a medicine.
We also reviewed the existing research on sildenafil and certain aspects of sexual function, including the time that elapses before orgasm and ejaculation.
Finally, we've shared with you other treatment options that you might consider if you're sensitive to PE and want to increase the time to ejaculation, improve your overall sexual performance, and enjoy more satisfying sex.
The basis of premature ejaculation
Before we dive into the specific details of sildenafil and premature ejaculation, let's briefly explain what premature ejaculation is.
Premature ejaculation is ejaculation that occurs within one minute of vaginal penetration, before you want it, during all or almost all sexual activity. It's also known as “rapid ejaculation” because it often occurs with little or no warning after you've penetrated your partner.
It's normal to occasionally reach orgasm and ejaculate faster than you'd like when having sex, and that doesn't necessarily mean premature ejaculation.
To be diagnosed with premature ejaculation, you usually need to have symptoms that last for at least six months, that cause you some degree of clinical discomfort, and are not caused by a non-sexual factor, such as mental illness or medication.
Like many other forms of male sexual dysfunction, premature ejaculation can vary significantly in severity.
If you have mild PE, you may be able to have sex for one minute before reaching orgasm and ejaculating. If you have severe PE, it can be difficult to prevent ejaculation at any time during sexual activity, even before penetration.
PE can be lifelong (meaning it has occurred since your first sexual experience) or acquired. It can also occur generally (meaning you experience PE with any sexual activity), or only with certain types of sexual activity or with specific partners.
Our guide to premature ejaculation takes a deeper look at what PE is, the factors that can cause it, common symptoms, and more.
What is Sildenafil?
What is sildenafil exactly? Sildenafil is the active ingredient in Viagra, a popular erectile dysfunction drug. It belongs to a class of medications called PDE5 inhibitors and works by increasing blood flow to your penis, making it easier for you to get an erection.
More specifically, sildenafil inhibits the effects of an enzyme called phosphodiesterase-5, which is involved in controlling the diameter of the blood vessels that supply blood to your penis.
Erections are all about blood flow. When you're excited, blood flows to the tissue in your penis, making your penis bigger and firmer. Medications such as sildenafil cause more blood to flow to your penis, so you can get and keep an erection.
Sildenafil is one of several PDE5 inhibitors used to treat erectile dysfunction. Other erectile dysfunction medications include tadalafil (Cialis®), vardenafil (Levitra®), and avanafil (available as Stendra®).
Contrary to popular belief, medications like sildenafil don't cause random erections or make you stop interested in sex -- instead, you only get erections when you're feeling sexually aroused, such as during sexual encounters.
Does Sildenafil Treat Premature Ejaculation?
Sildenafil was originally developed as a medicine for certain heart conditions, such as angina pectoris (a type of chest pain caused by reduced blood flow to the heart). Due to its widespread use in Viagra, however, it is best known as a medicine for erectile dysfunction.
Because sildenafil has been approved by the FDA as a treatment for erectile dysfunction, almost all scientific research into its effects focuses on using it to improve erections.
Over the decades, however, researchers have investigated several other possible uses of drugs such as sildenafil, including answering one question: Does Viagra help with premature ejaculation?
That's why there are a few studies looking at the possible effects of sildenafil as a treatment for premature ejaculation.
In one study published in the International Journal of Urology in 2007, 180 men with premature ejaculation were divided into three groups.
The first group (Group A) was treated with 50 mg of sildenafil, while the people in Group B received a daily dose of paroxetine (often sold as Paxil®), an SSRI that is often used off-label to treat PE.
People in the third group (group C) received no medication but were instructed to use the squeezing technique (a technique that squeezes the penis before orgasm) to reduce sensitivity during sex.
The researchers followed up with the participants after six months. Men in Group A (the group that received sildenafil) experienced improvements in intravaginal ejaculatory latency (IELT, or time to ejaculation after penetration), sexual satisfaction, and overall severity of their PE.
Members of the sildenafil group also reported having sex more frequently, suggesting that sildenafil's effects on erections and sexual stamina may also increase overall sexual confidence.
The study concluded that sildenafil is “highly effective and safe for treating PE” and noted that it had a higher level of efficacy than paroxetine and the squeezing technique.
In an older clinical study published in the Journal of Sexual Medicine in 2005, researchers looked at the effects of sildenafil as a treatment option for men diagnosed with premature ejaculation.
For this study, men between the ages of 18 and 65 with diagnosed premature ejaculation received sildenafil in a placebo-controlled, double-blind environment. The men who used sildenafil were instructed to take the medication for eight weeks.
After the trial period, men in the sildenafil group had an increase in IELT (intervaginal ejaculation latency time) and an improvement in VTS-ELT (vibrotactile stimulation ejaculatory latency time) compared to the placebo group.
Although these scores increased, improvements in ejaculation time were not statistically significant.
Men in the sildenafil group also reported significant increases in their levels of ejaculation control, ejaculation confidence, and sexual satisfaction. They also had a shorter refractory period — the time it takes to recover sexually after ejaculation.
Overall, the study concluded that sildenafil “increased self-esteem, perception of ejaculation control, and overall sexual satisfaction” compared to placebo treatment, although it was noted that the increase in ejaculation latency time caused by sildenafil was not significant.
In other words, the “little blue pill” appears to offer real benefits to men who suffer from premature ejaculation, although the actual increase in time to ejaculation is not always significant and varies from study to study.
Several other studies have also looked at the effects of sildenafil for men with PE, including as an adjuvant therapy (a medication given alongside another form of treatment).
In one study published in the journal Urology, researchers found that sildenafil worked well when taken in combination with the SSRI paroxetine and forms of psychological and behavioral therapy, including men with PE who did not respond to other treatments.
A more recent 2019 study found that men with a combination of premature ejaculation and erectile dysfunction responded well to treatment with sildenafil and dapoxetine, a new drug that is currently under development as a PE drug.
How does Sildenafil treat premature ejaculation?
Right now, healthcare professionals don't know how or why medications for ED like sildenafil extend the time it takes for men with premature ejaculation to reach orgasm and ejaculate.
A common theory about the effects of sildenafil on premature ejaculation is that it may inhibit neurotransmission in your genitourinary system.
Experts also believe that sildenafil and other PDE5 inhibitors may dilate the smooth muscles near the vas deferens and seminal vesicles, which are responsible for transporting semen and sperm cells to the penis during orgasm and ejaculation.
Finally, some of the effects of sildenafil may simply be the result of a boost in self-confidence, as many ED medications are associated with less anxiety about sexual performance.
Sildenafil Side Effects and Safety
Sildenafil is a safe and effective medicine for most men. However, it can cause side effects. It can also cause interactions when used with certain medications, including medications for common medical conditions such as hypertension (high blood pressure).
Common sildenafil side effects include:
- Headaches
- Rinse
- Dyspepsia (indigestion)
- Changes in vision (blurred vision or color vision changes)
- Nasal congestion
- Back pain
- Myalgia (muscle pain)
- Nausea
- Vertigo
- Rash
Most of the time, sildenafil only causes mild side effects. It's important to talk to your healthcare provider if you get serious side effects from sildenafil, or side effects that persist after sildenafil stops working.
Sildenafil and other PDE5 inhibitors may interact with some other medications, including nitrates and alpha blockers used to treat high blood pressure. Recreational drugs that contain nitrates, such as poppers, may also interact with sildenafil.
When used with sildenafil, these substances can cause a sudden, dangerous drop in blood pressure that can make you feel dizzy, faint, or have a serious cardiovascular event.
To keep yourself safe, it's important to tell your healthcare provider about all medications you are currently taking or have recently taken before starting treatment with sildenafil.
It's also important to tell your healthcare provider if you have a medical history of cardiovascular problems, such as heart attack, heart failure, or heart surgery.
Our guide to Viagra side effects goes into more detail about the possible side effects and interactions between medications that may occur with Viagra or generic sildenafil.
Other treatments for premature ejaculation
In addition to ED drugs such as sildenafil, there are numerous other effective treatments for premature ejaculation.
These include topical wipes that reduce sensitivity and make it easier to control ejaculation, as well as prescription medications such as antidepressants.
Sprays, creams and topical treatments
If you have a mild or moderate form of premature ejaculation, you can delay ejaculation and gain more control over your orgasms by using a topical treatment that reduces the sensitivity in your penis.
For example, our Delay Wipes for men are made with topical anesthetics benzocaine and lidocaine to control sensitivity without reducing sexual pleasure.
Selective Serotonin Reuptake Inhibitors (SSRI)
Although the FDA has not yet approved specific pills for premature ejaculation, a range of existing medications are prescribed off-label to treat PE, including the SSRIs sertraline (the generic form of Zoloft®) and paroxetine (Paxil®).
These medications, which require a prescription, can help increase ejaculation time and give you more control over your orgasms during sexual activity.
We offer sertraline and paroxetine for premature ejaculation online, after a consultation with a healthcare provider who will determine if a prescription is appropriate.
Techniques for treating premature ejaculation
In addition to using medication, performing certain exercises and techniques -- or simply making a few changes to your habits and daily lifestyle -- can help improve your sexual performance and reduce the severity of PE. These include:
Do pelvic floor exercises to strengthen the muscles that control ejaculation
With approaches such as the squeezing technique to delay ejaculation during sex
Masturbate before having sex to take advantage of your refractory time
Switch to a thicker condom that reduces sensitivity when having sex
Distract yourself or use relaxation techniques so as not to orgasm
Our guide to stopping premature ejaculation goes into more detail about these tactics and how to use them to improve your stamina and sexual function.
The conclusion about the use of Sildenafil (Viagra) for PE
Although not much scientific research has been done on sildenafil as a treatment for PE, the studies that are currently available show promising results.
Sildenafil increases intervaginal ejaculation, latency, and sexual satisfaction, which means it may be able to help you last longer in bed and enjoy sex more. It also seems to boost your confidence in bed, which can help if you're prone to sexual performance anxiety.
However, it's also worth noting that much more research needs to be done before anything definitive can be said.
We offer sildenafil online as part of our range of erectile dysfunction medications after a consultation with a doctor who will determine if a prescription is appropriate.
We also offer a range of evidence-based treatments for premature ejaculation including delay wipes and oral medications that you can use as needed to improve sexual stamina.
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