Premature ejaculation (PE) is one of the most common sexual dysfunctions in men. It has been attributed to psychological problems, somatic disorders and genetics.
Paxil is a type of antidepressant that belongs to the class of drugs called selective serotonin reuptake inhibitors (SSRI). Although PE is not listed on its label, SSRIs have shown promise in treating this disorder.
1. Before a sexual encounter
Premature ejaculation (PE) is one of the most common sexual dysfunctions, affecting about a third of all men. It can be very distressing for both partners and is associated with negative effects on sex and relationships. However, despite its high prevalence, PE remains under-researched and the available therapeutic options are limited. This review was conducted to analyse the current evidence on PE treatment modalities. This was done using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria.
To diagnose PE, your health care provider will ask questions about your sexual history and medical history. He or she might also do a physical exam. The doctor might order blood tests to check your hormone levels.
If SSRIs don’t help, your doctor might prescribe a tricyclic antidepressant, such as clomipramine (Anafranil). This medication has been shown to help people with PE. However, it can cause side effects like nausea, perspiration, drowsiness and decreased sex drive.
If you’re taking paroxetine, you might also want to talk to your doctor about ED products, such as Viagra Connect or Priligy. These drugs can help you get an erection and last longer during sex, which can reduce the stress that leads to PE. They can also help you avoid putting your penis in the water, which can make it harder to get an erection.
2. After a sexual encounter
Premature ejaculation is the most common sexual complaint in men. It happens when semen leaves the body too soon during a sexual encounter, and it can occur at any time, even during masturbation. It can be a problem for both you and your partner, and it may lead to feelings of frustration, shame and hopelessness. But fortunately, it is treatable. There are medications and behavioral therapy that can help.
One study found that daily 20-mg paroxetine increased ejaculatory latency (the time between penetration and ejaculation) by about three minutes, compared to placebo. This medication belongs to a group of antidepressants known as selective serotonin reuptake inhibitors, and it is also available under the brand name Zoloft.
Another treatment option is to try a behavioral technique called “stop-squeeze” training. This involves your partner squeezing your penis after you feel yourself close to ejaculating. It can help you to better sense when you’re about to ejaculate, and it can make the difference between an enjoyable and frustrating experience.
In addition to these treatments, some studies have shown that phosphodiesterase-5 inhibitors, which are used to treat erectile dysfunction, might reduce PE. These drugs include sildenafil (Viagra), tadalafil (Cialis, Adcirca) and vardenafil (Levitra). In one study, paroxetine was given with tadalafil to improve sex performance, and this combination proved to be more effective than paroxetine alone.
3. After a heavy meal
Many medications can delay orgasm, including antidepressants, pain relievers and drugs for erectile dysfunction. Creams that contain a numbing agent, such as lidocaine and prilocaine, may also help to delay PE. These creams can be applied to the penis 10 to 15 minutes before sex to reduce sensation and delay ejaculation. They are available without prescription.
Antidepressants, such as paroxetine (Paxil), fluoxetine (Prozac) and sertraline (Zoloft) may help to treat PE by increasing the amount of serotonin that is released into postsynaptic membrane receptors. The effect of these SSRIs lasts about two to three hours. They can be taken on a daily basis or on-demand as needed.
One study found that a 20 mg daily dose of paroxetine increased the average ejaculatory latency time in patients with PE by about 1 minute. This treatment was more effective than placebo, with no significant side effects. The patients in the study who received daily paroxetine had higher Arizona Sexual Experience Scale, Glombock Rust Inventory of Sexual Satisfaction raw scores and premature ejaculation subscale scores than those in the placebo group. One month after paroxetine treatment was discontinued, the ejaculatory latency time returned to normal.
In another study, researchers found that a combination of paroxetine and the phosphodiesterase-5 inhibitor tadalafil improved the results of a single-dose ejaculation test in men with PE. In this trial, 100 male potent patients, ages 17 to 49, with lifelong PE and an intravaginal ejaculation latency time less than 1.5 minutes were treated with either 10 mg paroxetine daily or a placebo. Patients receiving paroxetine plus tadalafil had a significantly greater increase in the ejaculatory latency time than those who received placebo.
4. After a stressful event
If you’re dealing with PE, talk to your healthcare provider. It’s important to understand that this is normal and the condition can be effectively treated. A conversation with your urologist, mental health professional or endocrinologist may help to ease anxiety and stress associated with the condition. For instance, it can be reassuring to know that most PE is caused by a combination of psychological and biological factors.
There are also medications that can be used to treat PE, although they’re usually prescribed to address other issues like depression or anxiety. Typically, these are antidepressants called selective serotonin reuptake inhibitors (SSRIs). Examples include citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac) and paroxetine (Paxil). These medications prevent the brain from reducing its supply of serotonin, ensuring that more is available to regulate mood.
Other medications, such as anesthetic creams and sprays that contain lidocaine, can be used to delay ejaculation. These must be applied to the head and shaft of the penis and left to work for a few minutes before sex. It’s a good idea to wash the anesthetic off before sexual activity to avoid transferring it to your partner.
A more intensive approach involves a combination of behavioral and psychological treatments. This might involve a series of sessions with a mental health specialist who can work on ways to reduce your performance anxiety and teach you better coping strategies.
