Read below about painful erection, including causes, treatment options and remedies. Or get a personalized analysis of your painful erection from our A.I. health assistant. At Buoy, we build tools that help you know what’s wrong right now and how to get the right care.

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Painful Erection Symptoms

An erection is the stiffening and enlargement of the penis due to increased blood flow. Erections are the result of a complex interplay of psychological, vascular and neural processes that are most often associated with sexual arousal; however, it is important to note that erections can be stimulated by other causes as well.

Erections become painful when they persist. A painful erection is not normal, and this condition is called priapism [1]. In priapism, beyond the pain, the most important painful erection symptom is the duration of the erection. An erection that lasts for more than 4 hours is a medical emergency and needs prompt attention.

Pain often goes hand-in-hand with an erection that persists for longer than normal, but even if you do not experience pain, you must seek medical attention for symptoms of prolonged erection in order to prevent serious complications. Blood trapped in the penis quickly loses oxygen. This oxygen-deprived blood can begin to damage and destroy the tissues of the penis leading to critical conditions such as erectile dysfunction and infertility.

Painful Erection Causes

Painful erections (priapism) occur when there are problems with how blood flows, or circulates, to and from the penis.

Problems in circulation to the penis can be categorized as:

  • Ischemic: blood not able to leave the penis
  • Non-ischemic: blood flow to and from the penis is not regulated properly

Conditions that affect the blood vessels, smooth muscles and nerves of the penis can all affect the circulation to the penis and result in either ischemic or non-ischemic causes of priapism [1]. As a result, the causes of painful erection symptoms are varied and broad [2]. It is very important to see your doctor in order to diagnose the root cause of the issue.

Blood disorders:

  • Functional: Medical conditions that affect the way different components of your blood function – for example, sickle cell anemia, a medical condition that affects the shape of your red blood cells, often results in ischemic priapism.

  • Synthetic: Medical conditions that affect the processes that regulate the production of the different components of the blood can result in ischemic priapism. For example, in leukemia, a condition in which your body makes too many blood cells, ischemic priapism can often occur [2,3].


  • Prescription Medications: Priapism is a possible side effect of a number of medications that you may be prescribed for other conditions. For example, antidepressants, hypertension medications and medication used to treat erectile dysfunction can all cause painful erection symptoms.
  • Non-prescription medications/drugs: Recreational drugs such as alcohol, marijuana, cocaine and other illicit substances can cause many types of ischemic priapism [3,4].


  • Trauma or injury to the penis or pelvic area often causes non-ischemic priapism. Traumatic events can range from serious incidents such as motor vehicle accidents to seemingly benign causes such as an insect bite or sting.
  • Regardless of the cause, traumatic events that lead to painful erection symptoms and penis pain must also be followed up immediately as well.

6 Possible Conditions

The list below shows results from the use of our quiz by Buoy users who experienced painful erection. This list does not constitute medical advice and may not accurately represent what you have.

  1. 1.Urethritis

    Urethritis is an inflammation of the urethra, which is the tube that carries urine away from the bladder.

    Within a day or two of antibiotic treatment, symptoms usually resolve.

    Top Symptoms:
    painful urination, penis pain, fluid leaking, pink/blood-tinged urine, cloudy urine
    Primary care doctor
  2. 2.Late Onset Hypogonadism

    In the male body, the testicles produce a sex hormone called testosterone. In the adult man, testosterone affects fertility, libido, mental and physical energy levels, muscle strength, and general well being. Late-onset hypogonadism refers to a condition where not enough testosterone is produced after puberty has already passed (hence the name late-onset).

    Outlook depends on underlying cause, but hormone therapy is highly effective.

    Top Symptoms:
    fatigue, difficulty concentrating, trouble sleeping, depressed mood, irritability
    Primary care doctor
  3. 3.Hemochromatosis

    Hemochromatosis is a disease in which too much iron builds up in the body. This can be hereditary or caused by another condition like liver failure.


    Top Symptoms:
    fatigue, abdominal pain (stomach ache), joint pain, decreased sex drive, frequent urination
    Primary care doctor

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  4. 4.Prolactinoma

    Prolactinomas are common non-cancerous pituitary tumors. This growth causes too much of the hormone prolactin to be produced.

    Treatment is dependent on size of growth as well as symptom severity.

    Top Symptoms:
    headache, vision changes, decreased sex drive, impotence, milky fluid leaking from the breast
    Primary care doctor
  5. 5.Urinary Tract Infection

    In women, the opening to the urethra (the tube that carries urine from the bladder to the outside of the body) is very close to the anus, and bacteria from the anus can easily escape and travel up the urethra. These bacteria can infect the bladder, and cause what is known as a urinary tract infection (UTI).

    Symptoms most often go away within 24 to 48 hours after treatment begins.

    Top Symptoms:
    abdominal cramps (stomach cramps), pelvis pain, sudden urgency to urinate, signs of urinary tract inflammation, urinary changes
    Symptoms that always occur with urinary tract infection:
    signs of urinary tract inflammation
    Phone call or in-person visit
  6. 6.Penis Fracture

    A penile fracture, also known as broken penis, occurs when there is traumatic injury to the penis.

    Recovery is dependent on severity of injury as well as type of treatment

    Ultra rare
    Top Symptoms:
    penis pain, penis injury, swollen penis, penis bruise
    Symptoms that always occur with penis fracture:
    penis pain, penis injury
    Hospital emergency room

Painful Erection Treatments, Relief and Prevention

As soon as you notice symptoms of priapism, seek emergency medical care.

The doctor will determine whether your painful erection symptoms are related to ischemic or non-ischemic causes and depending on the cause perform one or more the following treatments:

  • Treatment for ischemic priapism involves draining the blood from the penis and using medications to facilitate blood flow out and away from the penis [4]. Your doctor may do a small procedure using a needle and syringe to drain excess blood from the penis. The medication will constrict the blood vessels that carry blood to the penis (arteries) in order to open up the vessels that allow blood to flow out (veins).
  • Treatment for non-ischemic priapism often does not require direct intervention [4]. The painful erection often goes away with measures such as pressure and ice packs on the affected area.
  • Surgery is only performed when the above treatments are unsuccessful and not often necessary. Your surgeon will perform a procedure that reroutes blood flow and allows the blood to move normally through the penis.

If you experience recurrent painful erection symptoms that resolve on their own, see your doctor. You might need treatment to prevent further episodes.

FAQs About Painful Erection

Here are some frequently asked questions about painful erection.

Why do I get painful erections in my sleep?

Getting painful erections in your sleep is not a common symptom. To get an erection in the absence of sexual desire is called “priapism.” This condition is serious and requires evaluation by a physician. The most common reason you may get painful erections in your sleep is due to sickle cell disease, a disease in which your red blood cells are abnormally shaped and can block off blood vessels.

Why do I get painful erections in my sleep?

repeated question

Why do I have long and painful erections?

Long and painful erections are called “priapism.” This condition is serious, and if it lasts longer than 4 hours it requires emergency treatment. Priapism may occur without clear cause, or may be due to conditions such as sickle cell disease, thalassemia, spinal cord trauma, or genetic disorders. Priapism may also be caused by some medications such as drugs for erectile dysfunction, blood pressure medications, antidepressants, antipsychotics, anticonvulsants, and recreational drugs.

Can a UTI cause a painful erection?

Urinary tract infections (UTIs) generally do not cause painful erections. UTIs are very uncommon in men, and when they occur, they are usually due to structural abnormalities in the urinary tract or placement of a catheter. UTI symptoms include painful urination, frequent and urgent urination, bladder pain, and change in urine color. Systemic signs of severe UTIs include fever, chills, lightheadiness and fatigue.

Do STDS cause painful erections?

Sexually transmitted diseases (STDs, also known as sexually transmitted infections or STIs) do not cause painful erections; however, they can cause pain or burning with ejaculation. You may also experience pain from open sores on the penis from STD infection. If you note sores on your penis or have burning or itching with ejaculation, you should seek medical attention.

Questions Your Doctor May Ask About Painful Erection

  • Q.Are you sexually active?
  • Q.Do you feel pain when you urinate?
  • Q.Have you noticed a decrease in your libido or sex drive?
  • Q.Have you ever been diagnosed with diabetes?

If you've answered yes to one or more of these questions, try our painful erection symptom checker to find out more.

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Painful Erection Symptom Checker Statistics

  • People who have experienced painful erection have also experienced:

    • 21% Painful Urination
    • 11% Penis Pain
    • 6% Impotence
  • People who have experienced painful erection were most often matched with:

    • 40% Urethritis
    • 30% Late Onset Hypogonadism
    • 30% Hemochromatosis
  • Source: Aggregated and anonymized results from visits to the Buoy AI health assistant (check it out by clicking on “Take Quiz”).

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  1. Shigehara K, Namiki M. Clinical Management of Priapism: A Review. The World Journal of Men's Health. 2016;34(1):1-8. NCBI Link.
  2. Shah AP. Erection, Persistent. Merck Manual Consumer Version. Updated September 2017. Merck Manual Consumer Version Link.
  3. Drugs Reported to Cause Priapism. UCSF Health. UCSF Health Link.
  4. Anele UA, Le BV, Burnett AL, et al. How I Treat Priapism. Blood. 2015;125(23):3551-3558. NCBI Link.
  5. Muneer A, Alnajjar M. Recent Advances in the Management of Priapism. F1000Research. 2018;7:37. NCBI Link.