Painful intercourse or painful ejaculation is the most simple term to describe it. There are many other terms in the dictionary like dysejaculation, odynorgasmia, post orgasmic pain, dysorgasmia or orgasmalgia, etc etc but really there is no other simpler term to describe it but painful ejaculation.

To be honest, it is quite common but poorly understood phenomenon associated with sexual dysfunction.

It actually happens in 1–10% in the general population depending where you live and it actually increases to 30–75% among men who suffer from chronic prostatitis or chronic pelvic pain syndrome.

The severity of painful ejaculations may vary from a minor discomfort to excruciating pain.

The pain typically starts immediately before or during ejaculation and commonly lasts between 2 to 24 hours. It can be so painful that you can get turn off and your partner dissatisfied and concerned at same time.

CAUSES: why do we have this happening?

1. Infections and sexually transmitted infections.

One other thing that all men shares besides our obvious anatomy, is our prostate.

The prostate is like the major town where our semen have to flow through and contributing to the flow. Imagine if there is congestion at the town caused by inflammation and foreign bacteria attacking. The very thought itself is painful. Chlamydia is often one STD/STI that results in prostatitis.

2. Stones

Stones that get stuck in the seminal vesicles which are like the canals in our town of prostrate. They can cause excruciating pain and inflammation.

3. Nerve causes

Sexual neurasthenia, big word here but it just means sensitive nerves firing off ad naseam till they are painful and exhausted.

4. Drugs

Essentially there is a small risk with all anti depressants: tricyclic antidepressants (TCAs, e.g. clomipramine, imipramine, desipramine, protriptyline, amoxapine), the selective serotonin reuptake inhibitors (SSRIs, e.g. fluoxetine), venlafaxine and the MAOIs

5. Prostate issues

The prostate itself can have issues with its own inhabitant cells with inflammation of prostate , prostate cancer, benign prostatic hyperplasia .

6. Post operation

Any prostate surgery , pelvic radiation and hernia repair amongst others.

7. Psychiatric

Psychological issues may also be the cause of painful ejaculations, especially if the patient does not experience this problem during masturbation.
Idiopathic – sometimes things just happen with no particular triger

What can doctors do for us?

Rigorous medical and sexual history! This along with chronological order of events is very important to finding out why. The type and location of the pain matters too. It is just not enough to tell the doc pain pain.

He/she will then do a focused physical examination that may disclose scars from previous surgeries or radiotherapy in the groin area whereas skin lumps and penile discharge may be suggestive of sexually transmitted diseases.

Palpation of a swollen and painful prostate during digital rectal examination is a diagnostic finding for acute prostatitis whereas a nodule can be felt in the presence of a prostate cancer.

Similarly, a urine test may confirm the location of urinary infection and screen for Chlamydia and gonorrhea. It is to confirm the diagnosis of prostatitis. And blood test for prostate specific antigen levels may also suggest prostate issues if raised.

Abdominal CT scans are rarely required. MRI studies may be helpful when investigating the cause of pudendal neuropathy. However, no obvious aetiology is found in a significant number of patients with the complaint of painful ejaculations, despite extensive investigation. Which lies in our Idiopathic category above.

Treatment of painful ejaculation must be tailored according to the underlying cause, if detected.

Painful ejaculation should never ever be taken for the peak of joyous fun with your partner.