Ejaculation pain, what to do?

Several local infections can cause painful ejaculation. It can be a type II prostatitis or a sexually transmitted infection.

Type II prostatitis

Prostatitis is characterized by inflammation of the prostate. Chronic prostatitis or type II prostatitis may be bacterial in origin and is more often related to persistent urinary tract infections or prostate pathology. It can be caused by a type I prostatitis that has been poorly treated or that has settled silently. Acute prostatitis or type I prostatitis is when it is bacterial in origin. It is usually a sexually transmitted infection. It can cause fever, abdominal pain and burning of the bladder.

These symptoms may go unnoticed in some people. In the absence of treatment, in case of delay in treatment or discontinuation of care due to rapid improvement, this can lead to an alteration of the patient’s general condition, and thus to type II prostatitis.

Type II prostatitis can thus manifest itself by the following symptoms:

• an unpleasant feeling of heaviness in the lower abdomen,
• pain,
• a burning or simply a discomfort at the time of urinating,
• painful ejaculation.

Chronic prostatitis can also be of non-bacterial origin. This form is referred to as chronic pelvic pain syndrome. The causes of this form of prostatitis are often difficult to identify exactly. They may be infectious or related to inflammatory phenomena. Chronic non-bacterial prostatitis can manifest itself by urinary or genital pain which can be associated with possible sexual or urinary disorders.

Painful ejaculation can also be a manifestation of a sexually transmitted infection. Although not the most common cause, male genital tract infections such as trichomoniasis can cause painful ejaculation. This sexually transmitted infection may not present symptoms in men. In some cases, the patient may feel a burning sensation after sex or while urinating.

Pain with ejaculation can also be caused by a local inflammation such as epididymitis. This is an inflammation and infection of the epididymis. The epididymis is the duct where sperm is stored and matured before it migrates to the prostate. This condition manifests itself in two forms: acute epididymitis which is the most common form and chronic epididymitis which is multifactorial.

This condition may manifest itself as scrotal discomfort and pain. This pain evolves rapidly within 48 to 72 hours and may be accompanied by fever (in one third of cases). Depending on the trajectory of the spermatic cord, the pain may radiate to the abdomen. Epididymitis can also manifest itself by symptoms such as pain on ejaculation and palpation, swelling of a testicle or penis, urethral discharge…

Most epididymitis is due to retrograde infections. The organisms responsible for epididymitis can be sexually transmitted bacteria such as Neisseria gonorrhoeae, Chlamydia trachomati. Bacteria from urogenital infections (Escherichia coli) may also be responsible for this condition. Other infectious agents of viral or bacterial origin such as Mycobacterium tuberculosis or Salmonella can also be the cause of epididymitis.

Painful ejaculation in a man can have neurological causes such as pudendal neuralgia. Also known as Alcock’s canal syndrome, pudendal neuralgia is a neurological condition that causes intense and chronic pain in the breech area. These pains are more pronounced when the individual is in a sitting position and subside when at rest. In men, they are often located in the testicles, penis and anus.

These painful sensations are similar to an electric shock, numbness, burning or pinching. They can be unbearable and have repercussions on the individual’s professional, social and sexual life. The pain experienced may be associated with pelvic hypersensitivity which involves sexual, urinary and anorectal disorders.

Pudental nerve compression can occur in a person for no apparent reason. It can also be caused by certain factors such as repeated practice of certain activities such as cycling or horseback riding, a fall that causes compression of the nerve or a hematoma, or surgery in an area that the nerve passes through.

Ejaculation pain can be caused by trigger points in the perineal muscles. Trigger points are located in all muscles that can be actively contracted in the body. These painful muscle tension points are one of the most common causes of chronic pain. They can develop as a result of stretching, compressing or overloading muscles.

Consisting of ligaments and muscles, the contraction of the perineum helps maintain an erection and plays a major role in the ejaculation process. The appearance of these trigger points in the perineal musculature can cause pain in this part of the body. This can lead to pain during ejaculation.

In some cases, the cause of painful ejaculation may be completely unknown to everyone. Furthermore, if the patient does not feel any pain during masturbation for example, but only during sexual intercourse, it may be psychological. Stress, trauma, anxiety, depression are also factors that can impact the quality of ejaculation during sex. The best thing to do at this time is to consult a therapist (sexologist) who will help you to see things more clearly.