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Painful Ejaculations: What’s Causing Them?

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There isn't much fun in having to deal with ejaculatory pain. It can be a sharp pain, or a dull ache that lingers long after ejaculation. Either way, it can make sex less enjoyable and be a source of anxiety, make you avoid sex altogether, or both.

There are a number of potential causes of painful ejaculations. When it comes to finding a solution, figuring out the root cause is essential, not just for diagnosis and treatment, but for your overall health, as some causes may indicate more serious underlying health issues.

What Are Painful Ejaculations?

Painful ejaculations, also called dysorgasmia or orgasmic dysesthesia, can refer to any pain or discomfort that occurs before, during, or after ejaculation. The pain can be sharp and intense or a dull ache. It may be localized to the penis or testicles, or it may radiate out to the abdomen or lower back. The pain may last for a few seconds, or it may linger for minutes or even hours.

What Causes Painful Ejaculations?

There are a number of potential causes of painful ejaculations, which can be broadly divided into three categories: physical, psychological, and medical.

Physical Causes

Physical causes of painful ejaculations are usually the result of an injury to the penis, testicles, or prostate. This can include:

Peyronie's disease: A condition characterized by the development of plaque in the tissues of the penis, which can cause pain and curvature of the penis. This condition is more common in older men, but can occur at any age. When the plaque is in the erectile tissue, it can cause pain with erections and ejaculations, and may also make it difficult to achieve or maintain an erection. Treatments for Peyronie's disease can include oral medications, injections, and surgery.

Injury: An injury to the penis, testicles, or prostate can cause pain with ejaculation. This can include an accident or trauma, such as a car accident, a fall, or a sports injury. It can also include surgery to the penis, testicles, or prostate. When surgery is the cause of the pain, it is typically temporary and will resolve on its own over time.

Prostatitis: Inflammation of the prostate gland can cause pain with ejaculation. This condition can be acute (short-term) or chronic (long-term). It is more common in men over the age of 50, but can occur at any age. Treatment for prostatitis can include antibiotics, anti-inflammatory medications, and pain relievers.

Psychological Causes

Psychological causes of painful ejaculations are usually related to anxiety or stress. This can include:

Performance anxiety: Fear of failure or of not being able to perform sexually can cause anxiety and lead to painful ejaculations. This type of anxiety is more common in men who are new to sexual activity or who have had previous sexual difficulties.

Relationship problems: Struggling with communication or other relationship issues can lead to stress and anxiety, which can in turn cause pain with ejaculation.

Medical Causes

Medical causes of painful ejaculations are usually the result of an underlying medical condition. This can include:

Hernias: A hernia is a condition in which an organ or tissue protrudes through a weak point in the surrounding muscle or tissue. Hernias in the groin can put pressure on the testicles and cause pain with ejaculation. Treatments for hernias can include surgery to repair the hernia.

Kidney stones: Kidney stones are a common cause of pain in the lower abdomen and groin. They can cause pain with ejaculation as well as urinary pain and difficulty urinating. Stones that are too large to pass on their own may need to be removed with surgery. Ejaculating when there is a stone in the urethra can be very painful.

Prostate cancer: Prostate cancer is the most common type of cancer in men. It can cause pain with ejaculation as well as urinary symptoms such as hesitancy, frequency, and urgency. Prostate cancer is typically treated with surgery, radiation, or hormone therapy.

Prostate enlargement: An enlarged prostate can put pressure on the urethra and cause urinary symptoms such as hesitancy, frequency, and urgency. It can also cause pain with ejaculation. Treatment for an enlarged prostate can include medication, surgery, or lifestyle changes.

Other Causes of Painful Ejaculations

There are other potential causes of painful ejaculations. Here are some examples:

Cysts: Cysts can form on the seminal vesicles, which are the sacs that produce semen. The cysts can make ejaculation painful due to the pressure they put on the seminal vesicles.

Antidepressants: Antidepressants, especially selective serotonin reuptake inhibitors (SSRIs), can cause ejaculatory pain. In some cases, the pain goes away on its own. In other cases, the pain goes away when the person stops taking the medication.

Pudendal Neuropathy: This is a condition in which the nerve that runs from the base of the spine to the genitals becomes damaged. This can cause pain during ejaculation when the nerve is stimulated.

Trichomoniasis: This is a sexually transmitted infection (STI) that can cause painful ejaculation. The infection is caused by a parasite. It can be treated with antibiotics.

Radiation Therapy: Radiation therapy to the pelvis can cause damage to the nerves and blood vessels. This can lead to painful ejaculation. The pain is usually temporary, but it can last for months or years.

Diagnosis

Your doctor will ask you about your medical history and symptoms. They will also do a physical exam. In some cases, they may order tests to diagnose the cause of the pain. The tests may include:

Ultrasound: This test uses sound waves to create images of the inside of the body. It can be used to look for cysts on the seminal vesicles.

CT scan: This test uses X-rays to create images of the inside of the body. It can be used to look for cysts on the seminal vesicles.

MRI: This test uses magnetic waves to create images of the inside of the body. It can be used to look for cysts on the seminal vesicles.

Biopsy: This is a procedure to remove tissue from the body so it can be tested in a lab. A biopsy of the seminal vesicles may be done to rule out cancer.

When to Call Your Doctor

If you have pain during ejaculation, you should see your doctor. They can help diagnose the cause of the pain and recommend treatment. Pain that goes away on its own is usually not a cause for concern. But, if the pain is severe or lasts for more than a few days, you should see your doctor.

This blog post is for educational purposes only and does not constitute medical or other professional advice. Your specific circumstances should be discussed with a healthcare provider. All statements of opinion represent the writers' judgement at the time of publication and are subject to change. Phoenix and its affiliates provide no express or implied endorsements of third parties or their advice, opinions, information, products, or services.

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