Roman is a telemedicine company that provides a discreet, convenient, and affordable way for you to receive PE treatment from a doctor or nurse practitioner—all without leaving the couch. Roman Swipes are available for purchase directly from the website as an over-the-counter (OTC) product that does not require a prescription. If you are interested in prescription treatment, it starts with an online visit. The online visit will ask you about your symptoms, your medical history, and other basic information. You’ll also be asked to upload a photo of your ID to verify your identity. Once you have done all of this, a doctor or nurse practitioner will review everything, determine if you’re a candidate for PE treatment through telemedicine, and craft a personalized treatment plan for you.

Although no single treatment works for everyone, most men can be treated successfully. There are multiple oral medications, topical therapies, and other techniques that can be used alone or in combination with one another. Some people see immediate results, but for many men it takes some time before results are apparent. Some may find they need to try a few different methods before finding the right solution. If things don’t go as planned or if you experience an adverse side effect, don’t give up. You have options and we are here to help you find the best solution.

There are many possible causes of PE, ranging from physical causes to psychological causes. Although it may seem odd to get prescribed ED medication for PE, numerous studies have shown that it can be effective. There are a few reasons ED medication might help:

• ED medication can help relax the smooth muscles of organs involved in ejaculation
• ED medication can affect the nervous system in ways that may delay ejaculation
• ED medication may decrease the sensitivity of the penis
• ED medication can prolong the duration of an erection, increasing confidence, the perception of ejaculatory control, and overall sexual satisfaction
• ED medication can make it easier to get a second erection after ejaculation

Some patients may also have coexisting ED and PE. For these patients, it is recommended ED get treated first, to see if it has beneficial effects on PE.

There are also other important differences between the medications. For example, sildenafil citrate is less effective when taken with food and it can cause temporary blue vision (as if you’re looking through blue-tinted glasses) in some users. Tadalafil can be taken with food and is much less likely to cause temporary blue vision in users. Tadalafil can also be taken daily at lower doses.

Your doctor or nurse practitioner may recommend a combination of medication and behavioral therapy tips to deal with PE. No two people are alike, and it may take time and experimentation to find the methods that work best for you. Some recommended non-prescription techniques include:

• Topical anesthetics: Topical anesthetics can be applied to the penis just before sexual activity. They come as creams, lotions, or sprays and are available over-the-counter. The advantage of topical applications is that the side effect rate is low.
• Condoms: Condoms can help with PE by decreasing penile sensitivity. They also have the added benefit of reducing the risk of sexually transmitted infections and unwanted pregnancy.
• Behavioral modification: The squeeze and stop-start techniques are two different strategies that can be practiced during masturbation or sexual activity, and—over time—they can improve control over the timing of ejaculation.

Psychotherapy: Counseling, whether in person, by telephone, or by text messaging, may increase the likelihood of success for some patients.

There are three prescription-strength medications for PE available on the Roman platform: sildenafil citrate (the active ingredient in Viagra), tadalafil (the active ingredient in Cialis), and sertraline (a type of medication known as a selective serotonin reuptake inhibitor, or SSRI). Your doctor or nurse practitioner will decide which treatment option is most appropriate for you after reviewing the information you provide in your online visit. While one medication may be better for one person, a different medication may be better for another person. It all depends on your specific medical history, symptoms, and preferences. Of note, there is no medication that is specifically FDA-approved for the treatment of PE. However, sildenafil citrate, tadalafil, and sertraline can be prescribed off-label for this purpose, if appropriate.

In addition to these three prescription medications, Roman Swipes is an over-the-counter treatment for PE that you can purchase directly from the website without going through an online visit.

Off-label usage of a medication refers to using the medication for purposes that have not specifically been approved by the FDA. Healthcare professionals have the discretion to prescribe medications off-label if they believe it is an appropriate course of treatment for a particular patient.

Sertraline can be used in two ways to treat PE. It can be taken daily at a convenient time (e.g., after brushing your teeth in the morning) or it can be taken as-needed 4–8 hours before you plan to have sex. Studies have found that taking the medication daily is generally more effective than taking it as needed. However, taking the medication daily also increases the risk of experiencing side effects. Your doctor or nurse practitioner can work with you to help determine if daily or as-needed dosing is best for you.

Yes. Using Roman Swipes in combination with prescription treatment is not dangerous and can actually help delay ejaculation even more. This is especially good for patients who do not see enough of a benefit from prescription medication alone. On the other hand, some people will find that the combination delays ejaculation too much, decreasing satisfaction for them or their partner(s).