Painful Erection: Causes & Treatments

It’s the middle of the night and you’re fast asleep. But as you roll over from your back, you realize your nocturnal erection has kicked in, along with another less-than-pleasant sensation down below. You have a painful erection.

Maybe it’s a double dose of erectile dysfunction (ED) medications or some of those gas station sex pills. Perhaps it’s nothing but physiology — like if too much blood went to the blood vessels in your penis.

Whatever the cause of your penile discomfort is, it’s probably alarming and needs to stop.

No more awkwardly looking up “erection hurts” or “penile pain when erect” in search of a solution. We’ll cover everything you need to know about painful erection causes and treatments below.

So, what’s going on with painful erections? Is it a sign of erectile dysfunction? Surely, that’s not normal — right?

A prolonged erection that is painful is often a condition called priapism. Low-flow priapism, one type of priapism, occurs when blood remains in the erection chambers (corpora cavernosa) and can’t escape.

People with blood disorders like sickle cell disease that affect blood flow have an increased risk of priapism.

These painful, prolonged erections usually last four or more hours to qualify for a priapism diagnosis. (Of course, how long an erection should last varies — it can be anywhere from mere seconds to well over 45 minutes.)

We might think about painful erection as the result of misused erectile dysfunction medications. However, priapism can also occur when there’s trauma to the penis or supporting tissues, resulting in erectile tissue damage.

There are several other causes of penile discomfort, including:

• Peyronie’s disease. This is a disorder where plaque or scar tissue forms under the skin of the penis, causing bends or curvature in the penis, usually when erect. Peyronie’s disease can make erections painful and may even make sexual intercourse difficult or impossible.

• Penile fracture. Although uncommon, a penis fracture is a very severe injury that can occur during sexual intercourse.

• Infections. Sexually transmitted infections (STIs) can cause pelvic or penile discomfort — though it’s unclear if they create penis pain when erect. Then there are urinary tract infections (UTIs). Complicated UTIs in men (an infection of the urinary tract, which includes the kidneys, bladder and urethra) can also cause symptoms of pelvic or penile pain, along with pain in the genitals or while urinating. UTIs are rare in men.

• Implant complications. If you’re considering getting a penile implant — the Penuma®, for example — you may notice that your erection hurts after the surgery. Pain following the placement of an implant varies based on the patient’s tolerance and the particular implant used.

• Friction burn. Lots of sexual activity, either solo or with a partner, won’t rub the skin off your penis — but you can still experience friction burn on your penis. If the skin comes in contact with a hard object, it can be scraped off, causing abrasion or a heat burn.

• Hard flaccid syndrome. Sexual dysfunction isn’t just limited to erectile dysfunction and premature ejaculation (PE). Hard flaccid syndrome is when the penis is constantly partially hard while still flaccid, often preventing it from becoming fully erect despite sexual arousal. Penile pain is often noticed while standing.

Now that you’ve sufficiently raised your anxiety levels after reading some of the common painful erection causes — or you’re trying to remember if your penis came in contact with a hard object — this next section will hopefully reassure you.

But first, we have to note that painful erections could be a sign of something dangerous and should be evaluated sooner rather than later. If your painful erection is prolonged (lasting several hours), seek immediate medical advice from a healthcare provider.

Talk to a Healthcare Professional

Without a cause, there’s nothing a man can do from home for a painful erection. 

The first thing you should do if you’re experiencing painful erections? Talk to a healthcare provider. They can determine what’s going on — whether it’s the cause of priapism, an STI, another medical condition or something else entirely.

If your painful erection lasts four or more hours, it’s a medical emergency. Prolonged erections need immediate medical treatment to prevent permanent damage to your penis.

But while you don’t necessarily need to go to the emergency room for painful erections that are much shorter in duration and go away, you should still schedule an appointment with your primary provider or a urologist as soon as possible.

You clicked on this article for one of two reasons: Either you’re experiencing a painful erection right now, or you’re worried you took too much Viagra® and are experiencing bad side effects.

Although penile pain when erect isn’t a common concern for men, it can happen — and it could make you think you have penile cancer. Rather than stressing about what’s happening in your pants, let a healthcare provider diagnose you.

Here’s what to keep in mind.

• Painful erection causes can vary but most often tend to be a condition called priapism, a longer-than-normal-lasting painful erection.

• Other causes of penile discomfort can include STIs, complicated urinary tract infections, friction burns, hard flaccid syndrome, implant complications, Peyronie’s disease or a penis fracture.

• While you can’t treat a painful erection at home — especially without knowing the cause — you can talk to a healthcare provider to figure out the root cause and any necessary treatments.

Talking to a healthcare provider about your erectile concerns and medical history is the best way to access treatment options and return to a pain-free penis.