Pain when ejaculating can be caused by infection or inflammation in the bladder, urethra, or prostate, and also by an enlarged prostate. It often includes associated discomforts such as genital itching, pain when urinating, dark urine, abdominal pain, and low-grade fever. Learn more!
Pain when ejaculating is a symptom found in infections or inflammations in organs of the urinary tract and male reproductive system. Benign prostatic hyperplasia, a noncancerous enlargement of the prostate, is also one of the causes of discomfort during ejaculation. Understand below.
What Could It Be When a Man Feels Pain When Ejaculating?
The causes of pain when ejaculating are varied. Check them out:
- Sexually transmitted infections (such as chlamydia and trichomoniasis);
- Prostatitis (inflammation of the prostate);
- Urethritis (a urinary tract infection that affects the urethra);
- Epididymitis (inflammation of the duct that collects, stores, and transports sperm);
- Cystitis (infection and inflammation in the bladder);
- Benign prostatic hyperplasia (prostate enlargement);
- Prostate cancer;
- Medication side effects;
- Surgeries.
Sexually Transmitted Infections (STIs)
STIs such as chlamydia and trichomoniasis can make ejaculation painful.
Chlamydia is transmitted by the bacterium Chlamydia trachomatis, and symptoms may include testicular pain when ejaculating, pelvic pain, pain or burning sensation when urinating, penile discharge, or pain/bleeding during intercourse.
The treatment for chlamydia may involve antibiotics like azithromycin or doxycycline, according to medical evaluation and individual patient needs.
Trichomoniasis is transmitted by the protozoan Trichomonas vaginalis. In addition to pain when ejaculating, symptoms include discomfort when urinating, white fluid discharge, and redness of the penis.
The infectious agent can reach the male urethra. Therefore, the man feels pain in the prostate when ejaculating because the urethra and prostate are close to each other.
The treatment for trichomoniasis is usually metronidazole pills or tinidazole in a single oral dose if the previous prescription has no effect.
Prostatitis
Prostatitis is an inflammation of the prostate that can be caused by bacterial or viral infections, pelvic injuries, or autoimmune diseases. Symptoms include:
- Painful erection;
- Pain in the penis when ejaculating;
- Pain in the testicles;
- Pain in the area between the scrotum and anus;
- Frequent urination, especially at night;
- Pain or burning sensation when urinating;
- Pain when having a bowel movement.
In more severe cases of prostatitis, men may experience fever, chills, and blood in the urine or semen.
The treatment for prostatitis may include pain relievers and anti-inflammatories, alpha-blockers to ease urination, and sitz baths for pelvic pain. In some cases, physiotherapy can be prescribed to relax the pelvic muscles.
Urethritis
Urethritis is a urinary tract infection that affects the urethra. It can be caused by bacteria such as Chlamydia trachomatis and Neisseria gonorrhoeae, transmitted through unprotected sexual contact, or by catheter use. In addition to pain when ejaculating, urethritis symptoms include:
- Swollen lymph nodes in the groin;
- Itching or burning sensation in the penis;
- Pain when urinating;
- Pain in the testicles;
- Discharge from the urethra, which may be whitish, yellow-green, or contain blood/pus;
- Genital blisters or sores.
The treatment for urethritis involves antibiotics such as azithromycin, doxycycline, or ceftriaxone.
Epididymitis
Epididymitis is the inflammation of the epididymis, the duct that collects, stores, and transports sperm.
Causes include anatomical problems, testicular torsion, sexually transmitted infections such as chlamydia and gonorrhea, and chronic infectious diseases. Symptoms include:
- Swollen lymph nodes in the groin;
- Pain when ejaculating;
- Pressure sensation in the testicles;
- Redness and swelling in the scrotum;
- Pain during intercourse;
- Pain when urinating;
- Blood in the semen.
The treatment for epididymitis involves antibiotics such as ciprofloxacin, ceftriaxone, and doxycycline.
Cystitis
Cystitis is an infection and inflammation of the bladder caused by the bacterium Escherichia coli. It is present in the intestine and urinary tract, but when it multiplies, it can invade the bladder. Symptoms include:
- Lower back pain or pain in the lower abdomen;
- Heaviness in the lower abdomen;
- Feeling the urge to urinate frequently, but with little volume;
- Pain or burning sensation when urinating;
- Pain during sexual intercourse;
- Pain when ejaculating;
- Changes in urine color;
- Strong-smelling or bloody urine;
- Low-grade fever.
The treatment for cystitis may involve antibiotics such as amoxicillin or ciprofloxacin, and antiseptics like cystex.
Benign Prostatic Hyperplasia
Benign prostatic hyperplasia is a noncancerous enlargement of the prostate, common in older men. It is associated with reduced levels of the hormones testosterone and dihydrotestosterone. Symptoms of BPH include:
- Pain during ejaculation;
- Difficulty initiating urination;
- Feeling of incomplete bladder emptying;
- Increased urinary frequency;
- Reduced urinary stream volume and force;
- Dribbling at the end of urination;
- Frequent urinary infections that can affect the kidneys, bladder, or urethra;
- Changes in the bladder’s muscular wall.
The treatment for benign prostatic hyperplasia may include medication or surgery, depending on medical evaluation and each patient’s clinical condition. Options include:
- Alpha-blockers to facilitate urination (tamsulosin, alfuzosin, doxazosin);
- 5-alpha-reductase inhibitors to reduce prostate size (finasteride, dutasteride);
- Antibiotics in case of urinary infection;
- Surgery, where the prostate may be removed through the urethra or via an abdominal incision.
Prostate Cancer
Prostate cancer begins with the uncontrolled growth of prostate cells. Symptoms include:
- Pain or discomfort when urinating;
- Weakness or numbness in the legs;
- Erectile difficulties;
- Pain when ejaculating;
- Decreased semen volume;
- Blood in the urine or semen.
The treatment for prostate cancer may include radiation therapy, chemotherapy, immunotherapy, hormonal therapy, or prostate removal.
Ejaculatory Duct Obstruction
The ejaculatory ducts carry semen from the prostate to the urethra during ejaculation. Obstruction can occur due to inflammations such as prostatitis and epididymitis, pelvic surgeries, genital injuries, congenital issues, cysts, tumors, or smoking.
The most common symptom is painful ejaculation, but a reduced amount of ejaculate, blood in the semen, and pelvic pressure and discomfort are also frequently reported.
The treatment for ejaculatory duct obstruction may include antibiotics, surgery, and prostatic massage.
Surgeries
Some men feel discomfort when ejaculating after certain surgeries, such as a vasectomy.
During this procedure, the vas deferens—responsible for carrying sperm from the testicles to the urethra—are cut or blocked. Sperm production continues, but the sperm is not expelled. In rare cases, post-vasectomy syndrome occurs, causing a buildup of sperm that puts pressure on or inflames the testicles.
Medication Side Effects
Some medications are also among the causes of pain when ejaculating. See which ones below:
- Antidepressants: especially selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine, sertraline, and paroxetine, which can have side effects like reduced sexual desire and problems with ejaculation;
- Antipsychotics: certain antipsychotics may alter hormone levels and nerve sensitivity, leading to pain during ejaculation;
- Opioid Analgesics: using opioid pain relievers like morphine can reduce libido and also make ejaculation painful;
- Chemotherapy Drugs: chemotherapy medications, especially those used to treat testicular cancer or prostate cancer, can affect nerves in these areas, resulting in discomfort during ejaculation;
- Medications for prostate conditions: finasteride and dutasteride, for example, may cause pain when ejaculating and retrograde ejaculation, in which semen goes into the bladder instead of being expelled through the urethra;
- Medications for hypertension: propranolol and some diuretics reduce penile blood flow, causing discomfort during ejaculation;
- Medications for erectile dysfunction: in rare cases, ED medications can affect genital blood flow, leading to pain when ejaculating.
What to Do When You Feel Pain When Ejaculating?
Although pain when ejaculating can be temporary in some cases, it can also be linked to health conditions that require medical attention. Therefore, it is crucial to see a urologist right away for a diagnosis and proper treatment.
Recommended Treatments
Treatment for painful ejaculation varies depending on the cause.
In the case of prostatitis, treatment may involve measures to relieve symptoms, such as pain relievers and anti-inflammatories. If a bacterial infection is confirmed, antibiotics may be prescribed according to medical guidance.
If pain when ejaculating is caused by prostate cancer, treatment options may include radiation therapy, chemotherapy, hormone therapy, or surgery, depending on severity.
When to See a Doctor?
A urologist should be consulted if pain when ejaculating is persistent, even if it is mild. Seeking medical advice at the onset of symptoms can help with early detection and better management of the condition, according to each patient’s needs.
If you experience discomfort during ejaculation, contact Dr. Paulo Egydio to understand how to address sexual dysfunction. Also, be sure to follow him on TikTok for men’s sexual health tips.
