The prescription ones can: certain antidepressants delay ejaculation, taken daily or before sex. 'Delay pills' sold without prescription are supplements, unproven, and some have been found to contain hidden drugs.
“Pills” covers two very different things, and mixing them up is how people waste money or take risks. I’m going on the research here, not on anything I took myself.
Prescription pills
The pills with real evidence are medicines a doctor prescribes. The American Urological Association puts them in the first line of options: certain antidepressants (SSRIs such as paroxetine or sertraline) taken every day, clomipramine taken a few hours before sex, and, where it’s available, dapoxetine, the only one designed and approved specifically for premature ejaculation. It isn’t approved in the United States.
They work by acting on serotonin, a chemical involved in the ejaculation reflex. In studies, daily SSRIs added several minutes on average: paroxetine came out strongest, with about six and a half minutes more.
The other side: these are real medicines, with real side effects, and a noticeable number of men in the studies stopped because of them. In the US, using an antidepressant for this is off-label, and a doctor has to weigh it against your health and your other medication.
Over-the-counter “delay pills”
Everything sold online or in shops without a prescription as “delay”, “stamina” or “natural” pills is a supplement. Supplements aren’t checked for effectiveness before they’re sold, and there’s no good evidence that any of them delays ejaculation. Worse, the US Food and Drug Administration (FDA) regularly finds sexual enhancement products laced with hidden prescription drugs, such as the active ingredients of Viagra or Cialis. That can be dangerous, for example with heart medication (nitrates).
My take
If you’re considering pills, go through a doctor, not a website. I’ve written about dapoxetine and Viagra separately, because those two get asked about the most.
Sources
- Disorders of Ejaculation: AUA/SMSNA Guideline, American Urological Association, 2020
- SSRIs and SNRIs for Premature Ejaculation in Adult Men, American Family Physician (Cochrane for Clinicians), 2022
- Public notification: SexRx contains hidden drug ingredients, US Food and Drug Administration
The whole theme in one read: Premature ejaculation treatments: what works and what doesn’t