Since over-the-counter options haven't worked, there are highly effective prescription medications available. The most common first-line treatments are selective serotonin reuptake inhibitors (SSRIs), such as dapoxetine (taken on demand), or daily medications like paroxetine, sertraline, and fluoxetine, which help delay ejaculation. Another effective option is clomipramine. These medications are very safe and widely used for this condition. I highly recommend consulting a healthcare provider or urologist to discuss these options. They can help find the right generic medication and dosage for you. Please be reassured that this is a very common and highly treatable issue.