Alternatives to Priligy: Practical Options for Premature Ejaculation

Priligy (dapoxetine) helps many men, but it isn't the only way to manage premature ejaculation (PE). Maybe you had side effects, can't get the drug, or prefer a non-prescription approach. Here are clear, practical alternatives—what they do, how they work, and what to watch for.

Medical options worth knowing

Short-course SSRIs: Drugs like paroxetine, sertraline, and fluoxetine are used off-label for PE. They can delay ejaculation by changing serotonin levels. Paroxetine tends to be most effective but may take longer to work and can cause side effects like reduced libido or nausea. If you consider this route, expect your doctor to discuss dosing schedules and interactions with other meds.

Tramadol: This painkiller can delay ejaculation in some men. It works quickly but carries a risk of dependence and common opioid-related side effects — dizziness, nausea, or sedation. Avoid tramadol if you’re on certain antidepressants because of serotonin syndrome risk. Use only under medical supervision.

Topical anesthetics: Lidocaine or prilocaine creams and sprays numb the penis surface and are one of the fastest ways to reduce sensitivity. Apply a small amount 5–20 minutes before sex and wipe off excess to avoid numbing your partner. They’re cheap and effective for many, but they can reduce pleasure and, rarely, cause local irritation.

PDE5 inhibitors: Drugs like sildenafil (Viagra) or tadalafil (Cialis) don’t directly treat PE, but they help if erectile dysfunction is also present. Some men find combining a PDE5 inhibitor with an SSRI or topical anesthetic gives better results. Never mix PDE5 drugs with nitrates — that can dangerously lower blood pressure.

Non-drug strategies that work

Behavior techniques: The stop-start method and the squeeze technique are low-risk approaches that teach your body to delay climax. They take practice and partner cooperation, but they’re free and safe.

Pelvic floor exercises: Strengthening pelvic muscles can improve control. A physical therapist or specialist in pelvic health can show you the right moves and a practical routine.

Condoms and desensitizing condoms: Thicker condoms reduce sensation and can add a few minutes. Desensitizing condoms include a mild numbing agent built in, offering another simple option.

Sex therapy and counseling: PE often has a psychological component—performance anxiety, relationship stress, or past experiences. A sex therapist can teach techniques, reduce anxiety, and help partners communicate effectively.

How to choose: Start by talking to your doctor. Consider side effects, drug interactions, how spontaneous you want sex to be, and your overall health. Try one change at a time and track results for a few weeks. If one option fails, combine approaches under medical guidance.

Safety note: Always check with a clinician before starting medications or combining treatments. If you have heart disease, take nitrates, or use antidepressants, some options may be unsafe. With the right plan, many men find a solution that fits their life and restores confidence.