Sildenafil and tadalafil are designed for erectile dysfunction, which is why they have not resolved your premature ejaculation. For effective, long-term pharmaceutical treatment, selective serotonin reuptake inhibitors (SSRIs) are the clinical standard. Daily medications like paroxetine or sertraline, or on-demand options like dapoxetine, help delay ejaculation by regulating brain chemistry. Additionally, topical anaesthetics containing lidocaine or prilocaine can be applied beforehand to reduce sensitivity. These treatments are very safe and common. I highly recommend consulting a urologist or healthcare provider to find the right dosage and discuss whether combining medication with simple behavioural techniques would offer you the best lasting results.