A number of conditions can cause a man pain during sexual activity (also called dyspareunia). The
pain may strike as the man gets an erection, once he is inside his partner, during orgasm/ejaculation
or during the resolution phase, as blood flows away from the area. It might be located in the penis shaft or glans (tip),
in the scrotum or in the anus. Usuallyndyspareunia in men has a physical cause. Here are some examples:
A tight foreskin can cause painful erections, and sometimes difficulty in urinating. Unforced loosening of the foreskin normally occurs between the ages of 7 and 14; where it does not, the foreskin can be gently stretched over the course of a few weeks using a lubricant. Sometimes the frenulum (the skin that attaches the foreskin to the penis shaft on the underside of the glans) can tear during intercourse if the foreskin is tight; this can cause profuse bleeding, which may be quite frightening, but generally, the tear heals naturally. Where the foreskin cannot be retracted even when a boy is in his mid to late teens, the condition is called phimosis. This may be treated using a topical steroid cream or by surgery. Phimosis can also occur later in life, following an infection.
Balanitis means inflammation of the glans, causing soreness and itchiness. This can be caused by poor hygiene, irritation caused by soap, shower gel or washing powder, or by a skin complaint such as eczema or psoriasis. Balanitis can also be an early sign of diabetes.
Sexually Transmitted Infections (STI)
A genito-urinary infection such as NSU or gonorrhoea can cause pain in the penis or between the penis and anus, and discharge from the penis. Herpes causes burning pain with sores, ulcers or blisters, and candida (thrush) can cause pain, itchiness and a rash.
Penile fracture can occur if a man slips out of his partner during vigorous thrusting and hits a hard
object. A distinct cracking noise is heard and this is followed by immediate loss of erection, severe
pain, bruising and swelling. Immediate medical advice should be sought.
Peyronies Disease, which usually affects men aged 55 or over, is a gradual change in the shape of the
penis when erect, most notably a persistent curvature. This may make sexual intercourse painful or
impossible. Its causes are not well understood. The condition is treated with oral medication or by
Prostatitis (inflammation of the prostate gland) can cause pain and discomfort throughout the lower abdomen, back and groin area. There will often be urinary symptoms such as frequency or difficulty passing urine.
Painful ejaculation is an uncommon problem usually associated with an inflammation of the urethra, The seminal vesicles or the prostate gland, or by obstruction of the ejaculatory duct. Testicular cancer can cause pain in the testicles.
Occasionally, dyspareunia has a psychological origin. Possible causes are fear, guilt, and anxiety
around sex, perhaps because of a history of being sexually abused, or a strict religious
upbringing. In these cases, sex therapy can help.