Why Does My Penis Hurt When I Have Sex?

Dyspareunia is characterised by pain experienced during sex. This can lead to physical and/or mental discomfort, as well as difficulty continuing relations, in turn causing a lack of understanding within couples. Experiencing repeated pain in the genital area during sex can cause one to avoid, limit or even put a complete stop to any form of sexual intimacy.

Around 5% of men across the world suffer from dyspareunia. This problem can arise from the beginning of one’s sex life, or after a relatively normal period of sexual encounters. The symptoms can stem from psychological origins (anxiety, stress, reliving trauma…), biological origins (anatomical, neurological, infection or inflammation), or a combination of both (Delcea, 2019).

Dyspareunia remains to this day a difficult topic for men to discuss. However, in a study conducted with 4,290 Australian men aged 16 to 64 years old, 5% reported experiencing pain during urination, 5% during sexual encounters and 12% reported experiencing chronic pelvic pain (Pitts et al., 2008). It is therefore highly necessary that men feel more free to talk about the pain they experience during sex, and that they can consult a specialist as early as possible in order to avoid any prolonged suffering.

Insufficient lubrification and the dryness that comes as a result can cause increased friction during sexual encounters. This can provoke discomfort, and in some cases irritation, even cutaneous microlesions around the penis (Baber & Mears, 2007).

Pain during sex can also be a sign of sexually transmitted infections (STIs) such as chlamydia, gonorrhoea, gential herpes… that can all cause inflammation and pain during ejaculation. Amongst other things, dermatological diseases (lichen sclerosus…), balanitis (inflammation of the glans), urinary infections, prostatitis, Peyronie’s disease, phimosis (when the foreskin shrinks) , or the frenulum being too short, can all make sexual encounters painful.

Such bodily afflictions require medical treatment, or in rare cases, surgical intervention. Consult a medical professional and ask to be tested for STIs if needed (there are many companies that offer free at-home testing kits) to help you get treated early on and avoid any possible complications.

Allergies to latex condoms or ingredients used in some lubes can also cause itching, irritation or even burning. If you suspect you may be experiencing an allergic reaction, try opting for unscented, hypoallergenic products instead.

Experiencing pain during sexual encounters could also stem from practicing positions that put excessive strain on the penis, particularly if the angle of penetration isn’t optimal, or if the partner's movements aren’t well coordinated. When the penis is put under unusual or forced amounts of pressure, pain can arise during or after the act. Slow, controlled movements are less likely to cause pain than faster, more vigorous movements, both for the man penetrating and their partner.

Aside from this rare situation, other more moderate injuries- like a torn frenulum, strains or micro-traumatisms in the tissue- can arise due to badly coordinated sex. These situations are often encountered when there’s a lack of communication or uncontrolled enthusiasm.

To avoid these types of accidents, it’s essential to communicate and co-ordinate your expectations with the other person involved. Before, during, and after the experience, partners should discuss their preferences, limits and comfort levels. This, for example, includes choosing positions, the rhythm, or even the depth of penetration. An open dialogue and using a previously agreed upon safeword allows partners to react immediately if anything becomes painful or uncomfortable.

Partners should also be attentive to non verbal signs, as pain and discomfort aren’t always immediately verbalised. Increased muscular tension, clenching, withdrawing or expressions displaying discomfort are enough to let you know when you need to stop or adjust what you’re doing. Communication and consent are therefore necessary in order to prevent such incidents. It’s always better to prevent instead of heal, especially since certain traumatisms can give way to chronic pain if the problem isn’t dealt with quickly enough.

In the same Australian study previously cited, men who noted having pelvic pain were more likely to report having sexual experiences in which they felt forced or afraid (Pitts et al., 2008). A sexual encounter that lacks respectful, clear and supportive communication can revive past traumatic experiences and have a role in provoking physical pain. As a matter of fact, apprehension or fear can cause involuntary tension in the pelvic muscles (a mechanism in which the pelvic floor muscles instinctively contract as a result of stress or anxiety), accentuating pain (Anderson et al., 2009). This ends up creating a vicious cycle surrounding tension and pain, causing people to avoid sexual encounters.

What’s more, this study also states that being diagnosed with depression or anxiety also makes one more susceptible to all types of pelvic pains (Pitts et al., 2008). Intermittent or chronic pain can also cause persistent fatigue, depressive symptoms and heightened stress, thus altering one’s quality of life and sexual functions (Ferris et al., 2010). The pressure to perform can also drive the man to be so stressed that he suffers from painful hypertension in the pelvic region.

When a man feels pain during or after sexual encounters, it’s important to listen to the body’s signs and not let this pain become a regular source of stress or chronic suffering.

Consulting a health professional (GP, urologist, sexologist, dermatologist), will allow you to get an accurate diagnosis, identifying the source of the dyspareunia. Treatment will depend on the cause identified. In the case of infectious pathogens, antibiotics or antifungals will be prescribed. If pain is linked to an anatomical problem such as having too short a frenulum, phimosis or Peyronie’s disease, simple surgical procedures may be envisaged. These last ones have high success in terms of easing pain and improving sex lives (Galosi, Perdonà, & Gallo, 2010). With regards to dermatological issues ( like lichen sclerosus), these require specific creams or targeted surgical care.

When the origins of pain are psychological (depression or past trauma), or a mix of the two (for example, performance anxiety associated with biological forms of pain), recommended steps involve medical care, sex therapy, cognitive behavioural therapy, practising relaxation, even perineum rehabilitation aided by a specialist physiotherapist. The aim is to reduce pain, reinstate self confidence and encourage resuming one’s sex life in a relaxed way.

It must be noted here that men suffer prejudices when it comes to pain. In one article (Leeds Beckett University, 2012), Dr Tashani particularly explains that “learned masculinity encourages stoicism and encourages displays of withstanding pain”. Thus the weight of masculine stereotypes act as an obstacle to allowing men to express pain, as well as getting access to necessary care (Keogh & Boerner, 2020). Without cultural changes and without efforts from men to advocate for their health, male suffering- specifically sexual suffering- risks being ignored for too long. Let’s try and encourage men to discuss their health, and if necessary take care of it.

Don’t hesitate to speak to a professional about your health: male dyspareunia is more common than we initially think, and efficient solutions do exist. The earlier things are dealt with, the more likely it is that one can heal quickly and for the long term. This is especially important when ensuring pain doesn’t become chronic, and that it doesn’t lead to psychosexual problems (Tripp et al., 2022). Amongst partners, respect, attentiveness and vigilance are the best way to ensure pleasure remains pleasurable, and doesn’t morph into pain.

When you choose a lube , it’s important to consider the base ingredient in the product. Water-based lubricants are often recommended as they are gentle on the skin, easy to clean, and compatible with most condoms and sex toys. What’s more, they don’t stain clothes or sheets, making them a practical choice for many people.

Water-based lubes are also great for those with sensitive skin, as they’re generally hypoallergenic options. That being said, there exists other types of lube, such as silicone or oil based ones, that offer longer lasting lubrification. However, these options are not always compatible with every type of sex toy, particularly silicone ones, and can damage certain materials.

Finally, when using lube, make sure that the amount you apply is enough to keep things friction free for the duration of the sexual experience. Don’t be afraid to reapply if needed, especially in longer or more active encounters.

Using sex toys can improve your sex life, but not using them properly can cause pain. For those who are new to the sex toy world, it’s better to start off with toys designed specifically for beginners . These ones are often more modestly sized and are ergonomically shaped in order to make it easier to slowly introduce them into play.

It’s also important to consider what the toy is made from. Sex toys made from more gentle materials, such as medical grade silicone, are generally more comfortable and adapt better to the body's natural shapes. Silicone is not only gentle, but also non porous, making it safer for use on the body and easier to clean, thus reducing the risk of irritation or infection.