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What Is the Primary Alternative to Early Exercise for a Profitable American Option?

The primary alternative is to sell the option back into the market. By selling the option, the holder realizes both the intrinsic value and the remaining time value.

This is generally the optimal choice, as selling captures the full market price, whereas early exercise forfeits the time value.

Why Is the Early Exercise Feature of American Options Rarely Used in Practice?
Why Is Early Exercise of an American Call Option Generally Not Optimal for a Non-Dividend-Paying Asset?
Why Is Early Exercise of an American Call Option Often Considered Sub-Optimal?
Why Would an Option Holder Choose Not to Exercise an ITM Option?