ENPremature ejaculation is one of the most common complaints men have and one of the least often brought to a doctor. Many men live with it for years, try what they read online and never get a work-up.
This page explains what doctors count as premature ejaculation, what a German urological work-up is for, what premature ejaculation treatment in Germany consists of, and when travelling abroad for it makes sense and when it does not.
What actually counts as premature ejaculation
Doctors speak of premature ejaculation when three things come together: ejaculation consistently happens sooner than the man wants, he cannot delay it, and it causes distress to him or his partner. A single bad night is not a diagnosis.
The distinction that changes the treatment, and one the European Association of Urology guidelines also draw, is between the lifelong form, present since the first sexual experiences, and the acquired form, where something changed. The second raises the question of what changed, and that question has answers worth chasing.
Behind an acquired form there is usually an inflamed prostate, a thyroid disorder, erectile difficulty that the man compensates for by hurrying, some medicines, alcohol, or periods of heavy stress or a strained relationship. The same complaint can have very different causes, and that is exactly what the work-up is for.
What a German urological work-up looks for
The work-up looks for what lies behind the complaint and starts with a structured conversation: how long the problem has lasted, whether it happens in every situation and what has already been tried. This conversation does most of the diagnostic work.
Next come a physical examination and separate questions about erection. Urine and blood tests, a check of thyroid function and an examination of the prostate are added where the conversation, the symptoms or the examination point there. No single test proves the diagnosis: it rests on the man’s own account, while the tests look for an underlying cause.
What the work-up rules out or finds shapes the plan: treating an inflamed prostate or a thyroid problem can change the picture without touching the sexual complaint directly. How urology in Germany is organised and how prostate treatment in Germany works is explained on separate pages.
What treatment consists of
Treatment combines behavioural and psychosexual work, local treatment and medication, and the first part is not a consolation prize. It means techniques taught by a therapist, pelvic floor training and, where there is a partner, joint counselling. European urology guidelines advise combining these methods with medical treatment.
Local treatment means anaesthetic sprays and creams applied to the glans shortly before intercourse, which reduce sensation. Unless a condom is used, they can also numb the partner. They are prescription or pharmacy products, not a home remedy.
Medication is the third part. In Europe an on-demand short-acting agent, dapoxetine, is licensed for this diagnosis and taken before intercourse, while longer-acting antidepressants are sometimes used off-label under a doctor’s supervision. Whether any of these suits a particular man is decided by the treating doctor after the work-up. Where erectile difficulty is part of the picture, it is treated in its own right.
When travelling for this is worth it and when it is not
Not every man needs to travel: this is outpatient medicine, there is no operation to fly in for, and a man who can get a competent urologist and a sex therapist at home does not need a flight.
What a trip does give is a work-up done in one place over a few days, a urologist and, where needed, a sexual medicine specialist and an endocrinologist in the same building, and a written plan the man can continue at home. For men who cannot speak about this openly with a doctor at home, the distance itself is part of why it becomes possible.
Plan for a short stay, an interpreter chosen with discretion in mind, and a follow-up appointment by video rather than another flight. An overview of urology clinics in Germany helps with the choice of department, and the Urology Clinic Munich-Planegg is one example of a specialised urological hospital.
Frequently asked questions
Can premature ejaculation be cured?
It depends on the form and the cause. If the problem is acquired and the work-up finds its cause, such as an inflamed prostate, a thyroid disorder or erectile difficulty, treating that cause can change the picture. In the lifelong form, treatment aims to give the man more control over ejaculation through behavioural methods and medicines chosen by a doctor. No outcome can be promised in advance.
Which doctor treats premature ejaculation?
Start with a urologist. The urologist rules out inflammation, thyroid problems and other underlying causes and discusses medication. The behavioural part is led by a sexual medicine specialist or a psychotherapist, with the partner if the couple wishes. Erectile difficulty, if present, is treated as a separate task.
Should my partner come to the appointment?
No, it is not required: the conversation and the examination can be done alone. European guidelines still advise involving the partner where possible, as the doctor needs to understand how the problem affects both of you and joint counselling is part of the behavioural treatment. A partner can also join later, when that part begins.
How long does the work-up in Germany take?
Usually a few days: the conversation, the examination and any tests needed can be done in one place during a short stay. The urology department names the exact time once it has reviewed previous findings and the list of medicines already tried. The follow-up after the trip can be held by video.
How AlenMed arranges the appointment
AlenMed sends previous findings and the list of medicines already tried to a urology department, which answers what it would examine and how long it needs. The company works with 86 partner hospitals in 38 German cities and 345 doctors, and its own office is in Munich. There is an interpreter at every appointment, the hospital sends a written cost estimate, and AlenMed helps with the visa.
Ask in advance who the treating doctor will be, whether a psychosexual consultation is included, what the plan looks like if the first line does not work, and which documents you will take home. Where fertility is also a worry, see the page on fertility treatment in Germany.
This material is for information only and is not an offer. The treatment plan is decided by a doctor at an in-person consultation.
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