Sex should feel good, not painful. But for some men, it hurts. Male dyspareunia is the medical term for painful sexual intercourse in men.
*All images feature a model portrayal
(unless otherwise noted).
Sex should feel good, not painful. But for some men, it hurts.
Male dyspareunia is the medical term for painful sexual intercourse in men.
We don’t know exactly how common it is for men to experience dyspareunia, aka painful intercourse. Mostly because it hasn’t been studied enough (it is more common and more studied in women). But it can seriously disrupt your sex life and impact your mental health.
The causes range from minor issues like friction or irritation to more serious conditions, including infections. Most of the time, dyspareunia is temporary and treatable. We’ll cover the causes in more detail below.
Male dyspareunia is pain during sexual intercourse. It can feel different depending on the underlying cause.
You might notice:
Sharp, sudden pain
A dull ache that lingers
A burning sensation
Pain just in your penis
Discomfort spreading to other areas
Some men also feel pain during ejaculation.
Here are some potential reasons for painful intercourse in men:
Sexually transmitted infections (STIs)
A curve in your penis (Peyronie's disease)
Allergies or hypersensitivity
Friction burns or other types of trauma
Abnormal growths or tumors
Bladder problems
Medication side effects
Neurological problems
Let’s go over each in more detail.
The following STIs can make sex painful:
Chlamydia
Gonorrhea
Syphilis
Genital warts
Here’s why.
Infections like gonorrhea and chlamydia can cause inflammation in the urethra (the tube that carries urine and semen). This condition is called urethritis. It can lead to discomfort during sex or when you ejaculate or pee.
Other STIs, like herpes or syphilis, may cause sores around your penis that can get irritated during sexual activity. Syphilitic ulcers are usually painless, but can get irritated during sex. Herpes on the penis can be quite painful, often causing a burning or itching sensation. In many cases, it leads to the development of sores or fluid-filled blisters that can become tender and irritated, especially during urination or sexual activity.
Thankfully, most STIs are treatable (and preventable with condoms). If you think you have an STI, it’s a good idea to get tested.
Peyronie’s disease is a curve in the penis, usually from internal scarring after an injury. It doesn’t always hurt, but some men may feel discomfort during sex because of extra pressure near the curve.
You can have an allergic reaction to soaps, condoms, lube, or anything else that touches your penis. This is called allergic dermatitis.
It might cause a rash that’s:
Itchy
Dry
Scaly
Blistered
Thick or leathery
Strong and scented soaps are common culprits, so it’s best to stick with gentle, unscented products for washing down there.
Friction burns are a common — and painful — result of frequent or rough sexual intercourse or masturbation.
They can also happen due to:
Dry sex with little to no lubrication
Tight clothing that rubs against your penis
Improper use of sex toys
Traumatic injuries
Another more serious condition is a penile fracture. No, there aren’t any bones in your penis. A penile fracture happens when the tough connective tissue around the penis tears. This often happens from suddenly bending an erect penis during rough sex.
It’s a medical emergency. If it happens, get medical attention right away.
Some types of abnormal growths can cause sexual pain. These include:
Chancroids (a very rare bacterial STI)
Genital warts
Infected hair follicles
Molluscum contagiosum (a viral skin infection that causes small bumps on the genitals)
Penile cancer is also a possibility, though it’s rare. Fewer than 1 in 100,000 U.S. men develop penile cancer each year. And it mostly affects older men.
Sex can put pressure on your bladder, urethra, or prostate, which may cause pain — especially if there’s inflammation in those areas.
Common medical causes include:
Interstitial cystitis
Prostatitis
Pelvic pain syndrome (often from tight pelvic floor muscles)
Bladder stones
Bladder cancer
Some medications can affect your penis and make sexual activity uncomfortable. One example is priapism, an erection that lasts more than 4 hours. It can be quite painful and is a medical emergency.
Medications that can cause priapism as a side effect include:
The antidepressant trazodone (Desyrel®)
Antipsychotics like risperidone (Risperdal®)
Sildenafil (Viagra® or tadalafil (Cialis®)
Alpha-blockers like prazosin (Minipress®)
If you ever experience a prolonged, painful erection, don’t wait. Get help right away.
Penis pain can sometimes be linked to nerve problems. Here are a few neurological conditions that might be the cause:
Pudendal neuralgia. This happens when the pudendal nerve is irritated, often due to injury or surgery. It can lead to pain during ejaculation, erectile dysfunction, or other types of sexual dysfunction.
Peripheral neuropathy. Nerve damage from conditions like diabetes can affect feeling in the genitals. You might notice unusual sensations, like your penis feeling cold, a numb penis, or a strange feeling when you ejaculate.
Spinal cord injury. Damage to the spinal cord can cause referred pain in the penis and make it harder to get or keep an erection.
Post-herpetic neuralgia. This nerve pain can follow a shingles outbreak. If the virus affects the nerves in your genital area, it can lead to dyspareunia.
Other potential causes of pain during sex include:
Mental health issues. Trauma, including past sexual abuse, can make sex physically painful.
Phimosis. When the foreskin cannot be fully retracted over the glans, it can lead to tearing, inflammation, and pain during sex.
Circumcision complications. Scarring around the head of the penis (glans) or frenulum (the part that connects the foreskin to the head of your penis) can lead to pain during sex.
Testicular problems. Conditions like cysts or testicular cancer may cause pain if you apply pressure to your testicles during sex.
Skin disorders. Issues like lichen sclerosis can cause inflammation that can make sex uncomfortable.
Pain during sex can happen to anybody, but certain factors can make dyspareunia more likely for some people than others, including:
Using irritating substances. Some lubricants, condoms, and soaps with added fragrances or ingredients can cause penile irritation.
Lack of lubrication during sexual activity. Going without lubricant — especially during longer sessions — can make you more prone to chafing and friction burns.
Age. Some conditions, like STIs, are more common in younger people.
Having multiple sexual partners. Having unprotected sex with multiple partners raises your risk of STIs.
Some underlying health conditions. Issues like diabetes can lead to nerve damage or increase your risk of UTIs — all of which can cause penile pain.
Past penile injuries. A previous injury to your penis may increase your chances of developing Peyronie’s disease.
If you’re experiencing unusual or uncomfortable symptoms during sex, it’s a smart move to check in with a healthcare professional.
They’ll start with a few basic steps, including:
A physical exam to look for any visible signs like bumps or sores
Asking about your personal and family medical history
Asking about your symptoms, like when and where you feel pain
If this doesn’t provide clear answers, they might suggest additional tests or refer you to urology.
Additional tests can include:
Urine tests and blood tests to check for infections, inflammation, or conditions like diabetes
A neurological exam to check your nerve and brain function
Imaging (like an MRI) to look at the structure of your penis and nearby tissues
A urethral swab to check for potential infections
A psychological evaluation, especially if performance anxiety, stress, or trauma might be playing a role
Treatment for male dyspareunia depends on the underlying cause.
Here’s a look at what treatment might entail for each.
Friction burns and minor traumatic injuries often heal with rest.
Here’s how you can support the healing process:
Keep the area clean with mild soap and water.
Apply soothing ointments like petroleum jelly.
Avoid further friction until the area heals.
Wear loose clothing that doesn’t rub against your groin.
Use a cold compress to reduce inflammation.
Serious injuries like penile fractures need immediate medical attention. You may need surgery to help repair any damaged blood vessels.
Treatment for STIs depends on whether they’re bacteria or viral. If your doctor thinks you have a bacterial infection like chlamydia or gonorrhea, they’ll likely prescribe you antibiotics. But, these medications aren’t effective for viral infections.
If you have genital herpes, your doctor may prescribe antivirals like:
Acyclovir
Famciclovir
For genital warts or abnormal growths like skin tags, your doctor may recommend:
Cryotherapy to freeze them off
Laser therapy
Surgical removal
Topical creams
Peyronie’s disease doesn’t usually need treatment if it isn’t causing problems. If you’re experiencing frequent or intense pain, your doctor may suggest:
Collagenase injections
Oral medications to reduce scarring
Penile traction devices to help stretch out your penis
Shockwave therapy
Verapamil cream
If these aren’t effective and your symptoms are severe, your provider may recommend surgery.
The main treatment for allergies or hypersensitivity reactions is to avoid your triggers.
If you’re experiencing symptoms, you can apply petroleum jelly or other soothing creams to help relieve pain and irritation.
If the underlying cause of your dyspareunia is diabetes, you’ll likely need to take medications to help control your blood sugar levels.
Medications like gabapentinoids and duloxetine may help with nerve pain.
You can’t always avoid pain during sex, but there are simple ways to lower your risk and protect your sexual health.
Here’s how to keep sex comfortable and enjoyable:
Avoid scented products if you’ve had reactions before.
Use plenty of lube during extended bouts of sexual activity, including masturbation.
Talk to your doctor about potential sexual side effects before starting new medications.
Use condoms with new or untested partners. (Learn more about having safe sex.)
Get tested for STIs if you’re sexually active.
Eat a balanced diet and get plenty of exercise.
Noticed any changes down there? Think about checking in with a healthcare provider. They can help figure out what’s going on and how to treat it.
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 blog@forhims.com!