Pain during or after ejaculation can be difficult to mention—even to a doctor. Some men hope it will disappear, while others avoid intimacy because they worry it will happen again.

It is a symptom worth discussing. Painful ejaculation can have several causes, and identifying the reason is the first step towards appropriate treatment.

What does painful ejaculation feel like?

The experience varies. Some men notice burning or sharp pain, while others describe a deeper ache. Discomfort may occur in the penis, testicles, pelvis or the area between the scrotum and anus.

It can begin during ejaculation or continue afterwards. Your doctor may ask where the pain occurs, how long it lasts and whether it happens every time.

What can cause it?

Possible causes include inflammation of the prostate, infection, irritation of the urethra and certain medicines. Pain may also develop following pelvic surgery or radiotherapy. Occasionally, an obstruction affecting the passage of semen may be involved.

These possibilities cannot reliably be distinguished by the sensation alone. Painful ejaculation does not automatically mean you have an infection, and antibiotics are not appropriate for every case.

What happens during an assessment?

A consultation usually begins with a conversation about your symptoms, medical history, medicines and any previous procedures.

Your doctor may ask about urinary symptoms, sexual health and whether you have noticed blood in your urine or semen. Depending on the findings, assessment may include an examination, urine tests or testing for sexually transmitted infections.

Not everyone needs scans or invasive investigations. Testing should be guided by your individual symptoms and examination.

How is it treated?

Treatment depends on the underlying cause. It may involve treating a confirmed infection, reviewing a medicine or addressing another identified problem. There is no single treatment suitable for every man.

Seek urgent medical attention if the pain occurs with fever, feeling very unwell or an inability to urinate.

Starting the conversation

You don’t need medical terminology to explain the problem. Simply saying, “I have pain when I ejaculate,” gives your doctor a clear starting point.

If the symptom is recurring or affecting intimacy, speak with your GP about assessment and whether a referral to Dr Jo Schoeman in Brisbane would be helpful.