A penile ache can range from minor, temporary discomfort to severe, persistent pain signaling a serious medical issue. The ache may be felt at the tip, along the shaft, or deep within the base of the penis. Because the penis contains complex structures for both sexual and urinary function, any persistent or concerning pain should always be evaluated by a healthcare professional to identify the underlying cause and begin appropriate treatment quickly.
Common Mechanical and Lifestyle Triggers
Penile aching sometimes results from simple physical stress or irritation rather than a disease process. Common causes relate to external pressure or friction, such as from clothing or restrictive devices that are too tight and place prolonged pressure on the shaft or base. Intense or prolonged sexual activity can also lead to temporary soreness. Excessive friction, especially without sufficient lubrication, irritates the sensitive tissues. Post-ejaculation soreness is another temporary ache that resolves quickly. Repetitive micro-trauma from activities like long-distance cycling can cause aching due to pressure on the perineum and compression of nerves and blood vessels. These mechanical causes are typically benign and resolve once the source of irritation is removed.
Infectious and Inflammatory Conditions
Infections or localized inflammation within the genitourinary system are a significant cause of penile ache. Urethritis, inflammation of the urethra, is a frequent culprit, often presenting as burning pain during urination or irritation at the tip of the penis. This condition is commonly linked to sexually transmitted infections (STIs) such as Chlamydia and Gonorrhea. A discharge from the penis may also be present, which helps identify the bacterial cause for targeted antibiotic treatment.
Balanitis is another inflammatory cause, characterized by swelling and soreness of the glans (head of the penis). This inflammation is often due to fungal infections, particularly yeast, or bacterial growth, and is more common in uncircumcised individuals. Balanitis can also be triggered by irritation from harsh soaps, chemicals, or poor hygiene, leading to symptoms like redness, itching, and discharge beneath the foreskin. A Urinary Tract Infection (UTI) can also cause discomfort, as inflammation in the urinary tract may be perceived as a mild ache in the penis, often accompanied by a frequent or urgent need to urinate.
Structural Issues and Physical Trauma
Penile pain can be caused by physical damage or structural changes within the tissue. Peyronie’s disease involves fibrous scar tissue, called plaque, forming beneath the skin in the tunica albuginea (the sheath surrounding the erectile chambers). The acute phase often involves pain, especially during an erection, caused by active inflammation. This non-elastic scar tissue prevents the affected side of the penis from stretching, leading to a noticeable curve or bend. While the pain typically subsides in the chronic phase, the resulting curvature can cause significant functional problems, including difficulty with sexual intercourse.
Acute physical trauma can result in a “penile fracture,” which is a tear in the tunica albuginea, usually occurring when an erect penis is forcefully bent. Since the tunica albuginea is stiff during an erection, it is vulnerable to rupture. This injury is a medical emergency, causing sudden, severe pain, often accompanied by an audible popping sound, rapid loss of erection, and immediate swelling and bruising. Post-surgical complications, such as scarring or anatomical changes, can also result in long-term localized aching or discomfort.
Causes Related to Internal Organs and Referred Pain
Sometimes, a penile ache is “referred pain,” meaning the discomfort originates in a nearby structure but is felt in the penis. Prostatitis, inflammation of the prostate gland, is a common example. The prostate is located near the base of the penis, and its inflammation can cause a deep, generalized aching in the pelvic area. Prostatitis can be caused by bacterial infections or be non-bacterial, leading to pain felt in the testicles or during ejaculation.
Other sources of referred pain involve the epididymis and testicles; epididymitis or orchitis (inflammations of these structures) can cause pain that radiates toward the base of the penis. A kidney stone moving through the ureter can cause intense, cramping pain that travels down the flank and groin, sometimes manifesting as a tingling sensation at the tip of the penis. Nerve entrapment of the pudendal nerve can also cause neuropathic pain in the genital area. This condition, known as pudendal neuralgia, may cause a burning, shooting, or stabbing ache in the penis that often worsens when sitting.
Critical Symptoms Requiring Immediate Care
Certain symptoms accompanying a penile ache indicate a urological emergency requiring immediate medical attention. Priapism is a prolonged, often painful erection lasting more than four hours without sexual stimulation. This ischemic emergency traps blood in the erectile tissue, and the lack of oxygen can cause permanent tissue damage and erectile dysfunction if not treated urgently.
Sudden, severe pain accompanied by a snapping sound, loss of erection, and significant swelling suggests a penile fracture. The inability to urinate, known as acute urinary retention, is another urgent symptom. Finally, severe penile pain accompanied by systemic symptoms like a high fever, chills, or generalized illness suggests a severe infection that could potentially lead to sepsis.