Pain after ejaculation is not a rare condition. Various studies estimate that between 2 and 10 percent of men are experiencing it at any given time, and a majority of men experience painful ejaculation or penis pain after ejaculation at some point in their lives. Painful ejaculation can occur at any point in a man's life, but it is most common in men aged 50 to 59. Prostate conditions are the most common cause of painful ejaculation in men of all ages, although prostate problems tend to be caused by infections acquired during sexual intercourse in teens and younger men and caused by enlargement of the prostate in men over 50. Up to 58 percent of men with prostate problems, one study found, suffer painful ejaculation.
There is a long list of medical conditions that can cause pain during and after ejaculation. Many of them are things most men would never think about.
- Men who have used drugs for erectile dysfunction (Viagra, Levitra, Cialis, yohimbine hydrochloride, or similar medications) or party drugs for sexual stamina (include amyl nitrate, also known as poppers) in the last year are more likely to experience painful ejaculation than those who have not.
- Sometimes the only symptom of a bacterial infection of the prostate (bacterial prostatitis) is pain in the penis during and after ejaculation. Younger men tend to get these kinds of infections after trying new positions in sexual intercourse, especially unprotected active anal sex, but older men tend to get the problem when they have hemorrhoids and other sources of anal leakage that can send bacteria into the tip of the penis. Men of any age can get these infections by either means. When teens aged 16 to 19 get these kinds of infections they tend to catastrophize the condition, making symptoms even worse.
- Some men develop cysts known as spermatoceles near the testes, inside the scrotum, but not inside a testicle. These cysts cause a dull pain that is worse during erection and ejaculation. There is no medication to prevent this problem, and most doctors will prefer to recommend painkillers rather than to aspirate the cysts with a needle or remove them surgically.
- The muscle relaxants Amrid and Fexmid (both products are cyclobenzaprine) cause pain in the penis during erection and more so during and after ejaculation.
- Old-style tricyclic antidepressants, which are seldom used today except in treating nerve damage, can cause painful ejaculation and pain after ejaculation. The most commonly prescribed of the medications in this class is amitriptylline (Elavil).
- The newer SSRI and SNRI antidepressants (Luvox, Prozac, Lexapro, Pristiq, and others) can cause painful ejaculation and pain after ejaculation, but they also can cause impotence, premature ejaculation, penile anesthesia, priapism (an erection that lasts more than four hours and requires emergency medical treatment), and loss of interest in sex.
- Surgery for inguinal hernia sometimes results in painful ejaculation.
- Prostate enlargement (benign prostatic hyperplasia, which is not the same as prostate cancer) often causes pain during erection or ejaculation.
- Spasms of the pelvic muscles or the pelvic floor can cause post-ejaculatory pain. Kegel exercises can help relieve this problem.
- Kidney stones or prostate stones can be excruciating painful if lodged in the penis during masturbation or sexual intercourse.
- A condition called pudendal neuropathy can cause post-ejaculatory pain, but the pain it causes in the coccyx (tail bone), pelvis, and lower back is constant.
Dealing with these medical issues can relieve pain during erection or ejaculation or afterwards, but what can a man do in the meantime? It usually helps to have sex in the partner-on-top position, that is, lying on one's back. When not having sex, it helps to sit on a "perineal support" pad, any kind of small cushion that supports the area between the anus and the testicles. You may have to make your own. Men who exercise may have to give up bicycling, leg pressing, and sit ups until the pain goes away.
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