Painful Erection | Erection Pains & Priapism 

When it comes to men’s health, certain issues can be difficult to discuss openly. One such concern is painful erections, medically known as priapism. While it may not be a common topic of conversation, understanding the causes, symptoms, and treatments of painful erections is essential for men’s well-being.

In this comprehensive guide, we’ll delve into the world of painful erections, covering the 10 most common causes, addressing frequently asked questions, and providing valuable insights into when to seek medical attention.   

10 Most Common Causes of Painful Erections

  1. Ischemic/Non-ischemic: Ischemic priapism, characterized by reduced blood flow out of the penis, is a leading cause of painful erections. Non-ischemic priapism, while less common, involves high blood flow into the penis.

  2. Blood Disorders: Blood disorders such as sickle cell disease and thalassemia can lead to painful erections by impairing blood circulation.

  3. Medications: Certain medications, including those for erectile dysfunction, blood pressure, antidepressants, antipsychotics, and recreational drugs, can trigger priapism.

  4. Traumatic Causes: Physical trauma, spinal cord injuries, or penile injuries can result in long and painful erections.

  5. Urinary Tract Infection: While rare, UTIs in men may lead to painful urination but are not typically associated with painful erections.
  6. Urethritis: Inflammation of the urethra can be a source of discomfort but is generally not linked to painful erections.

  7. Prolactinoma: An uncommon pituitary gland tumor can disrupt hormonal balance, potentially causing erection issues.

  8. Penis Fracture: Penis fractures, although rare, can cause severe pain and require immediate medical attention.

  9. Late-Onset Hypogonadism: A decline in testosterone levels in older men can lead to sexual health problems.

  10. Hemochromatosis: Excessive iron buildup in the body due to hemochromatosis can affect sexual function.   

                    Symptoms of Painful Erection

                    Symptoms of Painful Erection, also known as priapism, can be distressing and uncomfortable. One of the primary symptoms is the persistent and painful erection that lasts for an extended period, often exceeding four hours, without any sexual arousal or stimulation. This prolonged erection can cause considerable discomfort and anxiety for the individual experiencing it.

                    Read also: How Often Should a Man Ejaculate

                    Moreover, priapism often leads to the penis becoming rigid, swollen, and tender to the touch. The affected individual may also notice changes in the color of the penis, with it appearing reddish or purplish due to the accumulation of stagnant blood within the erectile tissues. These symptoms collectively create an alarming and painful experience that necessitates immediate medical attention to prevent potential complications.  

                    In addition to the physical symptoms, individuals with priapism may also experience emotional distress and psychological discomfort. The persistent pain and uncertainty about the cause can lead to anxiety and fear.

                    Moreover, the impact of priapism on sexual function and the potential risk of long-term complications, such as erectile dysfunction, can contribute to significant emotional strain. It is crucial for those experiencing painful erections to seek prompt medical care not only to address the physical discomfort but also to alleviate the emotional burden associated with this condition.  

                    1. Ischemic vs. Non-Ischemic Priapism

                    Ischemic and non-ischemic priapism are two distinct forms of prolonged and painful erections, each characterized by different underlying causes and implications.

                    Ischemic priapism is the more common and concerning type, typically occurring due to impaired blood flow out of the penis, often associated with conditions like sickle cell disease, certain medications, or trauma. It is considered a medical emergency because the stagnant blood can cause tissue damage and potentially lead to permanent erectile dysfunction if not promptly treated.

                    On the other hand, non-ischemic priapism is a less urgent condition, usually caused by a ruptured blood vessel or vascular malformation. While still requiring medical attention, non-ischemic priapism is generally less painful and less likely to result in tissue damage or long-term erectile dysfunction.

                    Distinguishing between these two types of priapism is crucial for healthcare providers to determine the appropriate treatment and ensure the best possible outcome for the affected individual.  

                     2. Blood Disorders and Erection Pain

                    Blood disorders can be a significant factor contributing to erection pain, particularly in cases of ischemic priapism. Conditions such as sickle cell disease, leukemia, or certain clotting disorders can disrupt the normal flow of blood in the penis. In ischemic priapism, which is the more common and concerning form of the condition, blood flow out of the penis becomes impaired, resulting in prolonged and painful erections.

                    These disorders can lead to the formation of blood clots or blockages within the erectile tissues, causing severe discomfort and potential tissue damage. Therefore, individuals with known blood disorders should be vigilant about any changes in their sexual health and seek immediate medical attention if they experience persistent erection pain, as early intervention is crucial to alleviate the discomfort and prevent complications associated with priapism.  

                    3. Medications and Their Impact

                    Medications can have a significant impact on the occurrence of painful erections or priapism. Certain drugs, such as those used to treat erectile dysfunction (e.g., sildenafil, tadalafil), are known to have priapism listed as a rare side effect. Prolonged and painful erections can result from an excessive or prolonged response to these medications.

                    Additionally, some medications used to manage other medical conditions, like anticoagulants or drugs used in the treatment of psychiatric disorders, may increase the risk of priapism due to their effects on blood flow or clotting. Individuals taking these medications should be aware of the potential side effects and promptly report any unusual or prolonged erections to their healthcare providers.

                    It’s essential for both healthcare providers and patients to weigh the risks and benefits of medications carefully and monitor for any adverse effects to ensure the overall well-being of individuals receiving treatment.  

                    4. Trauma and Erection Pain

                    Trauma can play a significant role in causing erection pain, especially in cases of non-ischemic priapism. Physical injury or trauma to the genital area can lead to damage to blood vessels, resulting in the leakage of blood into the erectile tissues. This can cause an erection that is often painful and unrelated to sexual arousal.

                    Trauma-induced priapism can occur due to accidents, sports injuries, or other events that involve blunt force to the genital region.
                    While non-ischemic priapism is generally less urgent than ischemic priapism, prompt medical attention is still necessary to assess and address any underlying damage and alleviate the associated pain.

                    Individuals who have experienced genital trauma and subsequently develop painful erections should seek immediate medical evaluation to determine the appropriate treatment and ensure their sexual health and well-being.  

                    5. Urinary Tract Infections and Their Uncommon Association

                    Urinary tract infections (UTIs) are generally characterized by symptoms such as frequent urination, burning sensations during urination, and abdominal discomfort. While painful erections are not a typical symptom of UTIs, there are uncommon instances where a UTI may indirectly lead to discomfort during erections. This association can occur when a UTI spreads to the prostate, a condition known as prostatitis.

                    Prostatitis can cause pain or discomfort in the pelvic region, which may extend to the genitals and result in painful erections.
                    It’s important to note that this is relatively rare, and most UTIs do not directly cause painful erections.
                    Nonetheless, if someone with a UTI experiences unusual genital pain or discomfort during erections, consulting a healthcare provider is advisable to rule out any complications or underlying conditions and receive appropriate treatment.  

                    6. Urethritis and Its Effects

                    Urethritis is a condition characterized by inflammation of the urethra, the tube that carries urine from the bladder out of the body.

                    It is commonly caused by bacterial infections, most notably sexually transmitted infections like chlamydia and gonorrhea. Urethritis can lead to various uncomfortable symptoms, including a burning sensation during urination, increased frequency of urination, and discharge from the urethra.

                    While painful erections are not a direct symptom of urethritis, the discomfort and irritation in the urethra can sometimes extend to the genital area, potentially causing some discomfort or pain during sexual activity or erections. Prompt diagnosis and treatment of urethritis are essential to alleviate symptoms, prevent complications, and reduce the risk of transmitting sexually transmitted infections to others through sexual contact.  

                    7. Prolactinoma: A Rare Cause

                    Prolactinoma, a rare type of pituitary tumor that causes an overproduction of the hormone prolactin, is an unusual but noteworthy factor in the context of painful erections. Elevated levels of prolactin can disrupt the balance of other hormones involved in sexual function, such as testosterone, leading to various sexual problems. While painful erections are not a primary symptom of prolactinoma, the hormonal imbalances it creates can contribute to sexual dysfunction, including difficulties with achieving or maintaining erections, and may lead to discomfort during sexual activity.

                    However, it’s essential to understand that prolactinomas are relatively rare, and painful erections alone are not indicative of this condition. Any persistent or unexplained sexual issues, including painful erections, should be evaluated by a healthcare professional to determine their underlying causes and appropriate treatment.  

                    8. Penis Fracture: A Sudden and Severe Issue

                    Penis fracture, though uncommon, is a sudden and severe urological issue that can have serious consequences. It typically occurs when there is a traumatic injury to the erect penis, causing the rupture of one or both of the chambers known as the corpora cavernosa.

                    This injury often results from vigorous sexual activity, such as aggressive bending or thrusting, or accidental trauma to the erect penis. When a penis fracture occurs, it is usually accompanied by a sharp and agonizing pain, followed by immediate swelling and bruising of the genital area.

                    Immediate medical attention is crucial in such cases, as a delay in treatment can lead to long-term complications, including deformities, erectile dysfunction, and scarring. Penis fracture is a true urological emergency, and seeking prompt medical care is vital for the best possible outcome and to mitigate the potential long-term impact on sexual health.  

                    9. Late-Onset Hypogonadism and Sexual Health

                    Late-onset hypogonadism, a condition characterized by declining testosterone levels in aging men, can have a significant impact on sexual health, including the occurrence of painful erections.

                    Hypogonadism is a condition in which the testes produce insufficient testosterone, the primary male sex hormone. This hormonal imbalance can lead to various sexual problems, such as reduced libido, difficulties achieving and maintaining erections, and even painful erections.

                    Painful erections in individuals with hypogonadism may result from the hormonal disruptions affecting the blood flow and erectile tissues. While late-onset hypogonadism is a natural part of aging, it’s crucial for those experiencing distressing symptoms like painful erections to consult a healthcare provider.

                    Treatment options, including hormone replacement therapy, can help alleviate these symptoms and improve overall sexual health by restoring testosterone levels to a more normal range.  

                    10. Hemochromatosis: The Impact on Sexual Function

                    Hemochromatosis is a hereditary disorder characterized by the excessive accumulation of iron in the body, which can have implications for sexual function, including the occurrence of painful erections.

                    The excessive iron buildup can affect various organs, including the testes and pituitary gland, disrupting the production and regulation of hormones, such as testosterone. As a result, individuals with hemochromatosis may experience sexual problems like reduced libido, erectile dysfunction, and in some cases, painful erections.

                    While not all individuals with hemochromatosis will experience these symptoms, those who do should seek medical evaluation and management. Proper treatment and monitoring can help address iron overload and its impact on sexual health, potentially alleviating symptoms like painful erections and improving overall well-being.  

                    Other Potential Factors: 

                    Gonococcal Urethritis and Erection Pain   

                    Gonococcal urethritis, caused by the bacterium Neisseria gonorrhoeae, is a sexually transmitted infection (STI) that can lead to erection pain in affected individuals. This STI primarily affects the urethra, causing inflammation and discomfort during urination.

                    However, the infection can extend to the genital area and potentially result in painful erections. The inflammation and irritation of the urethra can extend to the surrounding tissues, including the erectile tissues of the penis, leading to discomfort or pain during sexual arousal and erection.

                    Prompt diagnosis and treatment of gonococcal urethritis are essential not only to alleviate symptoms like erection pain but also to prevent the spread of the infection to sexual partners and to mitigate potential complications. Safe sexual practices and regular STI testing can help reduce the risk of gonococcal urethritis and its associated symptoms.  

                    Epididymitis and Its Influence

                    Epididymitis is a medical condition characterized by the inflammation of the epididymis, a coiled tube located at the back of the testicles that stores and carries sperm. While epididymitis typically presents with symptoms like testicular pain, swelling, and discomfort during urination, it can also have an influence on sexual health, including the potential for painful erections.

                    The inflammation and swelling in the epididymis can lead to referred pain and discomfort in the testicles and the surrounding genital area, which may extend to painful erections during sexual arousal.

                    It’s essential for individuals experiencing symptoms of epididymitis, including painful erections, to seek prompt medical attention. Early diagnosis and appropriate treatment can help alleviate discomfort, prevent complications, and preserve sexual health.  

                    Cushing Syndrome and Its Effects

                    Cushing’s syndrome, a rare hormonal disorder resulting from prolonged exposure to high levels of the hormone cortisol, can have various effects on the body, including potential implications for sexual health and the occurrence of painful erections.

                    Elevated cortisol levels can disrupt the normal balance of hormones involved in sexual function, leading to complications such as reduced libido, erectile dysfunction, and in some cases, painful erections.

                    The exact mechanisms by which Cushing’s syndrome may contribute to painful erections can vary, but the hormonal imbalances created by this condition can impact blood flow and the function of erectile tissues. Individuals with Cushing’s syndrome should be aware of the potential for sexual health issues and consult with healthcare professionals for comprehensive evaluation and management to address symptoms like painful erections and improve overall well-being.  

                    Chronic Prostatitis: A Potential Contributor

                    Chronic prostatitis, an inflammatory condition affecting the prostate gland, can indeed be a potential contributor to painful erections. The inflammation and discomfort associated with chronic prostatitis can extend to the surrounding tissues, including the urethra and the erectile tissues of the penis. This inflammation can lead to pain or discomfort during sexual arousal and erections.

                    Additionally, chronic prostatitis can result in a range of other symptoms, including urinary difficulties, which may further contribute to discomfort during sexual activity. It’s essential for individuals experiencing persistent painful erections or other symptoms suggestive of chronic prostatitis to seek medical evaluation and treatment.

                    Effective management of chronic prostatitis can help alleviate discomfort, improve sexual health, and enhance overall quality of life. 

                    Acute Prostatitis and Its Impact

                    Acute prostatitis, a sudden and severe infection or inflammation of the prostate gland, can significantly impact sexual health, including the occurrence of painful erections.

                    This condition is often accompanied by symptoms such as fever, chills, urinary urgency, and discomfort in the pelvic region.

                    The inflammation and tenderness of the prostate can extend to the surrounding tissues, including the urethra and the erectile tissues of the penis. This can lead to pain or discomfort during sexual arousal and erections.

                    Acute prostatitis can be a painful and distressing condition, and individuals experiencing painful erections along with other symptoms should seek immediate medical attention. Timely diagnosis and appropriate treatment are crucial not only to alleviate the discomfort but also to prevent potential complications and preserve sexual health.  

                    Read also Ejaculation: How It Works, Complications and Disorders 

                    Treatments for Erection Pain   

                    There are several treatment options available for individuals experiencing erection pain, and one of the innovative approaches gaining popularity is GAINSWave therapy. GAINSWave is a non-invasive, drug-free treatment that utilizes low-intensity shockwaves to improve blood flow and rejuvenate the blood vessels in the genital area. This therapy can effectively address the underlying vascular issues contributing to erection pain and erectile dysfunction, leading to improved sexual function and reduced discomfort during erections.

                    In addition to GAINSWave therapy, other treatment options for erection pain may include medications like pain relievers or anti-inflammatories to manage immediate discomfort and address any underlying causes. In cases where infections are involved, antibiotics may be prescribed. It’s essential for individuals experiencing erection pain to consult with a healthcare provider to determine the most suitable treatment approach based on their specific condition and needs.  

                    When Painful Erections Are an Emergency   

                    Painful erections can sometimes be an emergency medical situation, and it’s crucial to recognize when immediate medical attention is warranted. One of the most critical scenarios is priapism, a condition characterized by a persistent and painful erection lasting more than four hours, unrelated to sexual arousal or stimulation.

                    Priapism can result from various causes, including blood disorders, certain medications, or trauma, and it is considered a urological emergency.

                    Delaying treatment for priapism can lead to severe complications, including tissue damage and permanent erectile dysfunction. Therefore, individuals experiencing prolonged and painful erections should seek immediate medical care to address the underlying cause and prevent potential long-term consequences. It’s essential to prioritize prompt evaluation and treatment in such situations to safeguard both sexual health and overall well-being.  



                    Understanding painful erections, their causes, and appropriate treatments is essential for men’s health. While these issues may not always be easy to discuss, seeking timely medical attention is crucial for a better quality of life. If you or someone you know experiences persistent painful erections, consult a healthcare professional for proper evaluation and care.

                    Originally published by Gainswave.
                    Medically reviewed by David Cunningham, MD, GAINSWave’s Clinical Advisor.

                    FAQs about Painful Erection

                    Why Do I Get Painful Erections in My Sleep?

                    Getting painful erections in your sleep is not common and may indicate priapism, often associated with conditions like sickle cell disease.   

                    Why Do I Have Long and Painful Erections?

                    Long and painful erections, known as priapism, can occur without clear cause or due to conditions like sickle cell disease, medication side effects, or genetic factors.

                    Can a UTI Cause a Painful Erection?

                    Urinary tract infections (UTIs) are uncommon in men and typically do not lead to painful erections. UTI symptoms include painful urination and fever.   

                    Do STDs Cause Painful Erections?

                    Sexually transmitted diseases (STDs) do not directly cause painful erections but may result in pain during ejaculation or discomfort from open sores on the penis.

                    What is Priapism?

                    Priapism is a condition characterized by persistent and painful erections lasting longer than four hours, unrelated to sexual desire.

                    Are Painful Erections Serious?

                    Yes, painful erections are a serious medical concern, especially if they persist beyond four hours. Seek immediate medical attention.

                    Can Painful Erections Be Prevented?

                    While some causes of priapism cannot be prevented, avoiding certain medications or recreational drugs known to increase the risk can help reduce the likelihood of experiencing painful erections.

                    Can Priapism Lead to Permanent Erectile Dysfunction?

                    In some cases, untreated priapism can lead to permanent erectile dysfunction due to tissue damage. Seeking prompt medical attention is crucial to prevent this outcome.

                    Are There Any Long-term Complications Associated With Priapism?

                    Long-term complications may include scarring of the erectile tissues, erectile dysfunction, and psychological distress related to the condition and its treatment.

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