Premature ejaculation (PE) is a common sexual dysfunction affecting 20% to 30% 
of men worldwide. Definitions of PE vary, but it is typically characterized by 
short intravaginal ejaculatory latency time (IELT) with concomitant sexual 
dissatisfaction and distress. PE may be lifelong or acquired, but its etiology 
remains unclear. Treatment of PE typically involves pharmacotherapy, 
particularly when lifelong. Although there are numerous reports on the off-label 
use of selective serotonin reuptake inhibitors (SSRIs) and other compounds, only 
2 treatments have been evaluated in randomized controlled phase 3 clinical 
trials: PSD502 and dapoxetine (SSRI). Both significantly improved IELT and 
patient-reported outcome domains of ejaculatory control, sexual satisfaction, 
and distress as measured by the index of premature ejaculation (IPE), compared 
with placebo. They constitute the focus of this review. Evidence demonstrated 
that PSD502, dapoxetine and other SSRIs all significantly improve the symptoms 
of PE. Systemic use of SSRIs presents risks associated with the known 
pharmacology of this class. PSD502 allows for topical on-demand treatment 
applied applied immediately before intercourse, and is not associated with 
systemic adverse events.