If Priligy (dapoxetine) didn't suit you, or you want other options, there are several proven paths to try. Below I cover prescription drugs, topical treatments, and simple techniques you can use right away. I’ll keep it practical: what to expect, how fast each works, and key safety notes.
Short-acting and daily SSRIs — drugs like dapoxetine are in the SSRI family, but other SSRIs (paroxetine, sertraline, fluoxetine) are used off-label for premature ejaculation. These are usually taken daily, not on-demand. They can increase time to ejaculation for many men, but they often take 1–3 weeks to show full effect. Common side effects: nausea, drowsiness, and possible changes in libido or erectile function. Talk to your doctor about dosing and interactions.
Tramadol — an opioid pain medicine sometimes prescribed off-label for delay. It can work faster than daily SSRIs, but it carries risks: dizziness, nausea, dependency with long-term use, and dangerous interactions with antidepressants (risk of serotonin syndrome). This one needs careful medical supervision and is not a first-line choice for most men.
Other prescription choices — some doctors may consider combinations (low-dose SSRI plus on-demand therapy) or refer you to a specialist. Any prescription option should be discussed with your prescriber, especially if you take other meds.
Topical anesthetics — lidocaine or prilocaine creams and sprays are widely used and often available without a prescription. Apply them to the head of the penis about 10–15 minutes before sex, then wipe off excess before intercourse to reduce numbness for your partner. These usually work on-demand and have fewer systemic side effects than oral drugs.
Condoms with numbing agents — a simple, low-risk option. They reduce sensation and can help last longer. Regular condoms also lower sensitivity to some degree and are worth trying first.
Behavioral techniques and pelvic floor exercises — these cost nothing and help over time. Start-stop and squeeze techniques teach you to recognize points of high arousal. Pelvic floor (Kegel) exercises strengthen control and can reduce urgency. Combine these with partner communication for better results.
Choosing what’s right: think about how quickly you need results, whether you prefer on-demand versus daily treatment, and what side effects you can tolerate. Many men find the best outcome by combining methods — for example, topical anesthetic plus behavioral training. Always check drug interactions and discuss major choices with your doctor or a sexual health specialist. If you notice worrying side effects or mood changes, seek medical advice right away.
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