What are the recommended first-line pharmacological treatments for premature ejaculation in primary care?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Recommended first-line pharmacological treatments for premature ejaculation in primary care typically include selective serotonin reuptake inhibitors (SSRIs) such as dapoxetine, which is licensed specifically for this indication, and off-label use of other SSRIs like paroxetine, sertraline, or fluoxetine. These medications help delay ejaculation by modulating serotonin levels. Additionally, topical anesthetic agents may be considered to reduce penile sensitivity and delay ejaculation. However, the provided UK guideline excerpts do not explicitly detail pharmacological treatments for premature ejaculation, indicating a need to refer to specific sexual health or urology guidelines for precise recommendations.

In primary care, management often starts with education, behavioral techniques, and psychological support, with pharmacological treatments introduced if these are insufficient. SSRIs are generally considered first-line pharmacological options due to their efficacy and safety profile in this context.

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