Burning, or painful, ejaculation is a symptom known clinically as odynorgasmia or dysejaculation. This discomfort is felt during or immediately following orgasm, often localized in the urethra, the tube that transports both urine and semen, or the perineum (the area between the genitals and the anus). While the experience can cause significant distress, it is not a condition in itself but rather a physical manifestation of an underlying health problem that requires proper investigation and diagnosis. A wide range of conditions, from infections to structural issues, can lead to this specific type of pain.
Infectious Causes of Burning Ejaculation
The most common causes of a burning sensation during ejaculation involve inflammation triggered by bacterial or viral pathogens. Inflammation of the urethra, called urethritis, is a frequent source of this pain because the entire reproductive tract is activated during ejaculation. Sexually transmitted infections (STIs) are major contributors to urethritis, particularly Chlamydia trachomatis and Neisseria gonorrhoeae. These pathogens cause inflammation that makes the passage of semen an irritating experience.
The prostate gland is another common site for infection that causes painful ejaculation. Prostatitis is inflammation of this walnut-sized gland, which produces seminal fluid. When bacteria from the urinary tract or an STI spread to the prostate, they cause acute bacterial prostatitis. The resulting swelling and irritation of the gland can cause significant discomfort when the muscles around it contract during climax.
Infections can also travel to the structures connected to the testicles, leading to epididymitis or orchitis. Epididymitis is the inflammation of the coiled tube behind the testicle, while orchitis is inflammation of the testicle itself. These conditions are often secondary to a bacterial infection, such as a UTI or an STI, and commonly present with pain in the testicle or scrotum that is made worse by ejaculation. The presence of a urinary tract infection (UTI) itself can also cause a burning sensation that is exacerbated when semen passes through the inflamed urethra.
Non-Infectious and Structural Causes
Burning ejaculation can also arise from issues that are not related to a bacterial or viral infection. Chronic pelvic pain syndrome (CPPS), a form of non-bacterial chronic prostatitis, is a major cause where inflammation of the prostate and surrounding pelvic structures exists without an identifiable infection. This syndrome often involves muscle tension and nerve irritation in the pelvic floor, which can cause pain that flares up with the muscular contractions of ejaculation. Treatment for this type of chronic inflammation typically focuses on anti-inflammatory medications and muscle relaxers rather than antibiotics.
Structural abnormalities within the urinary and reproductive tracts can physically interfere with the flow of semen, causing pain. Urethral strictures, which are areas of narrowing in the urethra, can impede the passage and cause a burning sensation due to pressure and irritation. Similarly, small stones or calculi that block the ejaculatory duct can lead to intense pain during the expulsive phase of climax. These blockages prevent the free flow of fluid, causing a painful buildup of pressure.
Another category of non-infectious causes involves chemical or physical irritation of the urethra, often resulting in non-gonococcal urethritis (NGU). NGU is inflammation not caused by gonorrhea, and it can result from non-sexual factors. Sensitivity to chemical irritants in products such as spermicidal lubricants or harsh soaps can cause irritation of the delicate urethral lining. Physical trauma, such as that caused by inserting a catheter, can also directly injure the urethra and lead to inflammation and burning pain upon ejaculation.
When to Seek Medical Attention and Treatment
Experiencing a burning sensation during ejaculation is a clear signal that medical investigation is necessary to identify the source of the problem. You should seek prompt medical attention, especially if the burning is accompanied by red flag symptoms. These include a high fever, visible blood in your semen or urine, or an inability to urinate. These symptoms may indicate a spreading infection or a serious blockage that requires immediate intervention.
A physician will typically begin the diagnostic process with a thorough physical examination, including an assessment of the abdomen and a digital rectal exam to check the prostate. Diagnostic testing usually involves a urinalysis and a urine culture to look for signs of infection or inflammation. Testing for STIs, often using a urethral swab or urine sample, is also a standard procedure, as is a semen analysis to check for infectious agents. Imaging tests like an ultrasound or blood work to check prostate-specific antigen (PSA) levels may be used to assess the prostate or surrounding organs.
Treatment is always directed at the underlying cause once a diagnosis is confirmed. If the burning is due to a bacterial infection, such as an STI or bacterial prostatitis, a course of antibiotics will be prescribed to eliminate the pathogen. For non-bacterial causes like CPPS, treatment often involves anti-inflammatory medications or alpha-blockers to relax the muscles of the prostate and bladder neck. When the cause is a structural issue, such as a urethral stricture or a stone blocking a duct, a minimally invasive surgical procedure may be necessary to remove the blockage or widen the passage.