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Painful Erection: Causes & Treatments

Mike Bohl, MD, MPH, ALM

Reviewed by Mike Bohl, MD

Written by Rachel Sacks

Published 05/10/2022

Updated 01/18/2024

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.)

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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.

Choose your chew

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.

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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.

8 Sources

  1. Silberman, M., Stormont, G., Leslie, S.W., et al. Priapism. [Updated 2023 May 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK459178/
  2. Idris, I. M., Burnett, A. L., & DeBaun, M. R. (2022). Epidemiology and treatment of priapism in sickle cell disease. Hematology. American Society of Hematology. Education Program, 2022(1), 450–458. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9820196/
  3. Penile Curvature (Peyronie's Disease) - NIDDK. (n.d.). National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved from https://www.niddk.nih.gov/health-information/urologic-diseases/penile-curvature-peyronies-disease
  4. Diaz, K.C., Cronovich, H. Penis Fracture. [Updated 2022 Jul 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK551618/
  5. Wasserman, M., Weidner, W., Richardson, D., & Goldmeier, D. (2010). Sexually Transmitted Diseases and Sexual Function. The Journal of Sexual Medicine, 7(1_part_2), 389-413. Retrieved from https://academic.oup.com/jsm/article-abstract/7/1_part_2/389/6848930
  6. Sabih, A., Leslie, S.W. Complicated Urinary Tract Infections. [Updated 2023 Jan 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK436013/
  7. Mulcahy, J. J., Austoni, E., Barada, J. H., Choi, H. K., Hellstrom, W. J., Krishnamurti, S., Moncada, I., Shultheiss, D., Sohn, M., & Wessells, H. (2004). The Penile Implant for Erectile Dysfunction. The Journal of Sexual Medicine, 1(1), 98-109. Retrieved from https://academic.oup.com/jsm/article-abstract/1/1/98/6862977
  8. Agrawal, A., Raibagkar, S. C., & Vora, H. J. (2008). Friction burns: epidemiology and prevention. Annals of burns and fire disasters, 21(1), 3–6. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3188131/
Editorial Standards

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references. See a mistake? Let us know at [email protected]!

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Mike Bohl, MD

Dr. Mike Bohl is a licensed physician, a Medical Advisor at Hims & Hers, and the Director of Scientific & Medical Content at a stealth biotech startup, where he is involved in pharmaceutical drug development. Prior to joining Hims & Hers, Dr. Bohl spent several years working in digital health, focusing on patient education. He has also worked in medical journalism for The Dr. Oz Show (receiving recognition for contributions from the National Academy of Television Arts and Sciences when the show won Outstanding Informative Talk Show at the 2016–2017 Daytime Emmy® Awards) and at Sharecare. He is a Medical Expert Board Member at Eat This, Not That! and a Board Member at International Veterinary Outreach.

Dr. Bohl obtained his Bachelor of Arts and Doctor of Medicine from Brown University, his Master of Public Health from Columbia University, and his Master of Liberal Arts in Extension Studies—Journalism from Harvard University. He is currently pursuing a Master of Business Administration and Master of Science in Healthcare Leadership at Cornell University. Dr. Bohl trained in internal medicine with a focus on community health at NYU Langone Health.

Dr. Bohl is Certified in Public Health by the National Board of Public Health Examiners, Medical Writer Certified by the American Medical Writers Association, a certified Editor in the Life Sciences by the Board of Editors in the Life Sciences, a Certified Personal Trainer and Certified Nutrition Coach by the National Academy of Sports Medicine, and a Board Certified Medical Affairs Specialist by the Accreditation Council for Medical Affairs. He has graduate certificates in Digital Storytelling and Marketing Management & Digital Strategy from Harvard Extension School and certificates in Business Law and Corporate Governance from Cornell Law School.

In addition to his written work, Dr. Bohl has experience creating medical segments for radio and producing patient education videos. He has also spent time conducting orthopedic and biomaterial research at Case Western Reserve University and University Hospitals of Cleveland and practicing clinically as a general practitioner on international medical aid projects with Medical Ministry International.

Dr. Bohl lives in Manhattan and enjoys biking, resistance training, sailing, scuba diving, skiing, tennis, and traveling. You can find Dr. Bohl on LinkedIn for more information.

Publications

  • Younesi, M., Knapik, D. M., Cumsky, J., Donmez, B. O., He, P., Islam, A., Learn, G., McClellan, P., Bohl, M., Gillespie, R. J., & Akkus, O. (2017). Effects of PDGF-BB delivery from heparinized collagen sutures on the healing of lacerated chicken flexor tendon in vivo. Acta biomaterialia, 63, 200–209. https://www.sciencedirect.com/science/article/abs/pii/S1742706117305652?via%3Dihub

  • Gebhart, J. J., Weinberg, D. S., Bohl, M. S., & Liu, R. W. (2016). Relationship between pelvic incidence and osteoarthritis of the hip. Bone & joint research, 5(2), 66–72. https://boneandjoint.org.uk/Article/10.1302/2046-3758.52.2000552

  • Gebhart, J. J., Bohl, M. S., Weinberg, D. S., Cooperman, D. R., & Liu, R. W. (2015). Pelvic Incidence and Acetabular Version in Slipped Capital Femoral Epiphysis. Journal of pediatric orthopedics, 35(6), 565–570. https://journals.lww.com/pedorthopaedics/abstract/2015/09000/pelvic_incidence_and_acetabular_version_in_slipped.5.aspx

  • Islam, A., Bohl, M. S., Tsai, A. G., Younesi, M., Gillespie, R., & Akkus, O. (2015). Biomechanical evaluation of a novel suturing scheme for grafting load-bearing collagen scaffolds for rotator cuff repair. Clinical biomechanics (Bristol, Avon), 30(7), 669–675. https://www.clinbiomech.com/article/S0268-0033(15)00143-6/fulltext

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