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TREATMENT OPTIONS

Premature Ejaculation Medication in South Africa: What Exists and What to Know

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Medicines are one of the treatment options described in the guidelines for premature ejaculation (PE). This page gives general information about the kinds of medicine doctors may discuss. It is not a recommendation and not a medical assessment. It names no brands, gives no doses and does not say where to buy anything.

[DRAFT: Legal review needed before this page is published. Check the South African Medicines Act and the Advertising Regulatory Board rules on advertising medicines to the public, and verify current South African availability of each type of medicine mentioned.]

01

Medicines are prescribed by doctors, not by this clinic

Only a doctor can decide whether a medicine is suitable for you and prescribe it. This clinic does not prescribe medicines. Our practitioner is a naturopath, and he refers you to a doctor when a medicine is something you want to consider. See when to see a doctor. The European Association of Urology (EAU) guidelines describe medicine as the first-line treatment for lifelong PE, while for acquired PE they advise treating an underlying cause first.

02

Topical anaesthetics

These are creams, gels or sprays applied to the penis to reduce sensitivity. The guidelines include them as an option. Points to be aware of are that they can numb the skin, they can transfer to a partner, and they may be used together with a condom. Ask a doctor or pharmacist how a particular product should be used. See also delay sprays and condoms.

03

Antidepressants used off-label (SSRIs)

Some antidepressants of the SSRI type can delay ejaculation, and doctors sometimes prescribe them for PE even though this is not the purpose they were originally approved for. This is called off-label use. They need a doctor’s supervision, because they can have side effects, can interact with other medicines and should not be started or stopped suddenly.

04

Other options doctors discuss

Doctors may also consider other medicines in some situations, including treatment for a related problem such as erectile dysfunction, when that is part of the picture. What is available and suitable depends on your health, your other medicines and your preferences. This is a matter for your doctor, not for this page.

05

Risks and interactions

  • All medicines can have side effects, and some can interact with other medicines, supplements, alcohol or recreational drugs.
  • Tell your doctor about every medicine and supplement you take.
  • Do not take a medicine meant for someone else, and do not combine products without advice.
  • Do not stop a prescribed medicine on your own.
  • Report any unusual or severe reaction to a doctor straight away.

06

Medicines to avoid buying online

Medicines sold online or through informal sellers may be fake, of poor quality or wrongly labelled, and they may contain ingredients that are not declared. Products promising instant or guaranteed results for PE are a particular warning sign. Get advice from a doctor or pharmacist before taking anything. See also what can and cannot be promised.

07

How to raise it with your doctor

  • Say plainly that you are having a problem with ejaculating sooner than you want, and how long this has been going on.
  • Mention any erection problems, and any medicines, supplements or drugs you use.
  • Ask what the options are, what the risks of each are and what you should expect.
  • Ask how long you should try something before judging whether it helps.

You can also read our overview of treatment options and the page on medical causes of PE.

Sources and further reading

  1. Althof SE, McMahon CG, Waldinger MD, et al. An update of the International Society of Sexual Medicine's guidelines for the diagnosis and treatment of premature ejaculation. Sex Med 2014;2(2):60-90
  2. European Association of Urology guidelines on sexual and reproductive health, 2021 update: male sexual dysfunction. Eur Urol 2021;80(3):333-357

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