What Causes Painful Ejaculation?

Painful ejaculation is a lot more common than you’d think. Based on a PubMed search, somewhere between 1-25% of men around the world experience painful ejaculation, either alone or with other symptoms. That’s a lot of men. And a lot of pain.

If ejaculation causes pain in your penis, scrotum, rectum, or pelvic area, you may dread sex and masturbation. You may cut back on your sexual expression because you want to avoid the pain that accompanies orgasm. 

Abstinence affects not only your relationship with an intimate partner, but also your relationship with yourself. And, ultimately, it can affect your overall physical and mental health.

Alex Lesani, MD is an expert and caring urologist who wants men to enjoy sex without pain or dysfunction for the entirety of their lives. At his Las Vegas office, he diagnoses and treats painful ejaculation. Below are a few of the most common reasons for this distressing condition, and recommendations for treatment. 

Benign prostatic hyperplasia (BPH)

Your prostate gland is only about the size of a walnut, but it has a big job. The prostate produces some of the seminal fluid that conveys your sperm outside your body during ejaculation.

Almost all men who live long enough develop BPH, which is a benign, noncancerous condition. Unlike other organs, your prostate continues to grow throughout your life, which is why 90% of men who live until their 80s or 90s have BPH. However, you can develop it even in your 30s.

If you have BPH, painful ejaculation is probably only one of several symptoms. Others may include:

Sometimes simply losing weight, getting lots of exercise, and eating a healthy diet can improve BPH and alleviate symptoms. If lifestyle changes don’t help, Dr. Lesani may recommend medications, laser therapy, or surgery. Once your BPH resolves, your ejaculations should be pain-free.


Urinary tract infections (UTIs) and sexually transmitted infections (STIs) can inflame your urethra and other pelvic organs, leading to painful ejaculation. Past infections may also produce scarring that obstructs your urethra, so your seminal fluid is blocked while ejaculating.

Dr. Lesani usually prescribes a full course of antibiotics if you have a UTI or STI. If your urethra is scarred from past infections, he may recommend urinary tract reconstruction surgery. 


If the tubes in your reproductive tract are obstructed, the pressure from an ejaculation could cause tremendous pain. In addition to scar tissue, some of the most common obstructions include:

Dr. Lesani conducts X-ray, ultrasound, or MRI studies to determine if you have any blockage in your urethra, vas deferens, seminal vesicles, or other areas. If so, you may require medications to quell inflammation, or surgery to remove the obstructions. 

Pelvic pain

Pain in the pelvic area that lasts for more than three months is considered chronic pelvic pain. One of the symptoms of chronic pelvic pain is painful ejaculation. Dr. Lesani first conducts a work-up to determine the different factors involved in your pain, and then customizes a treatment plan. 

Medications and miscellaneous

Some kinds of medications, such as antidepressants and muscle relaxants, may also cause painful ejaculation, as can underlying medical conditions. During your evaluation, Dr. Lesani conducts a thorough physical exam and also takes a complete medical history to identify all sources of your ejaculation pain.

Don’t deprive yourself of sexual satisfaction due to painful ejaculation or other discomfort. Call us today for an evaluation, diagnosis, and treatment at 702-470-2579. You can also book online.

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