Ejaculation pain - pain during ejaculation

Ejaculation pain - pain during ejaculation

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One of the most uncomfortable complaints for a man is genital pain. Appropriate pain symptoms are all the more tragic if they occur during ejaculation. The most beautiful thing in the world for men can quickly become a nightmare, which not only destroys the acute moment of ejaculation, but can also decisively affect the overall sexuality of the man if the symptoms persist. There are many reasons for pain during ejaculation. Accordingly, the therapeutic approaches are sometimes very different. We will explain the details to you in our post below.

Male ejaculation

Male ejaculation describes the path of the sperm from the testicles into and out of the urethra. It can be done during sexual intercourse as well as by manual operation during masturbation. Occasionally there are cases in which the ejaculation takes place without any action whatsoever, which is usually associated with a particular sensitivity to arousal of the person concerned.

Regardless of this, the ejaculation always works on the same principle: the male sexual center located in the diencephalon sends rhythmic nerve impulses to the sympathetic nerve cells in the lumbar region due to an existing excitation. The lower abdominal nerve (hypogastric nerve) and the pubic nerve (hypogastric nerve) are significantly involved in this process. The corresponding section of the lumbar spinal canal is commonly referred to as the ejaculation center.

The two nerves pass on the received impulses to the lumbar and pelvic muscles, which cause rhythmic contractions. Particularly worth mentioning here is the

  • Bladder sphincter (Musculus sphincter vesicae),
  • Urethral muscle (Urethralis muscle),
  • Ischocavernous muscle (ischiocavernosus muscle)
  • and bulging bulge muscle (bulbospongiosus muscle).

Together with the erectile tissue (corpus cavernosum) of the male limb, which fills with blood during the erection, the muscle contractions lead to a constant increase in pressure in the prostate gland and the urethra coupled to it, causing the sperm to be released in batches is transported out of the paired testicles (testicles) via the vas deferens.

This process is usually painless for men. However, there are certain health problems that can cause pain during ejaculation. Pain can range from a slight pull in the testicles or penis to burning or stinging pain.

Causes of pain when ejaculating

The triggers of pain during ejaculation are sometimes very complex. For example, sore spots within the urethra or prostate are conceivable, which react with pain symptoms due to irritation caused by injecting secretions (in this case sperm).

The friction that usually occurs on the penis during sexual intercourse further increases the risk of pain in the event of a wound. However, other causes of pain, such as nerve or muscle problems, can often be identified as the cause of ejaculation pain. You can find more details in the following chapters.

Inflammation and infectious diseases

Pain during ejaculation often gives an indication of an existing infection of the male genital organs. The exact localization of the pain often gives treating doctors first indications of the focus of infection.

With urethritis, for example, the pain usually arises directly in the penis. The inner surface of the urethra is severely roughened in the event of such a disease and the lining of the lining of the mucous membrane is partially decomposed by inflammatory agents, which makes irritation all the more painful.

Pain in the direction of the pelvis, on the other hand, indicates an inflammation in the rear area of ​​the male genital organs. It is typically an inflammation of the prostate (prostatitis) or at least a highly advanced urethritis. The pain can radiate down to the perineum region as well as the testicles.

The latter can also cause inflammation-related pain, namely in the case of testicular inflammation (orchitis). The ejaculation pain usually goes hand in hand with a strong pulling in the testicles, which can radiate into the inguinal canal.

On the other hand, burning pain causes inflammation of the vas deferens (deferentitis). In addition to sexual intercourse, this inflammation also causes increased pain when urinating and usually includes both the testicle area and the prostate as well as the groin area and is accompanied by significant swelling in the area of ​​the vas deferens.

Inflammation of the urethra, prostate, vas deferens or testicles are due in most cases to previous venereal diseases. These usually arise from an infection with bacterial pathogens, fungi or parasites. Viruses can occasionally be identified as infectious agents. The main causes of infection are:

  • Candidiasis - the causative agent is the fungus Candida albicans,
  • Chlamydiosis - pathogens are bacteria from the family of chlamydia,
  • Genital herpes - the causative agent is the herpes simplex virus,
  • Gonorrhea / gonorrhea is caused by the Neisseria gonorrhoeae bacterium
  • HIV infection - pathogens are the human immunodeficiency viruses HIV-1 and HIV-2,
  • Syphilis is caused by the Treponema pallidum bacterium
  • and Trichomoniasis - the causative agent is the parasite Trichomonas vaginalis.

Danger: Sexually transmitted diseases are notifiable in Germany due to their increased risk of infection! In the case of such a disease, sexual intercourse should not take place until it has completely healed, or at least a condom should be used to prevent the infection from spreading further!

Muscle and nerve damage

An inflammatory infection of the genital organs does not always have to be involved in the ejaculation pain. Damages or diseases of the nerves or muscles located in the pelvic and groin area also provoke corresponding pain symptoms.

Again, however, inflammatory processes are to be recorded as a possible cause, whereby it is rarely infectious agents, but rather persistent irritation, injuries or lesions that trigger a corresponding muscle inflammation (myositis) or a nerve inflammation (neuritis).

On the one hand, the inflammatory stimulus leads to functional disorders of the affected nerve and muscle sections, which can manifest themselves as cramps or erectile dysfunction during ejaculation. On the other hand, nerve inflammation in particular always causes very severe pain, which can persist even after the sexual act.

Another reason for damage to the muscles and nerves that initiate ejaculation can be surgical errors that result in neurological or anatomical changes, which in turn trigger malfunctions, abnormal sensations and testicular pain or penile pain.

A very problematic complication in this regard is retrograde ejaculation. It describes an ejaculation disorder in which the sperm is expelled backwards and thus back into the bladder during ejaculation. In such a case, pain is of course not excluded.

In addition to surgical errors, retrograde ejaculation occurs especially in men of advanced age as a result of age-related prostate enlargement as well as the nerve and muscle activity that declines sharply in old age, which weakens the activity of the bladder sphincter muscle in particular. He is usually responsible for holding urine out of the bladder during ejaculation. If the bladder sphincter does not function properly, there is a risk, in addition to general urinary incontinence, that urine pours out of the penis during ejaculation and, conversely, sperm flows back into the bladder.

With regard to nerve damage and surgical errors, improperly performed circumcision (circumcision) should also be mentioned as a possible cause of ejaculation pain. If, for example, too much skin tissue is removed, especially at a young age, tension can arise in the area of ​​the glans in the course of growing up. Skin tension intensifies even more when it is erect and can lead to painful discomfort during sexual intercourse.

Scarring of the glans from circumcision also has a similar effect and can cause massive sensation disorders, if not pain during sexual intercourse.

Ejaculation pain due to psychological conflicts

Painful ejaculations should not be underestimated, even if they are due to a psychological conflict. What is meant here are psychological inhibitions, such as those that arise in the context of a sexual childhood trauma (especially sexual abuse) or a disturbed sex education at home.

The conflict-affected psyche of the affected person causes the nervous system to send contradictory signals, so that the nerves no longer know whether they “may” stimulate the muscles in the genital area to ejaculate or not. This signal disorder also results in disturbed muscle contractions, which can result in painful cramps during sexual intercourse.

Other causes of pain when ejaculating

In rare cases, pain during ejaculation is due to a congenital malformation that hinders trouble-free ejaculation behavior. The best example in this context is a closure of the injection channels (stenosis of the ejaculator duct). It not only leads to the patient's inability to conceive, but also to chronic pelvic pain, which manifests itself especially during and after ejaculation.

Occasionally, the occlusion can also be acquired and is mostly due to inflammation of the prostate or prostate carcinoma. The latter can also trigger ejaculation pain regardless of a occlusion.

The pain when ejaculating is rather harmless, if it is so-called cavalier pain. They develop in men after a long period of sexual abstinence from cramps in the muscles surrounding the seminal ducts. The painful spasm is due to the fact that the muscles are not used for a long time and should quickly subside with regular sexual activity.

Concomitant symptoms

As already mentioned, the pain symptoms during ejaculation can be different and occur either through stinging, pulling or burning pain. Other possible accompanying complaints are for example cramps or, in the case of internal injuries, bloody discharge (discharge in men). Furthermore, accompanying erectile dysfunction cannot be ruled out, since the pain inevitably leads to a decrease in excitement and thus to a backflow of blood from the erectile tissue.

In any case, the occurrence of pain means a very unpleasant experience for the man, who can hardly enjoy the sexual act as a result. If the pain symptoms last longer, the patient may experience a reduced sensation of pleasure, which results from a constant fear of renewed pain during ejaculation.

A real psychological burden, which can lead to enormous problems within a partnership in the case of chronic courses. And the self-esteem of affected men also suffers extremely from the side effects of persistent painful ejaculation.

If the painful ejaculation is based on a psychological trauma or a mental conflict, the psychological side effects take on a completely different dimension. Ejaculation pain can only be eliminated here if the original psychosomatic causes are remedied. Anxiety, panic or phobias can be observed again and again in the course of such causes. Overall, the following accompanying symptoms can be expected for pain when ejaculating:

  • Discharge disorders of the sperm,
  • purulent or bloody discharge (for infections and injuries),
  • Erectile dysfunction,
  • Muscle cramps,
  • psychological symptoms (e.g. fear, self-doubt or frustration),
  • Swelling,
  • Redness
  • and changes or hardening of the tissue.

Ejaculation pain - diagnosis

A medical clarification is necessary in any case for pain during ejaculation. A man affected is not spared the trip to the urologist here. Patients should describe the pain in great detail, even if it may be uncomfortable for one or the other.

It is important for the doctor to know when and where exactly the pain occurs, how long it lasts and how pronounced the pain is. Questions about sexual behavior, the number of sex partners and possible previous illnesses are also asked as part of the medical history, which must also be answered honestly and openly.

Important: If the patient is aware of possible psychological causes (e.g. psychological trauma or inhibitions), these must also be specified in detail so that psychotherapeutic treatment can be initiated in an emergency.

In a physical examination, the attending doctor will first examine the genitals and palpate them to determine possible tissue changes, swelling and redness.

Imaging diagnostic methods, such as an ultrasound, are also important in order to be able to assess the internal structures of the ureter system, the prostate and the testes more precisely. If there is reason to believe that there is inflammation or infection, smears and urine samples are taken and sent to the laboratory for further analysis. Possible infectious agents can be determined here.

Treatment of pain during ejaculation

Depending on the cause of the ejaculation pain, there are very different treatment options for the patient. From the use of simple home remedies for acute treatment to medicinal and medicinal measures to psychotherapeutic steps, all kinds of procedures are conceivable. The details are as follows:

Protection and cooling

Regardless of the underlying trigger, the genitals should be carefully protected until the cause of the pain has healed. Sexual intercourse should at least be reduced in the case of harmless causes if the pain is unbearable. Especially in the case of existing infections, nerve damage or injuries, sexual acts should be completely suspended until the cause of pain has completely healed.

Depending on the existing accompanying complaints, it can also make sense to support the protective measures by consciously cooling the genitals. Swelling and overheating (especially in the area of ​​the testicles) respond very well to this and sometimes even prevent an increase in pain intensity.


Genital infections are treated with antibiotics as standard. In addition, anti-inflammatory and analgesic preparations can be used. The latter are also an option for existing muscle and nerve pain.

In the case of tumor diseases such as prostate cancer as the cause, doctors often precede radiation therapy or surgical removal of the cancer with chemotherapy, which aims to reduce the size of the cancer. The classic active ingredients here include abiraterone, cabazitaxel, cyclophosphamide, doxorubicin or suramin.

In the meantime, there are also special hormone therapies for prostate cancer in which attempts are being made to lower the testosterone level, since the cancer cells in prostate cancer are highly dependent on an adequate supply of testosterone.

Medicinal herbs

In the case of prostate symptoms, but also inflammation of the urinary and spermatic ducts, some proven herbs help, which are otherwise actually used by women against the notorious cystitis. These include, for example, aronia, bearberry, nettle and goldenrod. The three herbs have a diuretic effect and thus bring about a lavish flushing of the male's inflammatory urinary and semen delivery systems. This rinses out infectious agents and cleanses the draining structures of the male genitalia.

Overall, the following medicinal herbs are recommended for infectious and inflammatory diseases in the area of ​​the male genital organs:

  • Field horsetail,
  • Apple (aronia),
  • Birch,
  • Bearberry,
  • Nettle,
  • Goldenrod,
  • Hawk,
  • Heather,
  • Hay flower,
  • Dandelion,
  • Chaste tree,
  • Coneflower,
  • juniper
  • and pasture.

The herbs can either be prepared as tea or they can also be part of a spa. By sitting in warm herbal water, the medicinal ingredients can act very specifically on the genitals. However, the patient should not spend longer than 15 minutes in the spa, because it is known that prolonged warmth is not good for the testicles and can impair sperm activity.


Speaking of diuretic - in order to stimulate the cleaning of ureters and the like by means of a good flush, an increased fluid intake is also appropriate. It also prevents drainage measures from drawing too much water from the body and thus leading to dehydration.

We therefore recommend drinking at least three liters per day until urinary tract, vas deferens, prostate or testicular infections have healed! In addition, diuretic foods such as

  • Artichokes,
  • Pineapple,
  • Pears,
  • Blueberries,
  • Blackberries,
  • Strawberries,
  • Fennel,
  • Cucumbers,
  • Blueberries,
  • Raspberries,
  • Elder,
  • Cranberries,
  • Rhubarb,
  • Celery,
  • Asparagus,
  • Tomatoes,
  • Watermelons
  • and grapes

be consumed. The fruits and vegetables also give the body a good dose of vitamins and nutrients, which strengthen the immune system against the infectious agents and thus shorten the healing time.

Berry fruits such as blueberries, blackberries, cranberries or blueberries also have the advantage that they have anti-inflammatory and disinfectant properties thanks to the antioxidants they contain. A bonus that is again used very successfully in gynecology to support therapeutic measures for urinary tract infections.


If clear psychological causes of the ejaculation pain were discovered in the course of a psychotherapeutic conversation history, then conversation therapy, and possibly also behavior therapy, is usually without options. The inner conflict must be resolved in order to restore interference-free signal transmission of the nerves and thus painlessness of the sexual act. If the patient is in a relationship, the partner is usually also involved in these psychotherapeutic treatment measures.

Psychotherapy is also necessary if the pain complaints and the associated impairments in sex life affect the patient in such a way that there is great psychological suffering.


It may not only be necessary to treat the ejaculation pain surgically with tumor diseases. Malformations of the genitals often require surgery. In addition to the removal or opening of problematic tissue using surgical cutting techniques, the laser method is also increasingly used here. (ma)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.


  • German Society for Urology: (accessed: November 19, 2019)
  • ONKO Internet portal: prostate cancer (accessed: November 19, 2019), ONKO
  • DGU guideline program: Interdisciplinary S3 guideline: epidemiology, diagnostics, therapy, prevention and management of uncomplicated, bacterial, community-acquired urinary tract infections in adult patients. Long version 1.1-2, 2017 AWMF register number: 043/044 (accessed: November 19, 2019), AWMF
  • Diri, Mehmet Akif and Gul, Murat: Bipolar prostate thermotherapy for the improvement of chronic prostatitis symptoms and ejaculation problems, In: Aging Male, 2019 Aug 9: 1-5, PubMed
  • Cicero, Arrigo F.G. , Allkanjari, Olta et al .: Nutraceutical treatment and prevention of benign prostatic hyperplasia and prostate cancer, In: Archivio Italiano di Urologia e Andrologia, Vol 91 No 3 (2019), PubMed
  • Ilie, Cristian P .; Mischianu, Dan L .; Pemberton, Richard J .: Painful ejaculation, in: BJU International, 99/6: 1335-1339, June 2007, Wiley Online Library

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