Most of the time sex feels great, so it can be unsettling when you feel pain after intercourse. For some men, the pain can trigger performance anxiety and diminish interest in being intimate with their partner.
Causes for the pain vary depending on your sexual and general health, says Orlando Health, a fellowship-trained urologist with Orlando Health Medical Group Urology.
“If you experience pain during or after sex only one time, it may just be a muscle sprain or a mild condition that will heal on its own,” Orlando Health says. “But if you regularly have intercourse-related pain, you should speak to your doctor.”
One of the most common reasons includes a condition called prostatitis, which affects up to 15 percent of American males, Orlando Health says.
What Is Prostatitis?
Your prostate gland produces the fluid that surrounds semen and is essential for male fertility. When the prostate’s tissue becomes inflamed, it causes prostatitis. Common symptoms of this condition are recurring chronic pain or aches, usually affecting the:
- Lower back
- Penis
- Central lower abdomen and pelvis
- Perineum — the space between the scrotum and anus
Acute prostatitis is usually caused when bacteria from the urinary tract enters the prostate. With chronic prostatitis, the reasons for infection are less clear. Since urinary tract infections (UTIs) and sexually transmitted infections (STIs) can carry bacteria into the prostate, they are major risk factors, depending on a man’s age and sexual history.
Antibiotics usually are prescribed to treat prostatitis. Anti-inflammatory and pain medications also can help. Your doctor may recommend imaging to determine whether additional issues, such as an abscess, may be hindering recovery. Even after treatment, you still could feel some discomfort for weeks or even months. Your doctor might recommend exercises that can help with rehabilitation or relaxation in the pelvis.
Other Reasons
Peyronie’s Disease, or penile curvature. When fibrous scar tissue forms on the penis, it can cause curved, painful erections. This can lead to erectile dysfunction, stress, anxiety and sometimes penile shortening. Peyronie’s is a common, noncancerous condition and can be treated with pain medication like NSAIDs, injections that break down the scar tissue once the pain has resolved or even with surgery.
Overly tight foreskin. If you’re uncircumcised, the head of the penis is covered by tissue called the foreskin. Normally, this tissue retracts during intercourse. But if you have an overly tight foreskin, it can’t retract because the skin is too tight, causing pain. Over time, the friction of this movement can cause it to tear or become inflamed or infected. Treatment may involve steroid cream or circumcision, if the pain persists.
Undescended testicle. This is an unusual cause of sex-related pain, but it can happen. During the last weeks before or soon after birth, the testicles usually descend from the abdominal area into the scrotum, the skin below the penis. When this doesn’t happen, it’s called an undescended testicle. This can result in a squeezing pain during sex, particularly if the testicle is lodged in the groin or the lower abdomen. Surgery is the most common treatment and generally involves removing the testicle.
Groin hernias. This can occur when tissue protrudes through a weak spot between your lower abdomen and thigh, usually if there’s an opening in the muscle wall that should have been closed at birth. The most common sign is a bulge or lump that pushes through the weak spot. This causes pain in the groin area, particularly during straining activities, including intercourse.
Scar tissue from previous treatments. If you’ve had surgery and scar tissue is near your abdomen, the pelvis or the perineum, it could trigger discomfort or pain during or after sex. Previous infections, trauma or other injuries also can leave scar tissue or nerve injuries. Cases of superficial scar tissue may be treated with surgery, while minor scarring may be treated with topical salves to loosen the tissue.