Pain during or after ejaculation can be an alarming and uncomfortable experience. Although it may feel difficult to talk about, painful ejaculation is more common than many realize—and often treatable. The discomfort may feel like a sharp pain, burning sensation, or deep ache in areas such as the penis, testicles, lower abdomen, or pelvic floor.

This article explores the symptoms, underlying causes, related complications, and when to consult a medical professional.

What Is Painful Ejaculation?

Painful ejaculation, also known as dysejaculation, refers to discomfort that occurs during or shortly after the release of semen. The pain can affect various parts of the body, including the penis, prostate, bladder, rectum, or perineum.

While some individuals experience pain only occasionally, others may deal with chronic discomfort that significantly affects their sexual well-being.

Symptoms of Painful Ejaculation

Symptoms can vary in intensity and location, depending on the underlying cause. Common signs include:

  • A burning or sharp sensation during or just after ejaculation

  • Pain in the penis, lower abdomen, rectum, or pelvic floor

  • Painful urination, particularly after sex

  • Discomfort that lasts for several minutes to hours following ejaculation

  • Symptoms that only occur during sex with a partner, not during masturbation

Some individuals notice pain consistently, while others experience symptoms intermittently.

What Causes Painful Ejaculation?

There are several potential reasons why ejaculation might be painful. Causes range from temporary infections to more chronic conditions involving the prostate or nerves.

1. Prostate Disorders

The prostate gland plays a key role in semen production, and conditions affecting this organ are among the most common causes of painful ejaculation.

Prostatitis

Inflammation or infection of the prostate—called prostatitis—can lead to pain during ejaculation and urination. Prostatitis can result from bacterial infections, nerve damage, or pelvic injury. It may present with symptoms like frequent urination, pelvic pain, and fever.

Benign Prostatic Hyperplasia (BPH)

BPH, or enlarged prostate, can also lead to discomfort. In some men, an enlarged prostate may affect ejaculation or cause a feeling of pressure or pain after orgasm.

Prostate Cancer or Surgery

Surgical interventions involving the prostate, including procedures for prostate cancer, can result in nerve damage or scar tissue formation, which may cause painful ejaculation.

2. Medication Side Effects

Some medications, particularly antidepressants, may affect sexual function. Side effects can include delayed ejaculation, reduced libido, erectile dysfunction, and pain with climax. Medications like SSRIs, beta-blockers, or certain blood pressure drugs may also play a role.

If symptoms began after starting a new medication, it’s worth discussing alternatives with a healthcare provider.

3. Emotional or Psychological Stress

Mental health and emotional factors can affect physical sensations during sex. Stress, anxiety, depression, or relationship tension can sometimes manifest as pain during intercourse or ejaculation—especially when there's no physical explanation.

Notably, if pain does not occur during masturbation but does during partnered sex, psychological causes should be considered.

4. Seminal Vesicle Issues

The seminal vesicles are glands that help produce semen. Conditions such as infections, blockages, or seminal vesicle calculi (stones) may cause painful ejaculation.

5. Pelvic Surgery or Radiation

Surgical or radiation treatment for cancers in the pelvis or bladder may damage nerves or tissues involved in ejaculation. This damage can cause chronic pain during or after orgasm.

6. Sexually Transmitted Infections (STIs)

STIs such as chlamydia, trichomoniasis, or gonorrhea can cause inflammation of the urethra and surrounding tissues, leading to pain or burning during ejaculation and urination.

These infections often occur without symptoms, so regular STI screening is important for anyone sexually active.

7. Neurological Disorders

Diseases that affect the nervous system, such as diabetes, multiple sclerosis, or spinal cord injury, may interfere with the signals involved in ejaculation and orgasm. This can cause abnormal sensations or pain.

8. Mercury Exposure

In rare cases, mercury toxicity from contaminated seafood or occupational exposure has been linked to painful ejaculation. This is not common but has been documented in medical literature.

Painful Ejaculation and Urination

Pain during both ejaculation and urination may signal conditions that involve the prostate, urethra, or bladder, such as:

  • Prostatitis

  • BPH

  • STIs (e.g., chlamydia, trichomoniasis)

Because many nerves and pathways are shared between these functions, irritation in one system may affect the other.

How Is It Treated?

Treatment depends on the underlying cause. A healthcare provider will usually begin with:

  • A full medical history

  • Review of medications and mental health status

  • Sexual and relationship history

  • Testing for STIs

  • A physical exam, including a digital rectal exam to evaluate the prostate

  • Blood tests, including PSA (prostate-specific antigen) if prostate conditions are suspected

  • Urine tests or ultrasound if necessary

Treatment Options May Include:

  • Antibiotics for bacterial infections, such as prostatitis or STIs

  • Changing medications if a drug is contributing to symptoms

  • Surgery for prostate issues or structural abnormalities

  • Psychotherapy to address emotional or psychological factors

  • Pelvic floor therapy or muscle relaxation techniques

For individuals with chronic or unexplained pain, supportive approaches such as pain relievers, anticonvulsants, or muscle relaxants may help manage symptoms.

Complications

Although painful ejaculation is not life-threatening, it can impact several aspects of a man’s health and lifestyle, including:

  • Loss of interest in sex

  • Difficulty achieving orgasm

  • Relationship strain

  • Feelings of embarrassment or shame

  • Reduced self-esteem

  • Concerns about fertility

In many cases, the longer the issue goes unaddressed, the more severe the emotional and physical toll may become.

When to See a Doctor

Pain during ejaculation should never be ignored, especially if:

  • The pain is consistent or worsening

  • Symptoms are accompanied by fever, blood in semen or urine, or urinary problems

  • You have a history of STIs or prostate issues

  • The pain affects your quality of life or sexual health

Urologists or sexual medicine specialists are trained to evaluate and treat these symptoms effectively.

Outlook

The good news is that painful ejaculation is usually treatable, especially when identified early. The key is to seek medical attention rather than suffer in silence. Many men delay treatment due to embarrassment or the assumption that the issue will resolve on its own.

By working with a knowledgeable healthcare provider, most individuals can find relief, regain sexual confidence, and improve their quality of life.