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Last updated: May 24, 2022
6 min read

Painful erection: causes, symptoms, treatments 

 

Disclaimer

If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.

A painful erection can certainly be jarring, and it may lead you to wonder why it hurts when you get hard. 

Painful erections can occur for a few different reasons. Sometimes, this pain signals a medical emergency like a penile fracture that could lead to erection problems in the future. So, it’s important to pay attention to your symptoms and seek medical attention if necessary. 

Below, we’ll walk you through some reasons why your penis may hurt, what may be causing your painful erections, and what treatments are available for erectile pain.

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Possible causes for penis pain 

Figuring out what’s causing penis pain can be difficult. For instance, pain while urinating and pain in the tip of the penis can be a sign of a variety of problems, including a urinary tract infection (UTI); inflammation of the urethra (urethritis), the tube that carries urine out of the body; or a sexually transmitted infection (STI). 

Pain or itching coming from the skin of the penis could be a sign of a common bacterial infection, an allergic reaction, friction from sexual activity, or an STI.  

And finally, pain during erection can also have multiple causes. The following are frequent causes of pain when erect, and the last two usually require immediate medical attention:

Symptoms of painful erections

Here’s a more in-depth look at the symptoms of Peyronie’s disease, priapism, and penile fractures, so you know what to watch for if you’re noticing pain during an erection:

Peyronie’s disease

Peyronie’s disease (PD) is caused by the build-up of fibrous scar tissue, which causes the penis to curve. It’s not a medical emergency, but it is the most common cause of painful erections—with estimates suggesting it can affect as many as 1 in 10 men. Many of these men may not have received a formal diagnosis. Symptoms of PD may include (NIH, 2019):

Exactly why some men develop PD is unclear. It has been linked to injury, though it can also develop over time without being linked to a specific trauma (NIH, 2019). 

Genetics may play a role in how the body responds to micro-injuries. Men who have connective tissue or autoimmune disorders or a family history of PD can be more likely to develop it. It’s also more common in older men than those in their 20s or 30s (NIH, 2019).

Penile fracture

Penile fracture can happen when there is trauma to an erect penis. Since there is no bone, the fracture is typically the tearing of the sheath of fibrous tissue that allows your penis to swell and get longer (Amer, 2016).

The blood pressure and blood flow involved in an erect penis can lead to what some describe as an explosion of blood within the penis at the time a penile fracture occurs. Other symptoms include (Diaz, 2021):

  • Popping or crackling noise
  • Severe pain
  • Rapid loss of erection
  • Swelling (“eggplant deformity”)
  • Bruising, hematoma (build-up of blood under the skin)
  • Blood in the urine
  • Difficulty urinating

A penile fracture is a medical emergency. Delays in treatment can lead to long-term problems such as painful erections or erectile dysfunction (Diaz, 2021).

Priapism (long-term erection)

Priapism, also called long-term erection, is a prolonged and usually painful erection. It happens when blood is trapped and unable to leave the penis. Its symptoms include having pain during an erection. While definitions vary, having an erection that lasts for four hours that’s not caused by sexual stimulation is typically what qualifies as priapism (Silberman, 2022).

The most commonly reported cause of ischemic priapism in adults is the use of certain medications. The injectable erectile dysfunction medications, papaverine and phentolamine, account for approximately two-thirds of priapism cases (Silberman, 2022). There are also other medications, like some antidepressants, that may cause priapism as a side effect (Cooke, 2010). 

Other causes of ischemic priapism include (Cherian, 2006): 

  • Sickle cell disease or other blood disorders such as leukemia
  • Recreational drug use 

While not as common, another type of priapism, non-ischemic priapism, is usually caused by too much blood flowing through the penis and can happen due to an injury. While this type is not as much of an emergency because there is no trapped blood in the penile chambers, it can be difficult to determine which type of priapism you have, so if you have priapism, it is better to be evaluated by a healthcare professional. 

How to get rid of an erection if it’s hurting you 

An erection that lasts longer than four hours is a medical emergency. It’s essential to pay attention to timing and contact your healthcare adviser early on if something doesn’t seem right (Silberman, 2022).

Contacting your healthcare provider can help because they can discuss your medical history, what may have led up to it, and the best course of treatment, along with a follow-up, if needed. 

At-home approaches

As long as it doesn’t delay medical treatment, there are a few approaches you can try to stop an erection. While these methods have not been well-studied, they are unlikely to hurt as long as they don’t delay additional treatment (Gravel, 2019): 

  • Apply an ice pack to the area (keeping a layer of cloth between ice and skin)
  • Cold shower
  • Masturbation

Seeking emergency care

If you’ve had an erection for four hours, it’s best to head to an emergency room to avoid tissue damage, which could lead to long-term complications. Depending on the circumstances and your medical background, your healthcare provider may suggest even earlier intervention (Gravel, 2019).

Treatments for erectile pain

Treatment for erectile pain differs depending on the diagnosis. Here’s how the three common causes of erectile pain are managed:

Peyronie’s disease

If you have PD, but it’s not painful and isn’t bothering you, you may have no reason to have treatment. Many men have a mildly curved penis, and that’s normal, so long as the curve does not affect their sexual functioning (Sandean, 2021).

But if PD is painful or causing problems, some treatments may help. These generally involve (Carson, 2020):

  • Breaking up scar tissue with injectable medications or surgery
  • Surgical penile straightening procedures (Cordon, 2017)
  • Penile implants (these can help in cases of ED or severe deformity)

Penile fracture

If testing confirms you have fractured your penis, it’s a medical emergency. Waiting can increase the risk of long-term damage to the penis. Treatment usually involves surgery to drain the blood and the use of dissolvable stitches to repair the tear (Diaz, 2021).

Research shows that prompt surgical intervention has a success rate of about 92% (Mensah, 2010). Untreated penile fracture can result in scarring, penile curvature, difficulty urinating, erectile dysfunction, and difficulty reaching orgasm (Diaz, 2021).

Priapism

While priapism is rare, it still leads to about 10,000 emergency room visits a year in the United States alone. About 13% of men may end up being hospitalized (Roghmann, 2013). 

The goal of treatment is to remove blood from the penis and save penile tissue to prevent erectile dysfunction later. The earlier treatment starts, the more successful it is. Treatment can involve (Levey, 2014):

  • Identifying what type of priapism is causing the erection
  • Pain medication
  • If it’s ischemic priapism, thin needles to remove blood from the penis
  • Medication injection (usually phenylephrine) if needed 
  • Earlier surgical shunting, if indicated

When to call a doctor

Whenever you have questions about penile pain or issues with an erection, it’s good to contact a healthcare provider.

Overall, whether it’s a mild infection or an emergency, early treatment leads to better outcomes. In the cases of penile fracture or priapism, immediate medical attention is required to prevent long-term erectile dysfunction. 

References

  1. Amer, T., Wilson, R., Chlosta, P., et al. (2016). Penile fracture: A meta-analysis. Urologia Internationalis, 96(3), 315–329. doi:10.1159/000444884. Retrieved from https://www.karger.com/Article/FullText/444884
  2. Carson, C. (2020). Peyronie’s disease: New paradigm for the treatment of a unique cause of erectile dysfunction. Postgraduate Medicine, 132(4), 4–8. doi:10.1080/00325481.2020.1805865. Retrieved from https://pubmed.ncbi.nlm.nih.gov/33156731/ 
  3. Cherian, J. (2006). Medical and surgical management of priapism. Postgraduate Medical Journal, 82(964), 89–94. doi:10.1136/pgmj.2005.037291. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2596691/ 
  4. Cooke, T. & Nieder, A. (2010).  Priapism. Complications of Urologic Surgery, 4. Retrieved May 23, 2022, from https://www.sciencedirect.com/topics/nursing-and-health-professions/priapism  
  5. Cordon, B. H., Osmonov, D., Hatzichristodoulou, G., et al. (2017). Peyronie’s penile plication. Translational Andrology and Urology, 6(4), 639–644. doi:10.21037/tau.2017.07.18. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5583063/ 
  6. Diaz, K. & Cronovich, H. (2021). Penis fracture. StatPearls. Retrieved May 23, 2022, from https://www.ncbi.nlm.nih.gov/books/NBK551618/ 
  7. Gravel, J., LeBlanc, C., & Varner, C. (2019). Management of priapism with a trial of exercise in the emergency department. CJEM, 21(1), 150–153. doi:10.1017/cem.2018.3. Retrieved from https://pubmed.ncbi.nlm.nih.gov/29547365/ 
  8. Levey, H. R., Segal, R. L., & Bivalacqua, T. J. (2014). Management of priapism: An update for clinicians. Therapeutic Advances in Urology, 6(6), 230–244. doi:10.1177/1756287214542096. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4236300/ 
  9. Mensah, J. E., Morton, B., & Kyei, M. (2010). Early surgical repair of penile fractures. Ghana Medical Journal, 44(3). doi:10.4314/gmj.v44i3.68898. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2996843/ 
  10. National Institute of Health (NIH). (2019). Penile curvature (Peyronie’s disease). Retrieved from https://www.niddk.nih.gov/health-information/urologic-diseases/penile-curvature-peyronies-disease  
  11. Roghmann, F., Becker, A., Sammon, J. D., et al. (2013). Incidence of priapism in emergency departments in the United States. Journal of Urology, 190(4), 1275–1280. doi:10.1016/j.juro.2013.03.118. Retrieved from https://pubmed.ncbi.nlm.nih.gov/23583536/ 
  12. Sandean, D. & Lotfollahzadeh, S. (2021). Peyronie disease. StatPearls. Retrieved May 23, 2022 from https://www.ncbi.nlm.nih.gov/books/NBK560628/ 
  13. Silberman, M., Stormont, G., & Hu, E. (2022). Priapism. StatPearls. Retrieved May 23, 2022 from https://www.ncbi.nlm.nih.gov/books/NBK459178/