Ejaculation Problems: Too Fast, Too Slow or Not at All?

If you are taking sildenafil for erectile dysfunction or pulmonary arterial hypertension, it’s possible to experience side effects. Most side effects are mild to moderate in severity.

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Before starting sildenafil treatment, be sure to tell your doctor if you have any of these factors. They’ll help determine if the drug is right for you. If you have sickle cell anemia, tell your doctor. You may have an increased risk of vaso-occlusive crisis (VOC) if you have sickle cell anemia and take sildenafil. With VOC, your blood cells block blood flow to your organs, which can be painful.

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Be sure to talk with your doctor if you have sickle cell anemia. They’ll advise if sildenafil is right for you. Conditions related to the shape of your penis. If you have conditions related to the shape of your penis, such as Peyronie’s disease, tell your doctor. These conditions may increase your risk of severe priapism* during sildenafil treatment.

The pause-squeeze technique

If you experience an erection lasting longer than 4 hours, call 911 or your local emergency number immediately. If you take nitrates for any reason. Taking sildenafil with drugs containing nitrates is contraindicated. (A contraindication is a factor or condition that could prevent your doctor from prescribing a drug due to risk of harm.) This is due to sildenafil’s potential to cause severe low blood pressure. * Examples of nitrates include nitroglycerin (Nitrolingual), isosorbide (Isordil), nitroprusside (Nitropress). If you’re experiencing symptoms of severe side effects while taking sildenafil, talk with your doctor right away. If you’d like to learn more about sildenafil, talk with your doctor or pharmacist.

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They can help answer any questions you have about side effects from taking the drug. A generic drug and its brand-name version contain the same active ingredient, so they’re expected to have the same side effects. Referring to the following articles about sildenafil and Viagra can provide you with additional information: For details about other aspects of sildenafil, refer to this article. To learn how sildenafil compares with Viagra, read this article. If you’d like to learn about sildenafil and cost, see this article.

Age Group	Response Rate (%)	Common Side Effects	Typical Dose	Notes
18-30	65	Headache, dizziness	50 mg	Younger patients often respond well
31-50	70	Flushing, nasal congestion	50-100 mg	Dose titration may be needed
51+	55	Dizziness, hypotension	25-50 mg	Increased caution advised

For details about 50 mg sildenafil price your condition, see our hypertension hub. You can also view our men’s health hub and this list of erectile dysfunction and premature ejaculation articles. Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

Tip	Explanation	Best Practice
Consult a healthcare professional	To determine appropriateness and safe dosage	Essential before starting treatment
Start with low dose	To minimize side effects and assess response	Usually 25-50 mg
Monitor and report side effects	To optimize treatment and safety	Follow-up appointments
Combine with behavioral therapy	Enhances overall outcomes	Address psychological factors

Brand name Viagra® (AKA sildenafil citrate) has earned a reputation as the go-to fix for sexual challenges — especially erectile dysfunction.

Treatment	Mode of Action	Effectiveness	Onset	Duration	Side Effects
Sildenafil	Vasodilation, neural effects	Moderate	30-60 min	4-6 hours	Headache, flushing
Dapoxetine	Selective serotonin reuptake inhibitor	High	1-3 hours	1-2 hours	Nausea, dizziness
Topical anesthetics	Local nerve block	Varies	Rapid	Minutes to hours	Loss of sensation

So, people often think of it as the magic pill for boosting stamina in bed. But can Viagra make you last longer in bed?

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If you take any of these drugs or any other nitrates, be sure to tell your doctor before starting sildenafil treatment. Sildenafil is contraindicated if you take a GC stimulator, including riociguat (Adempas). This is because these drugs may cause severe low blood pressure. Be sure to tell your doctor if you take this drug. They’ll likely recommend you do not take riociguat with sildenafil.

Defining premature ejaculation for experimental and clinical investigations

* For more details about this side effect, see the “Sildenafil: Serious side effects” section above. It’s unknown whether sildenafil is safe to take while pregnant or breastfeeding. Animal studies* did not show harm to the fetus when the drug was exposed to pregnant animals. However, keep in mind that animal studies don’t always reflect what will happen in humans. If you’re pregnant or can become sildenafil for women pregnant, talk with your doctor.

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They’ll review the risks and benefits with you and advise whether sildenafil treatment is right for you. In certain cases, your doctor may recommend that you continue taking sildenafil during pregnancy. Sildenafil may pass into breast milk, but it isn’t known how this could affect a child who is breastfed. If you are breastfeeding or planning to breastfeed, talk with your doctor. They can review the risks and benefits of taking sildenafil while breastfeeding. Viagra can absolutely help you maintain an erection if that’s where you’re struggling. And while it’s not FDA-approved specifically to treat premature ejaculation (PE), some research hints it might help you avoid early orgasm.

How Premature Ejaculation Differs from Erectile Dysfunction

It also includes feeling as if you have to swallow a lot. If you start to experience nosebleeds often or if they don’t stop, talk with your doctor. They may recommend applying a cold cloth to the bridge of your nose briefly or pinching your nostrils for a short period of time. Your doctor may also recommend medications to help with nosebleeds, such as oxymetazoline (Afrin). It usually happens without sexual stimulation or continues long after sex.

The role of tyrosine hydroxylase within dapoxetine-assisted therapy against premature ejaculation

Priapism was a rare side effect in clinical trials of sildenafil.* Priapism can become a serious side effect if your erection lasts longer than 4 hours. If you’ve ever had sickle cell anemia, multiple myeloma, or leukemia, you may have an increased risk of developing severe priapism. Call 911 (or your local emergency number) and go to the emergency room if you experience an erection that lasts longer than 4 hours. You may experience permanent damage to your penis if this is not treated right away. If your erections are lasting longer than usual, but less than 4 hours, talk with your doctor.

Clinical study of SS-cream in patients with lifelong premature ejaculation

They may recommend decreasing your sildenafil dosage. As with most drugs, sildenafil can cause an allergic reaction in some people. However, these reactions were rarely reported in clinical trials.* Symptoms can be mild or serious and can include: For mild symptoms of an allergic reaction, call your doctor right away. They may recommend ways to ease your symptoms and help determine whether you should keep taking sildenafil. However, if your symptoms are serious and you think you’re having a medical emergency, immediately call 911 or your local emergency number. We’ve outlined the facts on sildenafil citrate and its potential for increasing sexual stamina. Plus, we’ll introduce you to other proven ways to improve your performance in the bedroom.

• Sildenafil enhances blood flow but doesn't directly delay ejaculation.
• PE is often linked with heightened genital sensitivity.
• Timed use of sildenafil may improve sexual confidence.
• Medication dose should be carefully managed.
• PDE5 inhibitors may have a role in PE enhancement.
• Regular sexual activity can help reduce PE symptoms.
• Psycho-sexual therapy addresses underlying issues.
• Identifying triggers can help manage PE episodes.
• Drugs are part of a comprehensive PE management plan.
• Pharmacotherapy may require adjustment over time.
• Always follow medical advice regarding medication use.

Some reports suggest that Viagra might be an effective treatment for premature ejaculation. Viagra (sildenafil citrate) is a type of erectile dysfunction medication called a phosphodiesterase type 5 inhibitor.

• Early ejaculation is a normal variation for some men.
• Understanding personal sexual response helps manage PE.
• Sensory-enhancing devices may delay climax.
• Medications are not the only solution to PE.
• Regular exercise benefits erectile and ejaculatory health.
• Stress management techniques can improve PE outcomes.
• PE can be a sign of underlying medical issues.
• clinician-guided treatment yields better safety profiles.
• Support from partners encourages successful treatment.
• Combining therapy approaches often gives the best results.
• Healthy lifestyle choices support sexual function.

PDE5 inhibitors like Viagra, Cialis® (tadalafil), and Levitra® (vardenafil) treat ED by increasing blood flow to the soft erectile tissues and blood vessels in your penis.

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Be sure to talk with your doctor about your health history before you take sildenafil. This drug may not be the right treatment for you if you have certain medical conditions or other factors that affect your health. These are considered drug-condition or drug-factor interactions. The conditions and factors to consider include: If you’ve ever had PVOD, taking sildenafil can lead to heart problems. Your doctor won’t typically recommend taking sildenafil if you’ve ever had PVOD.

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Talk with your doctor if you develop fluid in your lungs while taking sildenafil. If you develop PVOD, your doctor will likely recommend another medication for your condition. If you’ve had an allergic reaction to canadian sildenafil citrate sildenafil or any of its ingredients, your doctor will likely not prescribe sildenafil. Taking sildenafil could cause you to have another allergic reaction. Ask your doctor what other medications may be better options for you.

Treatment for PE

Talk with your doctor if you’ve ever had eye disorders or if you start to experience vision loss while taking sildenafil. An eye condition called non-arteritic anterior ischemic optic neuropathy (NAION) may occur in people taking sildenafil. Certain factors can increase your risk of developing NAION during sildenafil treatment. These include previous eye conditions or coronary artery disease. They also include being age 50 years or older or smoking. Erectile dysfunction medications can help you get an erection or maintain a firmer erection to improve the sexual experience for you and your partner. On average, Viagra lasts for up to four hours after you take your dose. So, if you tend to lose your erection during sex, Viagra’s effects could help you have sex for longer. "Sildenafil takes my stamina and endurance to the next level, allowing both of us to achieve amazing orgasms! My partner is 7 years younger and has an extremely high sex drive, so being able to keep up and satisfy her has improved our sex life and strengthened our relationship." There are a few interesting studies about Viagra’s effects on sexual dysfunction.

• Premature ejaculation is classified as lifelong or acquired.
• Lifelong PE begins from the first sexual experience.
• Acquired PE develops after a period of normal function.
• Sensory sensitivity might influence PE severity.
• Partner communication can improve PE management.
• Pelvic floor exercises may help control ejaculation.
• Squeeze techniques can delay climax.
• Pharmacological options include SSRIs, dapoxetine.
• Biofeedback therapy is an emerging PE treatment.
• Erectile dysfunction and PE can coexist.
• Proper diagnosis ensures effective treatment.

In a small 2007 study published in the International Journal of Urology: Official Journal of the Japanese Urological Association, researchers found a link between sildenafil (the active ingredient in Viagra) and an increase in ejaculation time in men experiencing PE. Another study from 2005 published in The Journal of Sexual Medicine found that men who used sildenafil experienced a small increase in time before ejaculation. The increase compared to placebo wasn’t statistically significant, but men did have an increased perception of ejaculatory control and overall sexual satisfaction. According to a clinical study published in the International Journal of Impotence Research, sildenafil may reduce refractory time by several minutes. In this study, the average reduction in time was about nine minutes.

• Sildenafil's role in PE is still under research.
• Off-label use requires informed consent.
• Behavioral techniques are first-line in many cases.
• The impact of psychological health on PE should not be ignored.
• Educating patients on realistic expectations is important.
• Sometimes, medication just masks underlying issues.
• Regular sexual activity can decrease PE severity.
• Consulting a urologist is recommended for persistent PE.
• Combining medication with therapy often improves outcomes.
• Delaying ejaculation involves both physical and mental strategies.
• Support and understanding enhance treatment adherence.

A 2023 clinical trial involving 160 participants suggests that combining sildenafil citrate (50 mg) and the opioid painkiller tramadol HCl (100 mg) is a safe and effective treatment for PE.