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Painful Ejaculation

Reviewed by  Maria Maureen Ablen, MD
Written by  Maria Maureen Ablen, MD
Published 06/30/2025

Pain during ejaculation isn’t just uncomfortable—it can be confusing, distressing, and often hard to talk about. For many Filipino men, this issue remains in the shadows due to stigma or lack of accessible sexual health education. But if you’re feeling a sharp, burning, or lingering ache when you climax, you’re not alone—and there are real, medically backed explanations and solutions. This guide breaks down why ejaculation might hurt, what it could mean for your health, and what you can do about it. From urinary tract infections to prostate concerns, we’ll walk you through the most common causes and what steps to take next.

1. What Causes Painful Ejaculation? 2. What You Can Do About It 3. Supporting Sexual Wellness in the Philippines

What Causes Painful Ejaculation?

Painful ejaculation—also called dysorgasmia or orgasmalgia—can happen for various reasons. Some are short-term and harmless, while others may need medical attention.

Prostate Problems

One of the most common culprits is the prostate, a small gland located just below the bladder. Conditions that affect it include:

  • Prostatitis: Inflammation of the prostate. It can be caused by bacterial infections or develop without any infection. Prostatitis often causes pelvic pain, burning during urination, and discomfort during or after ejaculation.

  • Benign Prostatic Hyperplasia (BPH): An enlarged prostate that can press on the urethra, leading to urinary symptoms and pain.

According to the Cleveland Clinic, prostatitis affects at least 10–15% of men at some point, and painful ejaculation is one of the hallmark symptoms. BPH is more common with age and can lead to chronic urinary discomfort. Treatments range from medications to procedures like transurethral resection of the prostate (TURP), depending on severity. 

Urinary Tract Infections (UTIs)

Although more common in women, UTIs can affect men too. When bacteria enter the urinary tract, they can inflame the urethra or bladder, making ejaculation painful. A UTI may also cause cloudy urine, a strong urge to pee, or a burning feeling during urination. If left untreated, UTIs can lead to complications like kidney infections. According to Johns Hopkins Medicine, early treatment with antibiotics typically resolves the issue quickly. 

Epididymitis and Orchitis

These are infections of the epididymis (a tube behind the testicle) or the testicles themselves. Usually caused by bacteria or sexually transmitted infections (STIs) like chlamydia or gonorrhea, these conditions can result in:

  • Swelling or tenderness in the scrotum

  • Pain during ejaculation or urination

  • Fever or fatigue in some cases

As highlighted by the Mayo Clinic, untreated epididymitis can lead to long-term discomfort or even fertility issues. Sexually transmitted causes may require both partners to be treated to prevent reinfection, as noted by the CDC’s STI guidelines. The World Health Organization (WHO) also emphasizes the importance of routine STI screening, particularly for sexually active men.

Nerve Damage

For men with a history of pelvic surgeries, diabetes, or spinal cord injuries, nerve-related issues may interfere with ejaculation. When nerves responsible for sexual function are impaired, it can lead to pain or changes in sensation. Diabetic neuropathy, for example, is known to affect nerves in the pelvic region, leading to sexual dysfunction. The American Diabetes Association (ADA) outlines that diabetes can significantly impact sexual health, affecting both men and women. For men, high blood sugar can lead to nerve damage and blood vessel damage, resulting in erectile dysfunction. For women, diabetes can decrease libido and impact sexual function. Additionally, diabetes can exacerbate mental health issues like depression and anxiety, further impacting sexual desire and satisfaction. Men with multiple sclerosis or Parkinson’s disease may also experience similar nerve-related symptoms.

Medications or Cancer Treatments

Some medications, such as antidepressants or treatments for prostate cancer like radiation or surgery, may result in painful ejaculation. This is often due to tissue damage or altered nerve signaling. If you're undergoing hormone therapy or radiation, it’s important to ask your oncologist about sexual side effects. The National Cancer Institute also discusses how to navigate changes in sexual health during and after cancer treatment.

Psychological Factors

Pain isn’t always physical. Anxiety, stress, and past trauma can make ejaculation feel uncomfortable or distressing. In some cases, men may unknowingly tense their pelvic muscles during sex, contributing to pain. Cognitive behavioral therapy (CBT) or sex therapy may help reduce performance anxiety. 

Post-Surgical Effects

After procedures like prostate surgery or vasectomy, some men may notice painful ejaculation. This usually improves over time but should still be discussed with a doctor if it persists. Scar tissue, nerve disruption, or changes in semen flow can all contribute to discomfort.

What You Can Do About It

Ejaculation shouldn’t hurt. If it does, here’s how to start addressing it:

Talk to a Healthcare Professional

A urologist can assess your symptoms, perform tests, and help identify the underlying cause. You may need a urine test, STI screening, prostate exam, or imaging like an ultrasound. Open conversations with your doctor—even if awkward—can make a huge difference in getting proper treatment. 

Consider Medications

If an infection is the cause, antibiotics may be prescribed. For men dealing with chronic prostatitis, a longer course of treatment or medications like alpha-blockers can help ease symptoms. Anti-inflammatory medications or even pelvic floor physical therapy may also be beneficial. Men experiencing hormonal imbalances may also benefit from hormone replacement therapy, but this should only be done under medical supervision.

Review Your Medications

If you’ve recently started a new medication—especially antidepressants or drugs for prostate issues—check with your doctor. Some side effects can include painful ejaculation, and a simple dosage adjustment may solve the problem.

Address Stress and Mental Health

Pain linked to psychological factors can be harder to pinpoint, but therapy, mindfulness, or even open conversations with a partner can help. Working with a mental health professional can uncover root causes and reduce sexual tension. Resources like MindNation provide mental health support in the Philippines, offering both therapy and counseling.

Lifestyle Adjustments

Stay hydrated, practice safe sex, use proper hygiene (especially if uncircumcised), and avoid excessive alcohol and spicy food—all of which may irritate the bladder or worsen symptoms. Post-coital urination can help flush bacteria from the urethra. Pelvic floor therapy, such as biofeedback or targeted stretching, can ease muscular tension contributing to discomfort. 

Supporting Sexual Wellness in the Philippines

For Filipino men dealing with painful ejaculation, know that it’s not a rare condition—and that treatment is available. From infections to nerve issues, solutions exist that can restore both comfort and confidence. At Andyou, we offer science-backed guides that support sexual health, designed for the needs of Filipino men in mind. When in doubt, talk to a licensed doctor. Addressing the issue early helps protect your health and improves your quality of life—not just in the bedroom, but beyond.