Painful ejaculation

7 Common Causes For Painful Ejaculation

Should pain come right after delightful joy with your partner? No! There is no such thing as extreme joy culminating in sharp pain. If it happens to you, my friend, you need to get some advice.

Painful ejaculation is the most simple term to describe it. There are many other terms in the dictionary like dysejaculation, odynorgasmia, post orgasmic pain, dysorgasmia or orgasmalgia, etc etc but really there is no other simpler term to describe it but painful ejaculation.

To be honest it is quite a common but poorly understood phenomenon associated with sexual dysfunction. 

It actually happens in  1–10% in the general population depending where you live and it actually increases to 30–75% among men who suffer from chronic prostatitis or chronic pelvic pain syndrome.

The severity of painful ejaculations may vary from a minor discomfort to excruciating pain (Really it may occur anywhere including penis, scrotum and perineal/perianal region, you get the idea…) The pain typically starts immediately before or during ejaculation and commonly lasts between 2 to 24 hours. It can be so painful that you can get turned off and your partner dissatisfied and concerned at same time.

So why do we have this happening?

7 simple reasons why

1. Infections, infections, sexually transmitted infections.

 One other thing that all men share besides our obvious anatomy, is our prostate.

The prostate is like the major town where our semen has to flow through and contributes to the flow. Imagine if there is congestion at the town caused by inflammation and foreign bacteria attacking. The very thought itself is painful. Chlamydia is often one STD/STI that results in prostatitis.

2. Stones

Nope, not the rolling stones but the ones that get stuck in the seminal vesicles which are like the canals of Venice but in our town of prostate.

3. Nerve causes

Sexual neurasthenia, wow big word here but it just means sensitive nerves firing off ad nauseam till they are painful and tired out.

4. Drugs

Essentially there is a small risk with all antidepressants: tricyclic antidepressants (TCAs, e.g. clomipramine, imipramine, desipramine, protriptyline, amoxapine), the selective serotonin reuptake inhibitors (SSRIs, e.g. fluoxetine), venlafaxine and the MAOIs

5. Prostate issues

Yes, the prostate itself can have issues with its own inhabitant cells with inflammation of prostate , prostate cancer, benign prostatic hyperplasia .

6. Post operation

Any prostate surgery , pelvic radiation and hernia repair amongst others.

7. Psychiatric

Sometimes it has nothing to do with the town but the overall governance of the town.

Psychological issues may also be the cause of painful ejaculations, especially if the patient does not experience this problem during masturbation.

Idiopathic – sometimes things just happen.

What can doctors do for us? Rigorous medical and sexual history! This along with chronological order of events is very important to finding out why. The type and location of the pain matters too. It is just not enough to tell the doc pain pain.

He/she will then do a focused physical examination that may disclose scars from previous surgeries or radiotherapy in the groin area whereas skin lumps and penile discharge may be suggestive of sexually transmitted diseases. Palpation of a swollen and painful prostate during digital rectal examination is a diagnostic finding for acute prostatitis whereas a nodule can be felt in the presence of a prostate cancer. 

Similarly, a urine test may confirm the location of urinary infection and confirm the diagnosis of prostatitis. And blood tests for prostate specific antigen levels may also suggest prostate issues if raised.

Abdominal CT scans are rarely required. MRI studies may be helpful when investigating the cause of pudendal neuropathy. However, no obvious aetiology is found in a significant number of patients with the complaint of painful ejaculations, despite extensive investigation. Which lies in our Idiopathic category above.

Treatment of painful ejaculation must be tailored according to the underlying cause, if detected. 

Remember friends, painful ejaculation should never ever be taken for the peak of joyous fun with your partner. Stay safe!

Next read: Delayed Ejaculation | Premature Ejaculation

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