The experience of stinging or burning during or immediately after ejaculation, medically termed dysorgasmia or orgasmalgia, can be alarming and significantly impact a person’s quality of life. This symptom is a recognized medical complaint that affects a notable percentage of the male population. The pain can manifest in the penis, scrotum, perineum, or lower abdomen. It ranges from a mild ache to intense, sharp discomfort. Though concerning, this sensation is frequently a sign of an underlying and treatable condition within the genitourinary system.
Infectious Sources of Ejaculatory Pain
An active microbial infection within the reproductive or urinary tract is one of the most immediate causes of painful ejaculation. Pathogens cause inflammation that irritates the delicate tissues through which semen must pass. Sexually transmitted infections (STIs) are a common source, particularly those causing urethritis, or inflammation of the urethra. Chlamydia and gonorrhea are frequent culprits, causing a burning sensation as semen is expelled through the swollen passageway.
Bacteria can travel upward from the urethra or bladder, leading to inflammation in other structures. Bacterial prostatitis, an infection of the prostate gland, is a significant cause of ejaculatory pain, especially when acute. The inflamed prostate is highly sensitive, and muscle contractions during orgasm place painful pressure on the swollen tissue. Urinary tract infections (UTIs) can also cause pain by introducing bacteria into the ducts, irritating the pathway that carries semen.
Infection can also target the testicles and the coiled tubes attached to them. Epididymitis is the inflammation of the epididymis, the tube that stores and transports sperm, and is often caused by an STI or a urinary pathogen. Orchitis, or inflammation of the testicle itself, often occurs alongside epididymitis. These conditions cause referred pain that is severely aggravated by the muscle contractions and fluid movement during ejaculation.
Structural and Inflammatory Contributors
Painful ejaculation is not always the result of an active infection; structural issues, chronic inflammation, and nerve problems frequently contribute to the symptom. The most common cause in this category is Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CPPS), characterized by long-term pelvic pain and inflammation without a detectable bacterial cause. Men with this chronic condition often report pain during ejaculation due to the heightened sensitivity of the prostate area.
This non-infectious pain is often linked to the pelvic floor muscles, which can become chronically tight or spasm. The strong, rhythmic contractions necessary for ejaculation can trigger severe pain in a tense or dysfunctional muscle group. Nerve irritation, such as pudendal neuralgia, where a major pelvic nerve is entrapped, can also cause burning or electric-shock sensations aggravated by the physical mechanics of ejaculation.
Physical obstructions along the seminal pathway can also create significant pressure and pain upon ejaculation. Small stones, or calculi, can form in the seminal vesicles, blocking the flow and causing intense discomfort as the body tries to force semen past the blockage. Scar tissue or narrowing in the ejaculatory ducts, often a lingering effect of previous infections, can also lead to a painful backup of fluid.
Chemical irritants are another source of non-infectious inflammation that can cause pain in the urethra. Irritation can occur from the use of certain spermicides, lubricants, or scented soaps, which cause a chemical urethritis. Additionally, some prescription medications, particularly certain classes of antidepressants, have been documented to cause painful ejaculation as a side effect.
Consulting a Physician and Treatment Paths
Any persistent stinging or pain during ejaculation warrants a medical evaluation to determine the precise cause and prevent potential complications. It is particularly important to seek prompt attention if the pain is accompanied by fever, chills, blood in the semen (hematospermia), or severe urinary difficulties. Addressing the underlying issue early is the most effective way to resolve the symptom.
The diagnostic process typically begins with a detailed medical and sexual history and a physical examination. Initial laboratory tests are crucial for identifying the cause.
Diagnostic Steps
- A physical examination, including a digital rectal exam to assess the prostate.
- Urinalysis and urine culture to check for bacterial infection.
- Specific screenings for sexually transmitted infections (STIs).
- Semen culture to analyze seminal fluid for pathogens or inflammatory markers.
Treatment is always tailored to the specific diagnosis. If an infectious cause is confirmed, a course of antibiotics is the standard treatment to eradicate the bacteria. For inflammatory conditions like non-bacterial prostatitis, treatment often involves anti-inflammatory medications and alpha-blockers, which help relax the muscles around the prostate to ease the flow of semen.
When the pain is linked to chronic pelvic floor muscle issues or nerve irritation, a specialized approach is required. This often includes referral for pelvic floor physical therapy to address muscle spasms. In cases of obstruction, minor surgical procedures may be necessary to remove stones or correct scar tissue. The prognosis for painful ejaculation is generally positive, as most causes are highly manageable or curable once accurately identified.