Painful Ejaculation: Causes, Symptoms, and Treatment

 Apart from being a very scary experience, painful ejaculation can harm relationships. For most men, it manifests as pain during or immediately after ejaculation.

Some men feel mortified when ejaculation is painful, but it is a relatively common symptom. It is treatable and can be the first symptom of swelling in the prostate.

As many as 30–75 percent of men with prostatitis experience pain during ejaculation, according to studies.

Associated Symptoms of Painful Ejaculation

The symptoms of painful ejaculation vary from man to man. They may also change over time. Some men experience symptoms after having sex with a partner, but not when they masturbate. Some symptoms include:

  • pain during or immediately after ejaculation
  • pain in or around the penis, bladder, or rectum
  • pain that starts shortly before or after ejaculation
  • pain during urination, especially immediately after ejaculating

The pain may last only a few minutes, or for up to 24 hours after ejaculation. It can be mild or very severe.

Causes of Painful Ejaculation

Painful ejaculation can be caused by a wide range of conditions. In most men, pain during ejaculation is as a result of a medical condition. Sometimes, doctors are not able to find a medical cause. When this happens, some men may need support in the form of psychotherapy to manage their condition.

Prostate disorders

Prostatitis is a common cause of painful ejaculation. Prostatitis is swelling and inflammation of the prostate. This swelling can be as a result of prostate infection. Prostatitis can also be caused by other issues, such as nerve damage or a urinary tract infection (UTI) that destroys the prostate.

READ ALSO: All You Need To Know About Impotence

Men with diabetes are more likely to experience nerve damage that causes prostatitis. Ejaculation can also be affected by a condition called nonthreatening prostatic hyperplasia (BPH), which causes the prostate to widen. Men with BPH may also experience painful or difficult urination or frequent urges to urinate. Other prostate problems like surgery on the prostate and prostate cancer, can also cause painful ejaculation.


Some medications can cause painful ejaculation. Antidepressants may cause a range of sexual issues, including changes in libido, erectile dysfunction (ED), and painful ejaculation.

Relationship and emotional problems

Anxiety, depression, and stress can affect the sex life of a man. Also, relationship problems may manifest as physical symptoms, including painful ejaculation. Men who experience no pain when they masturbate may have painful ejaculation because of relationship problems.

Seminal vesicle problems

The seminal vesicle is a gland where sperm mixes with other fluids to produce semen. This gland can develop hard growths called calculi that can cause painful ejaculation.

Pelvic procedures

Medical procedures on the genitals or in the pelvis, including pelvic radiation, can destroy the prostate and other parts of the body that play a role in ejaculation. This damage can make ejaculation painful.

Sexually transmitted infections

A wide range of sexually transmitted infections (STIs) can make ejaculation painful. Men may notice a burning sensation when urinating and/or ejaculating, caused by chlamydia and trichomoniasis infections.

Nervous system issues

Maladies that affect the nervous system, such as diabetes, can destroy the nerves connected with orgasm and ejaculation.

Some physical injuries can also harm the nerves. Men with spinal cord injuries may experience a range of strange sensations during ejaculation.

Mercury toxicity

Some case reports connect mercury poisoning, often due to contaminated fish, with painful ejaculation. More research is necessary to determine the strength of this link.

Painful ejaculation and urination

Some people who experience painful ejaculation may also experience painful urination. When this happens, the cause may be one of these underlying problems:

  • chlamydia
  • prostatitis
  • BPH
  • trichomoniasis

Many nerves and tissues are involved in both ejaculation and urination. As a result, any injuries or procedures that affect this area of the body could lead to painful ejaculation and urination.

Treatment of Painful Ejaculation

To treat painful ejaculation, the underlying cause has to be identified. An examination should begin with a complete medical history that includes questions about the mental health of the man and relationships. The doctor will ask about medications used currently and in the past, as well as any current or previous history of STIs. Comprehensive testing for STIs can also be helpful.

A pelvic exam, including a prostate exam, can evaluate for prostatitis, BPH, and injuries. The doctor may also perform blood work to test for prostate-specific antigen (PSA). This substance tends to rise in men with certain prostate conditions, including prostate cancer.

Treating the primary cause of painful ejaculation also fixes symptoms in most cases. Some treatment options may include:

  • antibiotic to treat a prostate infection or STI
  • switching medications if the culprit is a drug
  • surgery to treat prostate cancer and other prostate problems
  • psychotherapy and lifestyle changes to salvage relationship and emotional problems

Nerve damage may be irreversible, but a doctor will probably still want to treat the underlying cause. Doing so can prevent nerve damage from getting deteriorating.

When treatment fails, some alternative strategies can be tried including:


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