Medical treatment for premature (early) ejaculation includes several options. Any serious primary medical condition (eg, angina) should be treated, as should any accompanying erection problem (eg, erectile dysfunction). To achieve the best outcome, the female partner should be included as fully as possible in the treatment and counseling sessions. Outpatient care can be scheduled as appropriate for the clinical circumstances. Nonpharmacologic therapy may include the following: Efforts to relief of underlying performance pressure on the male Sex therapy (eg, instruction in the stop-start or squeeze-pause technique popularized by Masters and Johnson [1] ) Second attempt at coitus – If another erection can achieve be achieved shortly after an episode of premature ejaculation, ejaculatory control may be much better the second time Pharmacologic therapy may include the following: Topical desensitizing agents (eg, lidocaine and prilocaine) for the male Selective serotonin reuptake inhibitor (SSRI) therapy (eg, sertraline, paroxetine, fluoxetine, citalopram, or dapoxetine); alternatively, use of an agent with SSRI-like effect Phosphodiesterase type 5 (PDE5) inhibitor therapy (eg, sildenafil, tadalafil, or possibly vardenafil) Other agents (eg, pindolol or tramadol)