Can SSRI pills cause premature ejaculation?

Advice for men who come quicker after SSRI antidepressant withdrawal.

Man pointing to SSRI medication with title: premature ejaculation comes back

For men who want to last longer in bed, antidepressant medication has this handy side-effect. SSRI pills can fairly reliably delay the ejaculation reflex.

All together now – yay.

Man sitting on a bed with two women behind him, everyone looking elated.

But do SSRIs have the opposite effect too? Can they cause premature ejaculation, especially after you stop taking them?

I’m a psychotherapist, and I work with people going through depression and anxiety. Often they’re taking SSRI antidepressant medication, or they’ve come off it and are looking for other ways to manage their mood. And there are plenty of things we can offer in this respect.

Something I quite often hear is: I’m doing OK off the pills, but I miss the sexual prowess it gave me.

It’s usually guys saying this, in case you were wondering.

Or they feel that now, without the pills, they’re coming too quickly. They’ve developed premature ejaculation and they worry this might be permanent, as anyone would.

Man sitting on the edge of the bed with his partner behind him, both looking dismayed and unhappy

So we’re talking about SSRIs: fluoxetine, sertraline, citalopram, paroxetine and many more. All commonly used in the treatment of depression. Around 8 million people in the UK are on such a prescription.

These meds boost our serotonin levels, and it’s a known side-effect: higher serotonin dampens down our sexual response. Men and women find that it takes them longer to reach orgasm.

This is problematic when it takes too long to get there or we can’t get there at all. But for some guys it’s a bonus, empowering them to last longer in bed.

In fact, SSRIs are prescribed to men struggling with premature ejaculation specifically for this reason. And there’s dapoxetine, the on-demand SSRI developed specifically to treat PE.

Dapoxetine pills in their packaging

On-demand or taken daily, SSRIs are effective in this respect. But they come with other side-effects too.

So if you’re naturally on the quicker side, and you take SSRI medication for any reason, you may well last longer. For some guys it makes no difference, but it usually does. And then if you stop taking the medication, you’ll return to baseline. Within days, you’ll be back to your natural duration.

There is some anecdotal evidence of men coming quicker after coming off SSRIs. They didn’t have PE before but now they do. And if they go back on the medication, they slow down again. And if they come off it again, they speed up again. This can be massively frustrating and worrying.

And there’s at least one reported case in the medical journals. A 43 year-old man developed premature ejaculation after he stopped taking citalopram for depression.

Study title: Premature ejaculation associated with Citalopram withdrawal 2003

There may be other factors at play here. Changes in our relationships, our general health, stress levels. Lifestyle has a huge influence on our sexual function.

But we know that the neurotransmitter serotonin is a major factor too, and that’s what SSRIs target. They are Selective Serotonin Reuptake Inhibitors. They keep the serotonin flowing, but only for as long as we take the meds.

A couple of caveats here. If any of this is your experience or you’re concerned that it might be, you should seek advice from your doctor. Especially around starting and stopping SSRI medication. You should taper on and off, don’t just stop taking it.

And in the psychological profession, there’s debate about the pros and cons of SSRI antidepressant medication.

I’m somewhere in the middle. I think they have a place as a treatment for depression. They can save lives. But SSRIs can be over-prescribed for too long.

Scattered SSRI pills of various colours

So I’m not being all anti-SSRIs here. They are a treatment option for PE if you’re ok with the side-effects. Again speak with your doctor if you’re considering this. But there are more organic ways to overcome PE too.

And that’s my point here. So you’re missing that superpower that SSRIs gave you. You might feel like your PE has come back, or you have it now – that’s plausible.

But you don’t necessarily need to get back on SSRIs to last longer again.

Is it really a problem now? Is sex still satisfying, what’s your partner’s take on this?

Remember that the average, the baseline, for most guys is around 5 minutes. And 5 minutes can be just fine for a lot of partners, especially if you get creative with sex.

And if you want to be able to go for longer again, skills not pills may be way to go.

An organic approach to treating PE – enhancing our awareness, relaxation and connection – reaps benefits outside the bedroom too.

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