Hello thanks for asking from HCM for your health related queries I can understand your concern. Premature ejaculation or early ejaculation is a distressing problem. In most of individuals with premature ejaculation poor knowledge of sexual intercourse, anxiety etc are found to be the reasons of early ejaculation. Relief of anxiety and reassurance result in improvement in most of males. I d advise you to spend more and more time in foreplay and this will help to achieve hard erection and your ejaculation time will increase. Try to distract yourself during sexual intercourse and this will also help. If these non medicinal treatments fail to work then visit a psychiatrist for help. You have taken Tadalafil but the drug is a PDE-5 inhibitor drug and the drug is used in patients of erectile dysfunction. The drug has not much effects in premature ejaculation. SSRIs like Paroxetine, Dapoxetine etc have also failed to work. In such case in my opinion more stronger drugs like Tricyclic antidepressants especially Clomipramine can be tried. The drug helps to delay ejaculation and thus can help you. Please visit a psychiatrist for proper management of your problem. Thanks, Hope this helps you. Take care Dr. Seikhoo Bishnoi, Psychiatrist.