Painful Ejaculation, When to Seek Help?

Painful ejaculation

Painful ejaculation can seem like a frightening condition, however, in most cases it turn out to be nothing life-threatening. However, if the pain after ejaculation (or during it) is persistent, you need to see a doctor.

A painful ejaculation, also known as dysorgasmia or orgasmalgia can be experienced by men of various age groups.

The pain varies from mild discomfort to very severe pain that starts during / after ejaculation and ends along with ejaculation or lasts a bit longer.

The pain occurs in the penis area, your scrotum, and perineal area.

While most conditions that can cause painful ejaculation are not life-threatening, they can have a serious impact on your sex life. That’s why you shouldn’t keep silent about it and this that it will just pass with time.

Painful Ejaculation Causes and Treatments

There are 9 main painful ejaculation causes. Below you will find a list of them along with symptoms that they cause and their treatments:

1. Prostatitis

Prostatitis is a common health condition in men under 50 years of age. It causes an infection or inflammation of the prostate gland. Prostatitis is often a painful condition.

Prostatitis symptoms include:

  • mid-level to severe pain in the lower abdomen, including lower back, or rectum
  • having difficulty urinating
  • painful ejaculation
  • mid-level to severe pain when urinating
  • chills and / or fever
  • foul-smelling urine
  • pain in the testicles

Prostatitis diagnosis:

To diagnose whether or not you have Prostatitis, your doctor will have to give you a prostate exam. The exam is performed by inserting two fingers into your rectum and feeling the prostate for abnormalities. There may be additional blood and urine analysis involved. They will help determine the origin of your Prostatitis.

Prostatitis treatment:

The treatment of the Prostatitis depends on its origins and severity. If it’s bacterial Prostatitis that causes painful ejaculation and other systems, antibiotics will be prescribed. Additional pain relievers and alpha-blockers may be prescribed. They will help to relieve pain and reduce painful spasms.

2. Cysts or Stones

Stones that can form in the ejaculatory duct is Ejaculatory duct obstruction (EDO). It is a pathological condition when one or both ejaculatory ducts are obstructed. That causes very little to no sperm during ejaculation which results in pelvic pain and can even cause male infertility.

Ejaculatory duct obstruction (EDO) symptoms:

  • Little to no semen during ejaculation
  • Painful ejaculation
  • Pelvic pains
  • Abdominal pains

Ejaculatory duct obstruction treatment:

The treatment of Ejaculatory duct obstruction usually involves surgical intervention. The blockages are removed from the ejaculatory ducts during a surgical procedure called transurethral resection of the ejaculatory ducts.

3. Antidepressants

Some types of antidepressants can interfere with your sex life and cause unpleasant side-effects, including painful ejaculation.

If you are currently taking any antidepressants, take a look whether it could be one of these, as they are the types that are most likely to cause sexual health related side-effects:

  • selective serotonin reuptake inhibitors
  • serotonin and norepinephrine reuptake inhibitors
  • tricyclics and tetracyclics
  • monoamine oxidase inhibitors

If it tuns out that antidepressants could be the reason that causes painful ejaculation – talk to your doctor.

Don’t stop taking the medication without a doctor’s supervision. It could make your depression worse. That is a lot worse than having painful ejaculations.

Be sure to contact your doctor prior taking any action. I am sure that you will find a way to work around this and find alternative drugs that won’t cause such side-effects.

4. Psychological Problems

If you suffer from painful ejaculation only when having intercourse with your partner, your issues could be psychological.

So, try to pay attention whether that happens when you’re masturbating. If you don;t experience any pain after ejaculation when masturbating, there could be a chance that your issue is psychological.

The best way to determine that is talking to a professional psychologist or psychiatrist. In this case only professionals can be able to help you sort out your issues.

However, if there’s pain when masturbating and during intercourse, most likely your painful orgasm isn’t caused by psychological problems.

5. Pudendal Neuralgia

In short, Pudendal neuralgia is a health condition which appears when t a pelvic nerve has some damage done to it. Pudendal neuralgia can cause rectal and genital pain, as well as cause painful ejaculations and difficulty urinating.

Pudendal Neuralgia symptoms:

  • A sharp or burning pain in your lower body, genitals, or perineum
  • More sensitivity in your lower body
  • Feeling swollen in your lower body, genitals, or perineum
  • Frequent urination
  • Pain during sex
  • Difficulty to get an erection

Pudendal Neuralgia diagnosis:

If you experience any of these symptoms, be sure to contact your doctor. He or she will give you a physical exam that will help determine whether Pudendal neuralgia is what’s been troubling you.

In short the exam is performed by putting a finger to your rectum or vagina (for females) and pressing on the nerve.

Pudendal Neuralgia treatment:

Well, to heal this condition, your best medicine will be time. People who suffer from Pudendal neuralgia are treated with a combination of physical therapy and medicines to relieve pain. Some lifestyle changes could be helpful as well.

6. Prostate Cancer

Having prostate cancer can also cause painful ejaculation, even though prostate cancer is usually without any symptoms. That’s why, in case the pain after ejaculation remains persistent, it is always recommended to see a doctor. Most likely you don;t have prostate cancer but it’s better to sure rather than sorry.

Prostate Cancer symptoms:

Prostate Cancer diagnosis:

To diagnose prostate cancer various tests are used. Once you discuss your medical history with your doctor, here are the following tests that can be used on you to determine whether prostate cancer is causing painful ejaculation:

  • Digital rectal exam (DRE): a finger will be inserted into your rectum to inspect the prostate. This test helps the doctor feel whether any hard lumps have formed on your prostate gland. Such hard lumps could be tumors.
  • Prostate-specific antigen (PSA) test: A blood test that shows the levels of PSA in your body. PSA is a protein that the prostate produces.
  • Prostate biopsy:  a small part f your prostate gland will be taken to examine and confirm whether you really have prostate cancer.

Prostate Cancer treatment:

The Prostate cancer treatment depends on the stage of the cancer and it’s severity. If the cancer is non-aggressive, you may need only need to perform active surveillance of it.

If your cancer is aggressive, you may need to undergo chemotherapy or even have a surgery. Yet, this is very individual and your doctor will choose the best treatment for you.

7. Radiation Therapy

If for some reason you are undergoing a radiation therapy, it could be the reason behind your painful erections.

Usually, the symptoms are temporary and disappear completely soon after the treatment is over.

8. Trichomoniasis

Another reason that can cause painful ejaculation is called Trichomoniasis. It is a sexually transmitted disease (STD).

Trichomoniasis symptoms:

  • discharge from the urethra
  • burning sensation during urination
  • burning sensation after ejaculation
  • frequent urination
  • itchy genitals
  • swelling or redness of genitals

Trichomoniasis diagnosis:

This sexually transmitted disease is diagnosed through laboratory testing.

Trichomoniasis treatment:

This STD is treated with antibiotics. If you are diagnosed, make sure to contact all of your sexual partners and inform them about your sexual condition.

9. Recent Surgery

There are some surgeries that can interfere with your sexual life and even cause painful ejaculation.

Some of such surgeries include radical prostatectomy. It is a procedure during which part of the prostate or the whole prostate is removed due to prostate cancer.

Usually, such side-effects pass with time. However, you can always consult with your doctor, in case you have doubts and uncertainties.


Painful ejaculations originates from numerous causes. While most of them are temporary and non-life threatening, there are cases, such as prostate cancer, that can be deadly, if not attended immediately.

If you have any concerns, doubts, or painful ejaculations, contact a professional and arrange a consultation, at least.

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