Painful Ejaculation: Overview
By
Medicover Hospitals /
08 Mar 2021
Painful ejaculation (painful orgasm) is described as a pain or a burning sensation that occurs when a man ejaculates. He may feel pain between the anus and the genitals or in the testicles. He can also feel it in the urethra, the tube through which semen passes. The pain can be mild or severe. Many men with painful ejaculation suffer from depression and anxiety.
Painful ejaculation can damage relationships, erode self-esteem, and turn one of life's pleasures into a source of frustration. It can be a frightening experience, but it is nothing to be ashamed of. For most men, it manifests as pain during or immediately after ejaculation.
Some men feel embarrassed when ejaculation is painful, but it is a relatively common symptom. It is also highly treatable and can be the first symptom of another problem, such as swelling of the prostate.
Various studies have shown that between 1 and 10 percent of men experience this symptom. As many as 30-75% of men with a condition called prostatitis experience pain during ejaculation.
Causes
Prostatitis
Prostatitis is the term for inflammation or infection of the prostate. It is the most common urological problem in men under 50. This can cause painful or frequent urination, so it is easy to be mistaken for a urinary tract infection. Other signs include lower abdominal pain and difficulty getting an erection.
Surgery
Some types of surgery can cause several side effects, including painful ejaculation. One of these is radical prostatectomy, a procedure to remove all or part of the prostate and some surrounding tissue. Surgery is used to treat
Prostate cancer
.
Cysts or stones:
It is possible to develop cysts or stones in the ejaculatory duct. They can block ejaculation, causing infertility and painful ejaculation.
Pudendal neuropathy
Pudendal neuropathy is a condition in which a nerve in the pelvis is damaged. This can lead to genital and rectal pain. Some things that can affect the pudendal nerve are injury,
diabetes,
and
multiple sclerosis
(MS).
Prostate cancer
Although often asymptomatic, prostate cancer can cause painful ejaculation. Other symptoms may include problems with urination, erectile dysfunction, or blood in your urine or semen.
Trichomoniasis
Trichomoniasis is a sexually transmitted infection that can also cause burning or pain during urination.
Radiotherapy
Radiation therapy to the pelvis can cause erectile dysfunction, including painful ejaculation. These side effects are usually temporary.
Psychological problems
Sometimes the cause cannot be determined. If you don't have pain when you masturbate, it can be emotional. Consider seeing a therapist investigate this further.
Diagnosis
You will need a physical exam, including a digital rectal exam. Be prepared to give a full medical history and answer a few questions such as:
- How long have you had an orgasm?
- How long does it last?
- Do you produce ejaculate or do you have a dry orgasm?
- What other symptoms do you have?
- Does it hurt or burn when you urinate?
- Does your urine look normal?
- Are you currently taking any medication?
- Have you ever been treated for cancer?
- Is there a family history of prostate cancer?
- Do you have diabetes?
Diagnostic tests can include:
- urine tests to check for infection
- prostate-specific antigen test to assess prostate problems, including cancer
Depending on the results, additional tests, such as blood tests or imaging tests, may be needed.
Treatment
Treatment for painful ejaculation depends on the cause.
An examination should begin with a complete medical history, including questions about a man's mental health and relationships. The doctor will ask questions about medications used now and in the past, and any current or history of STIs. Comprehensive STI screening can also be helpful.
In most cases, treating the underlying cause also corrects the symptoms of painful ejaculation. Some treatment options may include:
- antibiotics to treat a prostate infection or STI
- change medication if the culprit is a medication
- surgery to treat prostate cancer and other prostate problems
- psychotherapy and lifestyle changes to resolve relationship and emotional issues
Nerve damage can be irreversible, but a doctor will probably still want to treat the underlying cause. This can prevent nerve damage from getting worse.
When to see a Doctor?
It is recommended that you contact your doctor for any case of painful ejaculation symptoms, especially if it is also associated with:
- Blood in semen
- Frequent or painful urination
- Inability to urinate
- Recurrent pain: in the lower back, hips, pelvic area, rectal area, or upper thighs
- Fever, chills, nausea, or body aches
Your healthcare professional will review any observable painful ejaculation symptoms and likely perform additional tests to determine if there are any more complex issues at work. As a rule, home remedies will neither be appropriate nor sufficient.
Prevention
When treatment fails or a doctor cannot determine the cause, a man may try alternative strategies that may reduce the pain. Some options include:
- sex therapy
- pelvic floor exercises to strengthen the muscles involved in ejaculation
- analgesic
- muscle relaxants
- anticonvulsant drugs
