Causes of Penis Pain

Why does your penis hurt?

Penis pain is very common, but it can be difficult to talk about. It can be caused by injuries, skin infections or irritation, or foreskin issues in uncircumcised boys and men.

The pain can also be internal, like from a urinary tract infection or a sexually transmitted disease (STD). Or pain can be from a fracture to the internal structures of the penis, or by a loss of blood flow to the penis.

To get the correct diagnosis, pay attention to the details of the pain.

• When did it start?
• Did the pain come on suddenly or has it slowly gotten worse?
• Is the pain sharp, dull, throbbing, or burning?
• Is it located at the base, middle, tip, just beneath the skin of the shaft, or throughout?
• Did it happen after a specific event, like getting hit while playing a sport or during intercourse?
• Is there any swelling or bruising?

Most causes of penile pain can be easily treated with medication. If you have a severe injury to your groin, or an erection that does not go away within 4 hours, get immediate medical care.

2. Sexually transmitted infection

Symptoms

• Burning, tingling, or stinging pain when urinating
• Discharge from the penis
• Constantly having the urge to go to the bathroom, even right after you just went
• Feeling like the bladder isn’t completely empty
• Pink (blood-tinged) urine
• Cloudy or foul-smelling urine
• Ulcers (open sores) on the penis

A sexually transmitted infection (STI) (also known as sexually transmitted disease or STD) is an infection that spreads during sexual intercourse. STIs are usually caused by an infection from chlamydia, gonorrhea, syphilis, or the herpes simplex virus.

Your doctor will diagnose you by asking questions, examining you, and with a urine sample.

Most STIs are treated with antibiotics, though herpes is a virus and is treated with antiviral medications. Any sexual partners will also need to be told about the diagnosis because they are likely to have the infection and will need to be treated.

3. Penile irritation

Symptoms

• Itchy skin on the penis
• Penile redness
• Similar irritation found on other parts of the body

Irritation of the penis is common. It can be from a number of causes, including cleaning with a new kind of soap, cleaning too much or not enough, or chafing.

If you are not circumcised, you may have balanitis, an inflammation at the head of the penis. It is often from poor foreskin hygiene. While irritating, it should not be extremely painful. Pain could mean it’s something more serious like an infection.

Try to avoid irritants by changing soaps or laundry detergent. Routinely clean the foreskin. You may want to use a topical ointment on the skin, such as an over-the-counter antihistamine or steroid cream.

4. Paraphimosis

Symptoms

• Retracted foreskin
• Painful swelling just beyond the retracted foreskin
• When extreme, the head of the penis may be blue or black

Paraphimosis is when retracted foreskin in an uncircumcised man gets stuck and cannot return to its normal position. Often this happens after having a urinary catheter, like during a hospital procedure. This can be serious as it can stop the blood flow to the foreskin or head of the penis.

Treatment consists of manually pulling the foreskin back over the head of the penis. It can be painful and you may be given pain medication before the procedure. If this can’t be done, urgent surgery may be needed.

5. Prostatitis

Symptoms

• Pain when urinating
• Urinating more frequently than usual
• Feeling a need to urinate (urgency)
• Difficulty urinating
• Pain in the pelvic area

Prostatitis is an inflammation of the prostate gland. The prostate is between the bladder and penis and makes the fluid that contains semen. Prostatitis can be sudden or chronic.

Sudden (acute) prostatitis is usually caused by a bacterial infection of the prostate. Bacteria can get into the prostate through a urinary tract infection (UTI) or an STD like gonorrhea or chlamydia.

You can also get an Infection after a medical procedure, like if a urinary catheter was inserted.

Prostatitis can also be caused by inflammation from a pelvic injury (from trauma or bicycling), an enlarged prostate, or a recent prostate biopsy.

It’s important to get it treated. When not treated, prostatitis can lead to bacteremia of the blood ("blood poisoning") or a prostatic abscess. Infections are treated with antibiotics.

Chronic prostatitis is when the prostate gland becomes inflamed over time. Men usually have symptoms for at least 3 months. Sometimes this inflammation is caused by bacteria (chronic bacterial prostatitis), but it can also be from something else, like chronic nonbacterial prostatitis or chronic pelvic pain syndrome.

Chronic prostatitis is difficult to completely cure. Treatment focuses on reducing symptoms and improving quality of life. This includes healthy lifestyle changes (such as dietary changes, exercise, and quitting smoking), antibiotics, medications for pain, acupuncture, physical therapy, and talk therapy to help cope with symptoms.

6. Priapism

Symptoms

• Erection lasting at least 4 hours
• Penile pain
• The tip of the penis is soft but the shaft is hard

Priapism is when an erection lasts at least 4 hours. During an erection, the blood flow into the penis is greater than the blood flow out of the penis. After the erection, the blood flow returns to normal. In priapism, the erection does not go away.

Priapism can be caused by sickle cell anemia or medications. Sometimes injectable medications to help with erectile dysfunction that last too long.

Because priapism deprives the penis of oxygen, it may cause permanent erectile dysfunction. See a doctor immediately.

Priapism is usually treated with a procedure that releases the pressure within the penis.

A doctor may inject into the penis a medication, such as phenylephrine, that constricts blood vessels, allowing blood to flow out. Or they may remove blood from the penis with a needle. Sometimes, both procedures are done. If these procedures don’t stop the erection, then you may need surgery.

7. Penile fracture

Symptoms

• Penile pain
• Swollen penis
• Bruising in the penis and groin area
• Hearing a snap or pop followed by loss of an erection

A penile fracture is also known as broken penis. It can happen when there’s trauma or an impact to an erect penis. Even though the penis doesn’t have a bone, there's a structure in the penis, called the tunica albuginea, that fills with blood during an erection.

Because it becomes so stiff when aroused, the tunica albuginea can tear if it is bent or buckles while filled with blood. Usually this is because of bending during intercourse from a missed thrust.

Sometimes the fracture is severe enough that you'll hear a "popping" sound and immediately lose the erection and then notice swelling. If this happens, go to the ER. You will probably need surgery to repair the torn tunica albuginea. If not treated, it can cause permanent erectile dysfunction.

8. Lichen sclerosus

Symptoms

• White, shiny, and scar-like patches on the genital or anal area
• Patches are itchy and often painful
• Redness and bruising surrounding the white area
• Pain while urinating

Lichen sclerosus is a chronic skin condition that causes patches of white, wrinkly, thin skin. It is most commonly in the anus or genital regions. These patches are often described as being like "cigarette paper." Usually, people also have bruising, bleeding, inflammation, itching, and pain.

Lichen sclerosus will slowly get worse over time. It can permanently damage skin if you don’t treat it. On an uncircumcised penis, the patches can tighten the foreskin.

Treatment includes oral and topical (applied to the skin) medications, phototherapy (with ultraviolet light), and circumcision to remove damaged foreskin.

Other possible causes

A number of conditions may also cause penis pain, though these are either rare or penis pain is not usually the main symptom. They include insect bites, human bites during sexual activity, injury from a catheter, skin infections, or impact from a car crash or getting hit by an object.

Penile pain during intercourse can be a source of sexual dysfunction. Kidney stones may also cause referred pain—the pain is felt in the penis but that is not where it is coming from.