Painful Ejaculation: 10 Causes & Treatments for Ejaculatory Pain & Burning

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You might be familiar with the 1975 song, “Love Hurts,” a sentiment many people can identify with, but why does ejaculation have to hurt? Up to 10 percent of men experience painful ejaculation, which can occur in different ways, depending on the man. These episodes can be a source of fear, frustration, and relationship challenges. Identifying the cause of painful ejaculation is the first step toward resolving it…and it can be resolved.

What is painful ejaculation?

Painful ejaculation can appear in several forms. For example:

  • Some men experience painful ejaculation only when having sex with a partner, others only when they masturbate, and yet others during both situations
  • The pain can be mild to severe and last a few minutes or up to 24 hours after ejaculation
  • Pain can occur during or immediately following ejaculation
  • Pain can be focused in or around the penis, rectum, or bladder
  • The pain can begin shortly before or after ejaculation
  • Pain also may occur during urination, especially immediately after ejaculation

Also read about penis pain symptoms and causes

Causes of painful ejaculation

For the majority of men who experience painful ejaculation, the cause is related to a medical reason, although psychological issues can play a role as well. Here are 10 causes of painful ejaculation:

  • Prostatitis. Inflammation and swelling of the prostate, aka prostatitis, can be caused by a variety of issues, ranging from a prostate infection to nerve damage, urinary tract infections, or trauma. Men who have diabetes are more prone to nerve damage and thus prostatitis. Painful ejaculation can be a complication of prostatitis.
  • Benign prostatic hyperplasia. Also known as an enlarged prostate, this condition can cause men to experience painful ejaculation as well as difficult urination.
  • Other prostate issues. Men who have undergone prostate surgery or who have prostate cancer may have pain during ejaculation.
  • Use of medications. The medications most often associated with painful ejaculation are antidepressants. Classes of antidepressants reported to cause this side effect include tricyclics (e.g., amoxapine, clomipramine, imipramine, protriptyline), selective serotonin reuptake inhibitors (e.g., fluoxetine), venlafaxine, and MAOIs. If you are taking any of these drugs and experiencing painful ejaculation, talk to your doctor about making a change in your medication.
  • Pelvic procedures. Men who have undergone procedures that impact the pelvis or genitals, such as pelvic radiation or catheterization, may report pain during ejaculation.
  • Emotional and relationship issues. When men have pain during ejaculation with their partner but not during masturbation, this may be an indication of an emotional or relationship issue behind the pain. Similarly, life situations that cause depression, tension, or anxiety can have a negative impact on sexual performance and cause painful ejaculation.
  • Seminal vesicle problems. It is possible for deposits known as calculi to form in the seminal vesicle, which is where sperm combines with other fluids to make semen. The presence of these hard growths may cause ejaculatory pain.
  • Sexually transmitted infections (STIs). The two sexually transmitted diseases that are commonly associated with uncomfortable or painful ejaculation are chlamydia and trichomoniasis, although others can be culprits as well. If you have any reason to suspect you have a sexually transmitted disease, see a medical professional for testing as soon as possible.
  • Nervous system disorders. Diabetes is likely the most common condition that can have an effect on the nervous system and damage the nerves, which in turn can impact ejaculation. Men who have back injuries or spinal cord damage also may have pain during ejaculation.
  • Mercury exposure. An uncommon but possible reason for painful ejaculation is exposure to mercury. Some cases have been reported after men consumed contaminated fish.

How to treat painful ejaculation

Men who are experiencing painful ejaculation should consult physicians who specialize in ejaculation dysfunction or genitourinary health. Identifying the cause early can result in effective treatment and reversal of the problem.

Treatment of painful ejaculation depends on the cause. It’s best to begin by visiting a healthcare professional and undergoing a thorough pelvic examination, possibly blood work, and a discussion of past and current symptoms and medical history.

Based on the findings, treatment could involve antibiotics for STIs or a prostate infection, making medication changes, pelvic floor exercises to strengthen muscles used during ejaculation, psychotherapy or sex therapy, medical procedures or medications to treat prostatitis or an enlarged prostate, or treatment of diabetes or other underlying medical conditions.

References

Demyttenaere K, Huygens R. Painful ejaculation and urinary hesitancy in association with antidepressant therapy: relief with tamsulosin. European Neuropsychophrmacology 2002 Aug; 12(4): 337-41

Parnham A, Serefoglu EC. Retrograde ejaculation, painful ejaculation and hematospermia. Translational Andrology and Urology 2016 Aug; 5(4): 592-601

Senthilkumaran S et al. Painful ejaculation. Something fishy. Saudi Medical Journal 2010 Apr; 31(4): 451-52

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