Painful orgasm (painful ejaculation) is commonly described as a pain or burning sensation that happens when a man ejaculates. He may feel pain between his anus and genitals or in his testes. He may also feel it in the urethra, the tube that semen passes through. Pain may be mild or severe.

A man may become so frustrated by this pain that he starts to avoid sex. His relationship with his partner may suffer as a result. Many men with painful ejaculation experience depression and anxiety.

Painful orgasm can have a number of causes:

Inflammation and Infections

• Prostatitis – inflammation of the prostate gland, which is involved with semen production
• Orchitis – inflammation of one of both testes, the glands that make sperm
• Urethritis – inflammation of urethra, the tube that semen passes through when a man ejaculates.
• Sexually-transmitted infections – such as trichomoniasis

Pelvic Conditions and Treatments

• Prostate cancer
• Pelvic radiation
• Lower pelvic surgery – such as radical prostatectomy (removal of the prostate)
• Nerve damage in the penis – such as from an injury or complications of diabetes.
• Chronic pain in the pelvis
• Blockages in the ejaculatory system – from cysts or stones

Some antidepressants, spermicides, and contraceptive creams have also been linked to painful ejaculation.

Sometimes, the cause of painful ejaculation is more difficult to pinpoint. Psychological problems can play a role, especially if a man has pain only with a partner, not when he masturbates.

To treat painful orgasm, a doctor must first determine the cause. Usually this involves a thorough medical exam. Sometimes, samples of urine or semen are analyzed.

Medications may help if there is inflammation of the testicles, prostate or urethra. Men who have sexually-transmitted infections are usually given antibiotics.

If painful ejaculation is a side effect of medication, it may help to lower the dose (with a doctor’s guidance) or change the medication type.

Men who have painful ejaculation due to nerve damage often find that the situation gets better as the nerve heals. This may take up to two years.

Counseling or sex therapy can be helpful if the problem is psychological.