We use telemedicine technology and U.S. licensed doctors to provide premature ejaculation treatments discreetly, conveniently, and inexpensively.

It starts with your online doctor visit. Your doctor needs to know about your health (e.g., your medications, lifestyle issues, prior surgeries) and how P.E. affects you. They also need to see a personal ID to confirm your identity and know who they will be helping. They review everything, determine if you’re a candidate for telemedicine and, if so (most people are), they will craft a personalized treatment plan.

Their treatment plan will include a great deal of information about P.E. It is important you take the time to read it all. You will be better prepared to manage your condition as a partner—and not just a patient.

If you qualify, our doctors will provide a diagnosis, behavioral therapy tips and prescribe the right course of treatment to help you last longer during sex.

One of the problems with the diagnosis and treatment of PE is that until recently there has not been agreement on what constitutes premature ejaculation. Many men believe they orgasm more quickly than they should only to discover that their time to orgasm is well within the average range. Other men might orgasm in 2 minutes but find it is neither a cause for concern for them nor for their partner.

1. According to the International Society of Sexual Medicine (ISSM) premature ejaculation is a male sexual dysfunction characterized by the following:
   Ejaculation that always or nearly always occurs prior to or within about 1 minute of vaginal penetration from the first sexual experience—Lifelong Premature Ejaculation (LPE),
   OR a clinically significant reduction in latency time (time it takes to reach orgasm after engaging in sex), often to about 3 minutes or less–Acquired Premature Ejaculation (APE);
2. The inability to delay ejaculation on all or nearly all vaginal penetrations; and
3. Negative personal consequences, such as distress, bother, frustration, and/or the avoidance of sexual intimacy.

All three elements must be included for PE to be diagnosed. Men with PE generally fall into two groups: those who have it from their first sexual experience and those who develop it later. The good thing is that many of the interventions work for both groups.

Another definition of PE that has been suggested by the World Health Organization (WHO) is “persistent or recurrent ejaculation with minimal stimulation before, on, or shortly after penetration and before the person wishes it, over which the sufferer has little or no voluntary control which causes the sufferer and/or his partner bother or distress.” This second definition is more flexible. It is also inclusive of gay men and their partners, which is a welcome addition to the definition.

Although no single treatment works for everyone, most men can be treated successfully. Just be sure to stay in touch with your physician. There are multiple medications that can be tried, different topical therapies, and varied techniques that can be used alone or in unique combinations. Some people see immediate results. Others will 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.

In addition to behavioral tips, there are several medication options that your doctor may recommend, depending on your unique health situation. These include Sertraline, Tadalafil (generic Cialis), and Sildenafil (generic Viagra).

The simplest effective treatment is usually the best choice, so your provider will try to prescribe the medication that is most likely to work well for you. Based on your feedback, however, your management may change over time by switching to another medication choice or using a combination of agents. Some men use an oral medication and apply a topical anesthetic that they then cover with a condom. They get the sensations they want, experience the prolonged pleasure of an extended sexual experience, and orgasm at a time both they and a partner find satisfying. For other men, such a combination is overkill. That is why your personal experience is so important.

Learn more about P.E. medication

Sildenafil and tadalafil are primarily thought of as erectile dysfunction (ED) medications, but they can be extremely effective for PE, as well. What is most interesting is that ED often is an underlying cause of PE. Sometimes, the same stress that causes either one can cause both. However, ED itself can begin a cascade of changes that results in PE. This is because men with ED often attempt to keep themselves erect by vigorously stimulating themselves, and this intense stimulation can inadvertently result in PE. When the erection is supported by sildenafil or tadalafil, vigorous stimulation is often not needed to maintain an erection. With less vigorous stimulation, men gain more control over the timing of their ejaculation.

Men who take sildenafil or tadalafil for ED and who do not have PE report that they will find it takes longer to orgasm than they might have anticipated so a biological effect of sildenafil or tadalafil may be at work also.

The medications available for treating P.E. work for the vast majority of patients and they usually do so without causing side effects. However, just as no drug works on everyone, no drug is 100% safe, and these treatments are no exception. Becoming familiar with the possible side effects will help you identify if you are one of the men who experience them. 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.

Yes, in most cases premature ejaculation can be diagnosed by a physician based on a patient self-reporting their symptoms and medical history.
Physicians on the Ro platform use telemedicine technologies to diagnose P.E. in the same way they diagnose patients in-person. Doctors ask questions to evaluate your symptoms and make sure it’s safe and appropriate to prescribe medication. The physicians on the Ro platform use your answers to diagnose your condition and create a treatment plan. That’s why it’s vital that you answer each question to the best of your knowledge and ensure that every communication with your physician is truthful, accurate, and thorough.

Your physician may recommend a combination of medication and behavioral therapy tips to deal with P.E. No two people are alike, and it may take some time and experimentation to find the methods that work best for you. Some men experience significant improvement with learned techniques so medication isn’t for everyone.

Some techniques we may recommend 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 and they are effective to some degree in almost everyone to decreasing sensation and prolonging the time before ejaculation.

Condoms: Condoms can help with PE by decreasing penile sensitivity and have the added benefit of reducing the likelihood of transmission of sexually transmitted infection or unwanted pregnancy. Using a spray, cream, or lotion with a condom is surprisingly effective for some men. It delays orgasm, gives some men just the right amount of pleasurable sensation, and when used with a topical anesthetic prevents the spread of the anesthetic to a partner.

Behavioral modification: The squeeze and start-stop techniques are 2 different strategies that can be practiced during masturbation or sexual activity and, over time, 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. The reality is that men who have had lifelong issues have often suffered silently with a burden that weighs on them every time they consider developing a physical and emotional attachment to another person. They face disappointing the very person they hope to please the most. For many men, it terminates relationships before they begin and can lead to isolation and a loss of companionship. Men with PE face increased risks of divorce and relationship stress, often more as a result of the emotional consequences of having PE than from the PE itself. Uncovering the reasons the PE developed are as important as breaking the cycle with medical interventions.
Also, psychotherapy can be enormously helpful in restoring a man’s sense of value and worth beyond the ability to delay an orgasm, which often restores their capacity to experience sex as they had before PE developed.

Combination Therapy: Any of the above treatments can be combined with any one or more of the other treatments. Although it’s often best to keep things simple, the good news is that combination therapy can help treat men who don’t respond satisfactorily to single mode therapies.

Your online visit costs $15. This doesn’t include the cost of your medication (if prescribed). If a physician determines you’re not a good candidate for telemedicine, you’ll get a full refund for your online visit.

Our services are not covered by insurance, but the $15 online visit is less than most co-pays.

If prescribed, the cost of treatment depends on the type of medication and the number of doses you receive. Check out the current Roman Pharmacy Network prices. Prices at your local pharmacy may vary and are often twice the cost of the Roman Pharmacy Network.

You’re only charged for the medication after a physician has approved a personalized treatment plan. If you’re unsuitable for telemedicine, you’ll be refunded for your online visit ($15).