Patient-Reported Outcomes with Sildenafil for Premature Ejaculation

Nearly all adverse events were mild to moderate in severity, and no serious treatment-emergent adverse events were reported.1 IP10-04 EFFICACY AND SAFETY OF ON-DEMAND THERAPY WITH CLOMIPRAMINE/SILDENAFIL COMBINATION COMPARED TO CLOMIPRAMINE OR SILDENAFIL ALONE IN PATIENTS WITH PREMATURE EJACULATION: MULTI-CENTER, PHASE 3 TRIAL. doi:10.1097/01.JU.0001109900.23127.a9.04 Crowdis M, Leslie SW, Nazir S. Premature Ejaculation. Treasure Island (FL): StatPearls Publishing; May 30, 2023.

The effects of Viagra® are pretty sildenafil citrate tablets 50mg well-known these days—the average guy understands that if you have erectile dysfunction (ED), the pill can help you get hard. But beyond that general awareness, specific intel about how and why it works, along with whether it’s actually safe to use, can start to waver.

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Write down questions in advance to make the most of your time with your provider. The list below suggests questions to ask your health care provider about premature ejaculation. Don't hesitate to sildenafil 25 mg tablets ask more questions during your appointment. What may be causing my premature ejaculation? How soon after I begin treatment can I expect improvement?

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How much improvement can I reasonably expect? Am I at risk of this problem recurring? Is there a generic alternative to the medicine you're prescribing? Are there any brochures or other printed material that I can take home with me? Your health care provider might ask very personal questions and might also want to talk to your partner.

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To help your provider determine the cause of your problem and the best course of treatment, be ready to answer questions, such as: How often do you have premature ejaculation? When did you first experience premature ejaculation? Do you have premature ejaculation only with a specific partner or partners? Do you experience premature ejaculation when you masturbate? Do you have premature ejaculation every time you have sex? But whether “the little blue pill” can have other effects on your sex life and general health can get fuzzy if you ask your buddies or the internet. The same is true for the effects of Viagra on premature ejaculation (PE). PE is one of the most common types of sexual dysfunction, with 4 to 39 percent of men reporting they’ve dealt with it at some point (although reports are often subjective and estimates vary widely).

So, if you’re worried you’re coming too fast, you’re definitely not alone.

• Sildenafil is a PDE5 inhibitor used mainly for erectile dysfunction.
• Some men use sildenafil to delay ejaculation temporarily.
• Sildenafil may improve confidence in sexual performance.
• It does not treat underlying causes of premature ejaculation.
• Sildenafil's effects can last up to 4-6 hours.
• Using sildenafil for PE is off-label and not medically approved.
• Combining sildenafil with other ED medications can be risky.
• Timing of sildenafil intake affects its effectiveness.
• Side effects include headaches, flushing, and nasal congestion.
• It may interact with nitrates, causing dangerous blood pressure drops.
• Always consult a doctor before using sildenafil for PE.

You’re also definitely not alone if you’re wondering whether Viagra could help you. Below, we’ve cleared up the details about what Viagra does, whether Viagra for premature ejaculation works, and what other PE treatments are available. Let’s get technical about Viagra for a second. Sildenafil citrate is the active ingredient in this brand-name drug. Both the generic and brand names belong to a class of drugs called phosphodiesterase type 5 or PDE5 inhibitors. The medications work by interfering with a type of enzyme, called phosphodiesterase type 5 (PDE5). That inhibition leads to a higher concentration of a molecule that relaxes and dilates the blood vessels in your penis, amping up the blood flow to your penis.

That extra blood flow is what makes it easier for you to get an erection.

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Combination therapy of sildenafil and clomipramine significantly improves ejaculatory latency time and patient-reported outcomes in men with PE compared to monotherapies. The phase 3 trial involved 795 men across 24 sites in Korea, showing greater efficacy of combination therapy in improving IELT, PEP, and PGIC scores. A phase 3 trial reveals a combination therapy for premature ejaculation significantly enhances treatment outcomes. Use of a combination therapy could be a game-changer for management of Results of a phase 3 trial presented at the “This is the first approved multicenter phase 3 trial of sildenafil 50 mg/clomipramine 15 mg combination for the treatment of premature ejaculation in the world and designate as incrementally modifying the drug,” said Du Geon Moon, MD, PhD, a professor in the Department of Urology at Korea University College of Medicine. “The study results suggest that the on-demand therapy of this combination has the potential in the treatment of the PE without ED for better efficacy with similar safety as clomipramine alone for PE.” Despite being among the most common sexual health disorders, with estimates suggesting prevalence could exceed 30% of men, satisfactory management of PE remains an elusive target for urologists.

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With no agents sporting indications specific to PE, providers are left with the challenge of determining proper treatments, with common choices including selective serotonin reuptake inhibitors, topical anesthetics, and behavioral therapies. Sponsored by CTC Bio, the AUA 2025 study from NAME was a 3-arm, prospective, randomized, double-blind, active-controlled, multi-center trial. The trial enrolled 795 men with PE without erectile dysfunction across 24 sites in Korea between October 2019 and April 2022. For the purpose of analysis, PE was defined based on DSM-V criteria, a PEDT score of 11 or higher, and an intravaginal ejaculatory latency time (IELT) of less than 3 minutes. A total of 265 participants were randomized to clomipramine 15 mg (Group A), 266 were randomized to sildenafil 50 mg (Group B), and 264 were randomized to a combination of clomipramine 15 mg and sildenafil 50 mg (Group C). It’s a proven effective treatment for ED. Each clinical study and systematic review, as well as all the PubMed and DOI studies you’ll find doing research alone on a Saturday night, agree that this ED medication does what it’s supposed to do.

• Misusing sildenafil for PE can cause serious health risks.
• The drug's primary purpose is erectile dysfunction.
• Off-label use for PE should be supervised by a doctor.
• Performance anxiety often exacerbates PE.
• Proper medication adherence improves results.
• Natural remedies lack strong scientific support.
• Combining drugs without guidance is dangerous.
• Behavioral adjustments can sometimes eliminate PE.
• It is vital to address both physical and psychological aspects.
• Clinical trials explore sildenafil's role in PE management.
• Open communication with a healthcare professional is key.

It’s also FDA approved to treat erectile dysfunction.

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However, more research is needed to determine their effectiveness. It's typical to feel embarrassed when talking about sexual problems. But you can trust that your health care provider has had similar conversations with many others. Premature ejaculation is a very common condition. And it's one that can be treated.

Basic questions to ask your doctor

Being ready to talk about premature ejaculation will help you get the treatment you need to put your sex life back on track. The information below should help you prepare to make the most of your appointment. When you make your appointment, ask if there are any restrictions you need to follow in the time leading up to your visit. How often do you ejaculate before you or your partner would wish? How long after you begin having intercourse do you typically ejaculate?

Early and Delayed Ejaculation: Psychological Considerations

Think back on your relationships and sexual encounters since you became sexually active. Have you had problems with premature ejaculation before? Write down any other medical conditions with which you've been diagnosed, including mental health conditions. Also note the names and strengths of all medications you are currently taking or have recently taken, including prescription drugs and those you buy without a prescription. Questions to ask your health care provider. Even so, people who don’t understand what it does may get things wrong—like whether Viagra can effectively treat PE. The short answer is anecdotally, yes, but scientifically, unclear.

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How much are you bothered by premature ejaculation? How much is your partner bothered by premature ejaculation? How satisfied are you with your current relationship? Are you also having trouble getting and keeping an erection (erectile dysfunction)? If so, what medications have you recently started or stopped taking?

Pregnancy and breastfeeding while taking sildenafil

Deciding to talk with your health care provider is an important step. In the meantime, consider exploring other ways in which you and your partner can connect. Although premature ejaculation can cause strain and anxiety in a relationship, it is a treatable condition. Premature ejaculation — Current concepts in the management: A narrative review. Disorders of ejaculation: An AUA/SMSNA guide.

More Information

Pelvic floor muscle training improves erectile dysfunction and premature ejaculation: A systematic review. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5-TR. National Institute of Diabetes and Digestive and Kidney Diseases. Khera M. Treatment of male sexual dysfunction. Sildenafil citrate was originally developed for heart conditions. It can still treat those, but the drug has since become the face of erectile dysfunction.

As for the effects of Viagra on premature ejaculation, there’s not so much data, and no Food and Drug Administration (FDA) approval for this use. (In fact, no medication is FDA-approved to treat PE). There are a few studies, though, that have examined the potential effects of sildenafil on premature ejaculation compared to a placebo and other treatments. One such study women sildenafil published in 2007 using just 180 male participants found that those men: Experienced improvements in IELT (intravaginal ejaculatory latency time, or time to ejaculation after penetration) Experienced improvements in IELT (intravaginal ejaculatory latency time, or time to ejaculation after penetration) Experienced a decrease in the severity of their PE Experienced a decrease in the severity of their PE The study concluded that sildenafil is “very effective and safe to treat PE” and may also increase confidence.

How Premature Ejaculation Differs from Erectile Dysfunction

The primary outcome of interest for the study were stopwatch-measured IELT at 12 weeks. Additional outcomes of interested included changes in Premature Ejaculation Profile (PEP) and Patient Global Impression of Change (PGIC).1 Results of the trial indicated all groups showed significant increases in IELT over 12 weeks: Group A: 191.72±12.72 seconds (P <.001) Group B: 168.35±12.29 seconds (P <.001) Group C: 279.41±20.06 seconds(P <.001) Further analysis demonstrated the increase in IELT was significantly greater in group C compared to either monotherapy group (each P <.001). Improvements in PEP scores were 91.46%, 85.59%, and 96.10% for groups A, B, and C, respectively, with group C achieving significantly greater rates of improvement than groups A (P = .037) or B (P <.001). Additionally, a consistent trend was observed for PGIC score improvements, with improvement rates of 41.87%, 34.50%, and 54.98%, respectively, again favoring group C relative to groups A (P = .004) and B (P <.001).1 Safety data suggested treatment-emergent adverse events occurred among 17.36%, 16.17%, and 25.00% of patients in groups A, B, and C, respectively, with no statistically significant differences between groups (P = .098). The most common treatment-emergent adverse events in group C were headache (9.09%), nausea (7.58%), flushing (7.95%), and dizziness (3.41%).