Pain during sex for males

If you experience pain or discomfort during or after sex, it can understandably lead to a loss of sexual desire and have a profound effect on your relationships.

But you shouldn’t suffer in silence. Pain during sex for men needs investigating and is often treatable, so first of all, go and see your GP. Understanding the type of pain, where in the body it is located and when it occurs can be very helpful in diagnosing and treating the issue.

Lack of lubrication during sex

Penetration requires lubrication, whether it’s vaginal or anal. Without it, both of you can become sore. Some women naturally produce enough vaginal lubrication for penetrative sex, some women need extra lubrication and often, with a lot of friction from thrusting, the vagina dries out. There are a wide variety of lubricants available, from pharmacies, supermarkets and on line, so experiment with some! Vaginal dryness can be caused by not being aroused enough, taking certain medications, or experiencing hormone changes, so lots of foreplay and clitoral stimulation might be really helpful (and enjoyable!)

Delayed ejaculation

Orgasmic difficulties such as delayed or absent ejaculation can lead to sore genital areas from too much penetration and friction. Make sure you use plenty of lubricant (lube) and try to take your focus off orgasm as the main goal during sex. Focus on the sensations you feel when you and your partner touch each other. Sex toys may also help as they offer a more intense level of stimulation.

Sexually transmitted infection (STI)

Yeast infections such as thrush, infections under the foreskin, as well as STIs such as trichomoniasis and genital herpes can all make sex painful. If you are concerned about your sexual health, you can either request an STI test or selected STI treatments.

Visit our sexual health hub to find out more about STIs and get sex and relationship advice. 

Allergic reaction

Allergy to latex condoms or soaps can cause irritation in the genital area, making sex uncomfortable. Pay attention to what might be causing this. Non-latex alternatives are available and it is advisable to use them with extra water-based lubricant.

Headaches after sex

Also known as Coital headache, Cephalalgia and Orgasmic migraine. Pain generally occurs above the neck at the back of the skull. It might be an ache that builds alongside sexual arousal and orgasm or a sudden thunderclap headache, which can be caused by changes in blood pressure. In rare cases, the pain could be an indicator of something more serious, so it is vital you speak to your GP to check this out.

Pain on ejaculation

Chronic Prostatis (PC) is a swelling of the prostate gland and is a condition that can cause painful ejaculation, painful penetration and delayed ejaculation.
Following orgasm and ejaculation, it is common to have a hypersensitive glans penis (the end of the penis).
If this is hugely uncomfortable it can lead to other sexual difficulties, such as loss of desire. Speak to your GP about how to de-sensitise the area.

Post Orgasmic Illness Syndrome (POIS)

Men with POIS often report feeling unwell after ejaculation. Symptoms can vary from fatigue to flu-like symptoms, which can be immediately after ejaculating or occur some time later, sometimes lasting for several days. Although some scientific research has been done, there is still more to understand about this condition.

Peyronie's disease - curved penis

Peyronie’s disease is where scar tissue forms inside the penis causing it to bend when erect, which can be painful. Most men have a slight curve in their penis when erect, but some men have a more pronounced bend in the penis, which may not cause problems. A slight bend in the penis that does not cause any problems is normal and nothing to worry about. However, if this does cause sex to be painful, you should consult your GP.

Phimosis - foreskin too tight

Phimosis is where the foreskin is too tight. This might only be apparent with an erection and can cause pain during penetrative intercourse. Condoms and lube may alleviate the discomfort. Tears in the foreskin that might not be noticeable can also cause sex to be painful. Speak to your GP about treatment if this is a problem for you.

Sexual position

You might find that your choice of sexual positions are increasing discomfort and pain, so play around with some alternatives; perhaps some will be more comfortable than others. Vary your angles, movements and thrust speeds. If penetration is a source of discomfort, try ‘intracrural sex’, which is where you rub your penis against your partner’s genitals using lubricant, creating a pleasurable friction without penetration.

Foreskin problems

Some men may experience pain during sex due to a tight foreskin, this can make penetration painful as the foreskin is pushed back. Small tears in the foreskin, that sometimes can’t be seen, can also cause soreness or a sharp, stinging pain when having sex. 

Priapism

Priapism is a long-lasting, painful erection and can cause permanent damage to your penis if it is not treated. While this can sometimes get better on its own, particularly if you try to go for a bath, drink lots of water, take a gentle walk or try and pass urine. However in some cases it may need hospital treatment to drain the excess blood from your penis. 

If you are finding sex painful or uncomfortable, don’t give up hope. If the issue has psychological causes, it may be treated with help from a qualified psychosexual therapist. If it is caused by something physical, you may find that your GP can help or refer you to another specialist who can. Often a combination of psychological therapy and medical treatment can be effective.

References

https://www.nhs.uk/common-health-questions/sexual-health/why-does-sex-hurt/
https://www.nhs.uk/conditions/priapism-painful-erections/

Charlotte Simpson is an Accredited Psychosexual Therapist and Relationship Counsellor in Private Practice in North West London.