Ejaculation Problems Fact Sheet
Ejaculation is a normal physiological process, but for some men, it can turn into a source of significant discomfort or even pain when ejaculating. This article aims to shed light on painful ejaculation, which affects many men but often goes under-reported due to the stigma associated with sexual dysfunction.
Causes of Ejaculation pain
Prostatitis and painful male orgasm
One of the leading causes of painful ejaculation is prostatitis. This condition can result from a bacterial infection (prostate infection), causing inflammation in the prostate gland.
Patients with prostatitis often experience pain in the lower abdomen, genital and rectal pain, and painful or frequent urination. Chronic prostatitis can evolve into chronic pelvic pain syndrome, a more severe condition.
Sexually Transmitted Infections (STIs) and Painful Ejaculation
Sexually transmitted infections can be a less common but significant cause of painful ejaculation. Infections such as chlamydia or gonorrhoea can lead to inflammation and infection in the prostate gland, urinary tract, testicles, and ejaculatory ducts. Painful sensations during or after ejaculation can be a result of the inflammatory response that the infection causes. In some cases, the urethra, the duct through which urine and semen pass, can also become inflamed, leading to urethral pain after ejaculation. Therefore, if you experience painful ejaculation, it is crucial to consider the possibility of a sexually transmitted infection and consult a healthcare provider for a complete medical history and appropriate tests, including urine and blood tests, to rule out STIs as the underlying cause.
Can an enlarged prostate cause painful ejaculation?
An enlarged prostate can also cause painful ejaculation. The enlarged prostate gland can pressurize the ejaculatory duct, leading to discomfort or pain during and after ejaculation. Frequent urination and lower urinary tract symptoms are other symptoms of an enlarged prostate.
Prostate Cancer
What are the five warning signs of prostate cancer?
1. Painful ejaculation
2. Blood in the semen
3. Painful urination
4. Frequent urination, especially at night
5. Lower back or pelvic pain
Radiation therapy is one of the ways to treat prostate cancer, although it may cause painful ejaculations as a side effect.
Urinary Tract Infections (UTIs)
A urinary tract infection (UTI) can cause painful ejaculation as well. In such cases, you may experience burning sensations in the urinary tract during ejaculation. Treatment typically involves adequate hydration, oral antibiotics, Hiprex, D-Mannose, and others.
What medications can cause painful ejaculation?
Certain medications, especially those used to treat depression, can result in painful ejaculation. Muscle relaxants and treatments for erectile dysfunction may also cause this symptom.
Urinary Catheter and Painful Ejaculation
The use of a urinary catheter can also contribute to instances of painful ejaculation.
A catheter, which is inserted through the urethra to facilitate urine drainage, can cause irritation or even minor trauma to the urethra and surrounding structures, including the prostate gland and ejaculatory ducts. This irritation can result in uncomfortable or painful sensations during or after ejaculation.
Additionally, the catheter may introduce bacteria into the urinary tract, leading to a urinary tract infection that exacerbates symptoms. Therefore, men who have recently used or are currently using a urinary catheter and experience painful ejaculation should consult their healthcare provider for a thorough evaluation, which may include urine tests to rule out infection.
Retrograde Ejaculation and Painful Ejaculation
Retrograde ejaculation, a condition where semen flows back into the bladder rather than exiting through the penis during ejaculation, is another factor that can be associated with painful ejaculation. While retrograde ejaculation is generally not painful, the underlying causes for this condition, such as nerve damage, surgery involving the lower urinary tract, or certain medications, can contribute to painful sensations during or after ejaculation. For example, procedures like inguinal hernia repair or bladder neck surgery can disrupt the muscles and nerves' normal functioning in ejaculation, leading to pain. In some cases, the discomfort may also be felt in the lower abdomen or pelvic region.
Other Possible Causes
Pudendal nerve neuropathy, a nerve disorder that includes nerve compression, can cause painful ejaculation.
Ejaculatory duct obstruction can cause severe pain in the seminal vesicles during ejaculation.
Vas deferens issues: Any obstruction or inflammation in the vas deferens can cause painful ejaculation.
Can Emotional or Psychological Issues Cause Painful ejaculation?
In some cases, emotional or mental health issues can be the underlying cause of painful ejaculation. Psychotherapy is commonly used to treat such instances of sexual dysfunction.
Is painful ejaculation severe?
The seriousness of painful ejaculation varies from person to person and depends on the underlying cause. For example, prostate cancer is a severe condition that could initially manifest as painful ejaculation. On the other hand, chronic pelvic pain or pudendal neuropathy may not be life-threatening but can severely impact your quality of life and sexual life.
What Causes Prostate Pain After Ejaculation?
Prostate pain after ejaculation could be a sign of prostatitis, an enlarged prostate, or even prostate cancer. In cases where treatment fails to relieve the symptoms, further tests such as a digital rectal examination, urine tests, and blood tests are typically recommended.
What Causes Urethral Pain After Ejaculation?
A urethral stricture, an abnormal narrowing of the urethral passage, can cause urethral pain after ejaculation. This condition can make ejaculation painful and is usually treated through surgical procedures like urethral dilation.
What Does Painful Ejaculation Feel Like?
The sensation of painful ejaculation may range from mild discomfort to severe pain in the genital and rectal areas. This can be accompanied by other symptoms such as painful urination.
When to See a Doctor?
If you experience painful ejaculation, it's crucial to consult a doctor. A complete medical history and a physical examination are often the first steps in diagnosis. During the physical exam, the doctor will examine the genitals and perform a rectal exam to feel the prostate gland.
Depending on the initial findings, your doctor may order urine tests, blood test/s, an MRI scan of your prostate, or an MRI pelvis and possibly request a flexible cystoscopy.
How to treat painful ejaculation
Treatment for painful ejaculation depends on the underlying cause. Antibiotics are usually prescribed for bacterial infections. For prostate problems, medications or even surgery may be recommended. Lifestyle changes, including pelvic exercises, can sometimes help relieve symptoms.
Male pelvic pain can be challenging.
Reflection from a Urologist on painful orgasm
Painful ejaculation is a relatively common symptom that can significantly impact the quality of life. Its causes are numerous, ranging from physical issues like an enlarged prostate or urinary tract infections to emotional and mental health problems. Early diagnosis and treatment are key to managing the symptoms effectively.
References:
1. American Urological Association. "Diagnosis and Treatment of Non-Neurogenic Overactive Bladder (OAB) in Adults: An AUA/SUFU Guideline." 2019.
2. European Association of Urology. "EAU Guidelines on Prostate Cancer." 2020.
3. Journal of Sexual Medicine. "Pudendal Neuralgia as a Cause of Chronic Pelvic Pain." 2018.
