The Priapism Paradox: What Sickle Cell Anemia Reveals About Size, Pressure, and Risk

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The Priapism Paradox: What Sickle Cell Anemia Reveals About Size, Pressure, and Risk

Hi everyone — Xavi here. Today, I want to use a serious medical condition to explain something that matters for enhancement: internal pressure  and blood flow dynamics  can change tissue, sometimes dramatically, but not always in a way you want, and not without risk. The condition is sickle cell anemia , where red blood cells can shift from a normal round shape into a crescent (“half-moon”) shape. What matters for our discussion is a complication it can trigger: a particular kind of priapism… 

Does Sex Hurt for Men? – 10+ Causes

Why Sex Could Hurt for Men

By Jerry Kennard
Updated on July 12, 2023
Medically reviewed by Jamin Brahmbhatt, MD

This article is a repost which originally appeared on verywell health

Edited for content. The opinions expressed in this article may not reflect the opinions of this site’s editors, staff or members.

Key Points

‧ There may be one or more causes to pain during sex for men.

‧ Refrain from sexual activity if you suspect you have an injury which needs attention.

‧ STIs can interfere with sexual performance and pleasure.

Pain during sex happens to both males and females, regardless of gender identity. When sex hurts, it can cause anxiety and affect sexual pleasure.

Sex can hurt for men for a variety of reasons, including sexually transmitted infections, foreskin problems, and being allergic to chemicals in birth control methods (such as latex condoms).

This article explores some common reasons sex can hurt for men. It also offers guidance for when to seek medical care.

For the purpose of this article, “male” refers to people born with penises, irrespective of whether they identify with one or more genders or no gender at all.

Why Does Sex Hurt for Males?

Some of the reasons sexual intercourse can hurt for men include:

Sexually Transmitted Infections

Some sexually transmitted infections (STIs) can cause pain during sex. Infections such as herpes and gonorrhea can cause burning and itching if left untreated. They can also cause sores, bumps, or blisters on the penis or anus.

If you think you may have been exposed to an STI, visit your healthcare provider or a clinic to get tested.

The sooner you know if you’re infected, the sooner you can get treatment. Early treatment can limit or prevent some effects of these infections.

Foreskin Problems

Uncircumcised men can develop tight foreskin, or phimosis. When you pull back the foreskin, or when your penis is erect, it can tear, bleed, get inflamed, or be painful.

This problem can usually be treated with an ointment. In some cases, adult circumcision can resolve the problem. Talk to your healthcare provider about your options.

Why Does Sex Hurt For Females?

In general, women are more prone to experience painful sex than men. Here are some of the reasons sex can hurt for females:

‧ Losing their virginity

‧ STIs

‧ Vaginismus

‧ Vulvodynia

‧ Endometriosis

‧ Uterine fibroids

‧ Ovarian cysts

‧ Cervical cancer

Curved Penis

Normal penises vary in length, girth, and shape from one person to the next. Sometimes, a curved penis can cause painful erections or make sex difficult.

Some penises curve because of conditions like hypospadias. That’s where the urethra opens away from the tip of the penis.

In some cases, a curve can develop over time. One cause of this is Peyronie’s disease, which causes scar tissue to form in the penis. Scars from previous traumas or infections can make sex painful, too.

Lesions and Growths

Sometimes a growth on the penis is what’s causing the pain. Some cancers cause growths. Cysts and lesions can also form on the penis or in the ducts and tubes that carry sperm.

If your prostate is enlarged, you may have pain when you ejaculate. It’s also possible that an infected pocket called an abscess can form on the penis.

Any of these growths can cause pain when you’re having sex or ejaculating.

Priapism

Most of the time, erections go away after sex. Sometimes a non-sexual erection lasts much longer than it normally would. This condition is called priapism, and it is often painful.

An Allergy

Some men have an allergic reaction to vaginal fluids or the chemicals in birth control methods. A medical professional can help you find out if you’re allergic to latex condoms or another substance.

Hypersensitivity

The penis can become very sensitive after orgasm and ejaculation. If you keep having sex after that point, it may be painful. This may mean you need to limit how many times you have sex with your partner on a given day or find other ways to experience pleasure together.

A rare condition called pudendal neuralgia affects a nerve in the pelvic region and may cause pain during sex as well.

Medications

Some antidepressants and muscle relaxers can cause pain when you ejaculate.4 It’s important to talk to your healthcare provider if you think a medication may be causing this kind of pain.

However, you should not stop taking your medication without discussing it with your healthcare provider first, because serious health problems can arise if you do.

Skin Disorders

Some skin conditions can lead to painful sex. These include:

‧ Zoon’s balanitis, an inflammation of the foreskin

‧ Erosive lichen planus, which causes an itchy rash or blisters

‧ Lichen sclerosus, which causes itchy white patches

‧ Genital psoriasis, an itchy inflammation of the skin

‧ Penile cancer

Other Causes of Painful Sex

Other possible reasons that a man or woman might find sex painful include:

‧ Sex positions: Some sexual positions are more uncomfortable than others. This can be due to a variety of reasons, including someone’s overall health, weight, flexibility. Some health conditions, such as back pain, can also make some positions painful. Work with your partner on finding the positions that are most comfortable for you. There are also other ways to enjoy sex that don’t involve intercourse.

‧ Lack of lubrication: Vaginal dryness can cause pain for a woman during sexual intercourse. This can also affect men and women during anal sex. Using a lubricant designed to be used during sex can help with this.

‧ Losing your virginity: Having sexual intercourse for the first time can be painful for women. Women are born with a hymen, thin, fleshy tissue that stretches across part of the opening of your vagina. When this tissue is penetrated, it may cause pain or bleeding. Men typically do not experience pain when they have sex for the first time.

‧ Postorgasmic illness syndrome: Postorgasmic illness syndrome (POIS) is a rare condition in which a person develops flu-like and allergy symptoms after orgasm. It is much more common in men than in women. Symptoms typically develop shortly after an orgasm, and can last for up to seven days before going away. It is not known what causes POIS.

When to See Your Healthcare Provider

It is important to see a healthcare provider if you are experiencing pain during sex so it can be treated as soon as possible.

If you don’t feel comfortable talking about it with your current provider, try to find a healthcare professional you can talk. The right diagnosis and treatment can improve your health and your sex life.

Summary

Pain during sex can be a sign that you have an STI, a skin disorder, an allergy, or another health condition. It could also be that the shape of your penis, a medication, a long-lasting erection, or post-orgasm sensitivity could be the reason.

Some conditions that cause this kind of pain can be serious. It’s vital that you seek medical care when sex hurts so that you can protect your own health and your partner’s.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

1. Urology Care Foundation. What are sexually transmitted infections (STIs) or diseases (STDs)?

2. National Health Service. Tight foreskin (phimosis and paraphimosis). Updated July 26, 2018.

3. The American College of Obstetricians and Gynecologists. When sex is painful.

4. Waqar M, Omar K, Moubasher A, Brunckhorst O, Ahmed K. Painful ejaculation: An ignored symptom. Cureus. 2020;12(10):e11253. Published 2020 Oct 30. doi:10.7759/cureus.11253

5. Muneer A, Alnajjar HM, Ralph D. Recent advances in the management of priapism. F1000Res. 2018;7:37. doi:10.12688/f1000research.12828.1

6. Marfatia YS, Patel D, Menon DS, Naswa S. Genital contact allergy: A diagnosis missed. Indian J Sex Transm Dis AIDS. 2016;37(1):1-6.

7. Turley KR, Rowland DL. Evolving ideas about the male refractory period. BJU Int. 2013;112(4):442-52. doi:10.1111/bju.12011

8. Genetic and Rare Diseases Information Center. Pudendal Neuralgia.

9. American College of Obstetricians and Gynecologists. Vulvovaginal health.

10. NIH. Genetic and Rare Diseases Information Center. Postorgasmic illness syndrome.

 

What Causes Morning Wood?

By Brandon Peters, MD Updated on March 23, 2023
Medically reviewed by Jamin Brahmbhatt, MD

This article is a repost which originally appeared on verywell health

Edited for content. The opinions expressed in this article may not reflect the opinions of this site’s editors, staff or members.

Key Points

‧ Morning erections are not necessarily associated with sex dreams.

‧ During sleep, REM sleep cycles affect erectile activity.

‧ Subtle contact of the penis with bedsheets can induce erections.

“Morning wood” is when the penis engorges with blood and you wake up with an erection. This is a perfectly normal occurrence. Most morning erections tend to last for a few minutes after awakening but can persist for longer.

Despite what some think, these erections are not so much associated with “sex dreams” as they are certain parts of the sleep cycle—namely, REM sleep.1 Changes in hormone levels, a full bladder, and even physical stimulation from a bedsheet can also cause morning wood.

This article explains the causes of morning erections, clinically known as nocturnal penile tumescence. It also reviews factors that independently contribute to morning wood in people with penises.

Erections and Your Sleep Cycle

Morning erections correspond to the timing of rapid eye movement (REM) sleep. Because REM sleep effects neurological stimulators that increase blood flow to the penis, penile erection is more likely during this part of the sleep cycle.1

Everybody has different sleep patterns. But since there are usually four or five stages of REM sleep during the night, people with penises may have four or five erections during the night, too. Each erection can last 25 to 35 minutes, though this doesn’t necessarily happen every night.

People stay in REM stage sleep for longer as morning approaches. By the time they wake, they are often still coming out of REM sleep. This is why you may experience morning wood, which typically subsides within a few minutes of awakening.

It seems that the body is doing what healthcare providers refer to as “testing systems” during sleep. This is a normal and healthy phenomenon in people with penises. In fact, it can also happen in those without them: The clitoris can become engorged with blood and erect during REM sleep as well.

Hormones Levels in the Morning

The sex hormone testosterone plays a central role in the sexual functions of people with penises. Research has shown that testosterone helps facilitate nearly every facet of an erection, from the activation of nerves that stimulate smooth muscles of the penis to the engorgement of blood in the spongy interior of the penis.

Testosterone levels also fluctuate and tend to be higher early in the morning than in the afternoon or evening.

This incidental increase can also be one of the contributing factors to a morning erection.

Even Subtle Touch Can Cause Erections

Physical touching of the penis can, on its own, cause an erection in the absence of sexual stimulation. Research has shown that physical stimulation sends sensory signals directly to the lower part of the spinal cord which functions at the body’s “erection center.”

Even when half-asleep or half-awake, these sensory nerves can be alert to even subtle changes in the environment. As such, the tactile sensation of a bedsheet or pajama fabric against the penis may be enough to provoke a morning erection.

Effect of a Full Bladder

Men who don’t get up to urinate during the night will have a full bladder in the morning. A full bladder can press on the sacral nerve, which is a group of five nerves in the lower back.

Your nervous system helps keep your body running while you sleep. Because the sacral nerve is responsible for erections while you’re asleep or half-asleep, stimulation of the nerve from a full bladder can cause an erection.

Morning erections can be a reassuring sign that your nerves, blood supply, and circulation are healthy.

What If Morning Erections Stop or I Never Have Them?

If you do not wake with an erection, it is not necessarily abnormal. It could be that you did not wake from REM sleep. It is also possible that the erection began to fade prior to waking completely.

In general, sleep-related erections decrease with age. But if you’re not waking at least occasionally with an erection, if may be time to visit your healthcare provider for a check-up.

Adolescents, teens, and young adults tend to have morning wood more often than older adults.

A complete lack of morning erections may suggest a problem with the blood vessels or nerves. It can also indicate erectile dysfunction, a common condition in which a person is unable to get or keep an erection firm enough for satisfactory sexual intercourse.

See your healthcare provider. They will probably want to do a full health history and eliminate other possibilities, such as obstructive sleep apnea, which is just one condition that can affect erections. A diagnostic sleep study called a polysomnogram may be recommended.

What If a Morning Erection Doesn’t Go Away?

Persistent erections may occur in a condition called priapism. With this uncommon condition, either blood flow through the penis is not as it should be (nonischemic or high-flow priapism) or blood gets trapped in the penis after it becomes erect (ischemic or low-flow priapism).

Priapism can result in erections that last hours. With nonischemic cases, the shaft of the penis may lose some rigidity and you likely won’t experience pain. With ischemic priapism, the shaft is rigid, the tip is soft, and there is pain that worsens with time.

Give the erection some time to resolve. If it goes away, but long-lasting and/or painful erections keep happening, see your healthcare provider.

If your erection lasts for more than four hours, go to the emergency room.

Summary

Morning erections correspond to the timing of rapid eye movement (REM) sleep, which you may still be coming out of when you wake up. They can also be caused by hormone fluctuations, a full bladder, and subtle touch.

These erections typically resolve within minutes of you waking up.

Morning wood is not only common, but normal. If you don’t ever experience these erections, they stop, or they last several hours, see a healthcare provider.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Youn G. Why do healthy men experience morning erections? Open Psychol J. 2017;10(1). doi:10.2174/1874350101710010049

Isidoria AM, Buvat J, Corona G, et al. A critical analysis of the role of testosterone in erectile function: from pathophysiology to treatment—a systematic review. Eur Urol. 2014 Jan;65(1):99-112. doi:10.1016/j.eururo.2013.08.048

Crawford ED, Poage W, Nyhuis A, et al. Measurement of testosterone: how important is a morning blood draw? Curr Med Res Opin. 2015;31(10):1911-4. doi: 10.1185/03007995.2015.1082994

Boston University School of Medicine. The central mechanisms of sexual function.

Leungwattanakij S. Erectile dysfunction. Bangkok Med J. 2016;11:57-. doi:10.31524/bkkmedj.2016.02.012

Urology Care Foundation. What is Priapism?

 

 

 

 

 

 

 

 

Blood clots cause 4-hour erection in man with coronavirus | Miami Herald

Did coronavirus cause a man to have a 4-hour erection? Doctors studied it to find out

By Katie Camero
July 02, 2020 02:30 PM

Edited for content

This article is a repost which originally appeared on The Miami Herald

Doctors in France believe the novel coronavirus could be to blame for a man’s erection that lasted more than four hours, a new case study says.

Blood clots found within the 62-year-old’s penis caused a painful case of priapism — the medical term for a prolonged erection — and is thought to have been triggered by the disease, according to the report published in June in The American Journal of Emergency Medicine.

The case appears to be the first that links penile erections to COVID-19, the team of doctors said.

“The clinical and laboratory presentation in our patient strongly suggests priapism related to SARS-CoV-2 infection,” the doctors said in the study. “This medical emergency should be recognized by healthcare professionals and treated promptly to prevent immediate and chronic functional complications.”

A significant number of coronavirus patients admitted to intensive care units form dangerous clots in their blood, several reports have shown. They are causing patients to have heart attacks, strokes, rashes and swollen fingers and toes, and can be found in the lungs, liver, kidneys and bowels, according to WebMD.

Some scientists speculate clotting is the result of an exhausted immune system that ends up turning against itself, causing a condition called “disseminated intravascular coagulation, where patients both bleed uncontrollably and clot too much at the same time,” the outlet said.

Others theorize the virus could be causing the clotting directly, but more research is needed to understand the phenomenon, experts say.

But when the patient visited a doctor feeling feverish and weak with a dry cough and diarrhea, there were no signs of a problematic erection, the study said. Clinicians gave the man antibiotics for what they thought was a bacterial infection.

Two days later, he was having breathing troubles and went to the hospital where he was “promptly intubated and mechanically ventilated,” the researchers said.

The patient’s blood pressure spiraled out of control and chest scans showed abnormalities in his lungs, but still no sign of an erection. It wasn’t until the patient was admitted into the ICU with fluid in his lungs that a “physical examination revealed previously unidentified priapism,” the study said.

Doctors drew blood from the man’s penis and found “dark blood clots and high carbon dioxide and low oxygen contents,” which means the clots were blocking blood from flowing out of the penis, Bruce Lee, a professor of health policy and management at the City University of New York, wrote in Forbes.

“When blood stays in the same place and can’t return to the lungs, it gets depleted of oxygen and loaded more and more with carbon dioxide,” Lee wrote.

Doctors injected medicine into the man’s penis which helped his condition, the study said.

“Although the arguments supporting a causal link between COVID-19 and priapism … are very strong in our case, reports of further cases would strengthen the evidence,” the researchers said.

Priapism is diagnosed when an erection goes on for more than four hours or isn’t related to sexual stimulation, according to the Mayo Clinic. It’s uncommon yet usually painful, and occurs in men in their 30s or older with certain conditions such as sickle cell anemia.

“Prompt treatment for priapism is usually needed to prevent tissue damage that could result in the inability to get or maintain an erection (erectile dysfunction),” the Mayo Clinic said.