Premature ejaculation is a sexual dysfunction in which ejaculation occurs sooner than desired, often within about one minute of penetration and before the person wishes it to happen. It may cause distress, frustration, or avoidance of intimacy.

Premature ejaculation is one of the most common male sexual disorders. Studies suggest that 20 to 30 percent of men experience it at some point in their lives.

Premature ejaculation can result from psychological factors such as performance anxiety, stress, or relationship issues, as well as biological factors like neurotransmitter imbalance, penile hypersensitivity, or genetic predisposition. Often, both psychological and biological factors are involved.

Paroxetine is a selective serotonin reuptake inhibitor antidepressant. It is marketed under brand names such as Paxil and is approved for conditions including depression, anxiety disorders, panic disorder, obsessive-compulsive disorder, post-traumatic stress disorder, and social anxiety disorder.

Although not officially approved for premature ejaculation in many countries, Paroxetine is prescribed off-label because it delays ejaculation by increasing serotonin levels in the brain.

No. In most countries, including the United States, Paroxetine is not officially approved for premature ejaculation. Its use for this condition is considered off-label.

A patient should consult a physician if premature ejaculation causes significant distress, has been present since first sexual activity, develops suddenly after a period of normal function, or occurs alongside other symptoms such as erectile dysfunction or pain.

Serotonin plays an important role in controlling ejaculation. Paroxetine increases serotonin availability in certain brain pathways by blocking its reuptake, which slows the ejaculation reflex.

Yes. Among selective serotonin reuptake inhibitors, Paroxetine is considered one of the most effective for delaying ejaculation. Clinical studies show it can significantly increase intravaginal ejaculatory latency time compared to baseline.

On average, Paroxetine may increase ejaculation time by three to eight times the baseline duration, depending on the dose and individual response.

Yes. Paroxetine (Paxil) is only available with a prescription. A licensed healthcare provider must evaluate your symptoms and medical history to decide if it’s appropriate for you.

Yes. You can receive a prescription for Paroxetine (Paxil) after completing a virtual visit with a licensed Mount Sinai Urology CME provider. If the provider determines it’s a good fit for your needs, they can prescribe it as part of your treatment plan.

No. Paroxetine (Paxil) is not sold over the counter. You’ll need a prescription from a licensed healthcare professional.

Yes. Mount Sinai Urology CME providers can issue a new prescription or refill an existing one after an online consultation. If approved, your medication will be shipped directly to your home in discreet packaging.

Typical doses range from 10 mg to 40 mg daily. Treatment often begins at 10 to 20 mg per day and may be adjusted depending on effectiveness and side effects.

Paroxetine can be taken daily or on demand. Daily dosing is generally more effective. On-demand dosing is taken about three to four hours before sexual activity but may produce less consistent results.

Studies suggest Paroxetine may produce a greater delay in ejaculation compared to some other SSRIs. However, individual response varies.

Some men notice improvement within five to ten days. Maximum effect usually appears after two to three weeks of consistent daily use.

Common side effects include nausea, drowsiness, fatigue, dry mouth, sweating, reduced libido, and erectile dysfunction.

Yes. Some men may experience difficulty achieving or maintaining an erection. Sexual side effects are relatively common with selective serotonin reuptake inhibitors.

Yes. Decreased libido is a known side effect and may affect some men during treatment.

Paroxetine can be used long term under medical supervision. Regular follow-up is important to monitor effectiveness and potential side effects.

No. Paroxetine manages symptoms but does not cure the condition. Ejaculatory timing usually returns to baseline after discontinuation.

Sudden discontinuation may cause withdrawal symptoms such as dizziness, irritability, nausea, and flu-like symptoms. The dose should be tapered gradually under medical supervision.

Paroxetine should be avoided or used cautiously in patients taking monoamine oxidase inhibitors, individuals with bipolar disorder, those with severe liver disease, or anyone with a known hypersensitivity to selective serotonin reuptake inhibitors.

Yes. It may be combined with behavioral techniques such as the start-stop method, topical anesthetic creams, or medications for erectile dysfunction when appropriate.

Dapoxetine is a short-acting selective serotonin reuptake inhibitor developed specifically for on-demand treatment of premature ejaculation in some countries. Paroxetine is longer acting and typically taken daily.

Paroxetine may be prescribed to adult men. In younger individuals, careful evaluation is required due to possible mood-related side effects and other risks.

There is no strong evidence that Paroxetine directly causes infertility. However, sexual side effects may indirectly influence reproductive plans.

Paroxetine is not addictive in the traditional sense. However, the body can adapt to it, and withdrawal symptoms may occur if it is stopped abruptly.

Paroxetine can be taken with or without food. Taking it with food may help reduce nausea.

A clinician may screen for contributing problems such as erectile dysfunction, prostatitis or other pelvic pain conditions, thyroid disorders, medication effects, depression, and anxiety. Treating the underlying issue can improve PE.

Paroxetine can interact with other medicines, including certain antidepressants, MAO inhibitors, some migraine medicines, and drugs that affect bleeding risk. Always share a full medication and supplement list with the prescriber.

Do not change the dose on your own. Contact the prescriber to discuss whether side effects are likely to improve, whether a dose adjustment is needed, or whether another option may be safer or better tolerated.

Common options include behavioral techniques (like stop-start), pelvic floor training, counseling or sex therapy for anxiety and relationship factors, and topical anesthetics in appropriate cases. Many people benefit from combining approaches.