Has anyone experienced post-ejaculatory pain?

June 30, 2007 1:22 PM

Does anyone else experience or know anything about post-ejaculatory pain in the testicles? My (first opinion) doctor is stumped. (Hint: It's not blue balls and I'm also infertile)

First: I've seen a doctor and am not using this for diagnosis. I'm just curious if anyone else has had personal experience with my problem. Please email anon_mefite at yahoo.com for clarifications or what-have-you.

I'm 24 and since 14 or so I've experienced a dull ache in my groin post-ejaculation. It's difficult to pinpoint the location of the pain, but it's around the testicles. My best guess is that it's half-way between the base of the penis and the testes, under the surface.

Interestingly, I've recently learned how to orgasm without ejaculating, and have no pain whatsoever in this case. I'll bring this up in my next doctor visit.

The pain was rare at 14 and lasted only a short while. It has steadily increased in frequency and duration and now occurs 90% of the time, typically for 1-4 hours if I'm sitting or laying down, 5-10 hours if I'm up and active. Erections intensify the pain.

When it became more than an annoyance, I saw my primary doctor, and then a Proctologist. The primary had never heard of it before. The Proctologist prescribed "Flomax" which stops ejaculation. I didn't notice a significant change while on Flomax, but I didn't orgasm much that month. After Flomax seemed to fail, the Proctologist basically said "I dunno".

He also told me I was infertile after I provided a semen sample. Somewhat stupidly, I gave the sample while on Flomax, so my volume was rather low. He insisted that this didn't matter, since the problem he found was immobility, but that I should still try again.

I was rather displeased with the Proctologist, so I'm going to get a second opinion soon. I'll definitely let he or she know about how non-ejaculation does not cause pain. Until then, does this sound familiar to anyone else? Thank you!

posted by anonymous to health & fitness (12 comments total)

The only thing this sounds like in my experience is a not uncommon but temporary post-vasectomy side effect. One of my friends was terrified that HE would be the unlucky one to have "painful ejaculations" as the consent form described it. In rare cases, it can be permanent.

So it makes me wonder if there was some trauma or malformation of the vas.

I am not even remotely a doctor, but I wonder if an MRI or some other diagnostic tool could check for something like this. And, perhaps a therapeutic vasectomy could help.

Just total speculation... sorry I don't have more!
posted by The Deej at 3:35 PM on June 30, 2007

I'd look into psychosomatic origins for something like this, especially considering the duration.
posted by Ironmouth at 4:19 PM on June 30, 2007

No, but I do experience periodic inflammation of the epididymis, which can create an vaguely-localized pain in the testicles. It doesn't appear to have much relationship to ejaculation, though ejaculation sometimes seems to alleviate it.

Given the infertility, I wonder whatever trouble you're having might be related to the epididymis. E.g., perhaps something is blocking the normal flow of sperm through that duct.
posted by treepour at 4:32 PM on June 30, 2007

Wouldn't a urologist be the type of specialist you'd want for this kind of question?
posted by Skwirl at 7:15 PM on June 30, 2007 [1 favorite has favorites]

I have experienced a pain that is similar to what you describe, though not as severe. It feels like the tubes or tendons or whatnot connecting my testicles to my body are being pulled or strained. I've never worried about it that much or investigated it, so I don't have an answer for you, but I wonder if it might be somehow related to a hernia.
posted by alms at 7:27 PM on June 30, 2007

Please get a referral to a urologist instead of a proctologist.
posted by Ynoxas at 7:50 PM on June 30, 2007

I had a vasectomy about a year and a half ago, and I have occasionally experienced painful ejaculation. For me it is more sharp than dull (but not very painful -- less than stubbing a toe, say 2 out of 10), but it is in roughly that same location. It only lasts a short time however (on the order of minutes, not hours). Certainly, your pain and mine are not identical, but the similarities are enough that I'd look into plumbing irregularities if I were you. A urologist is the way to go, as it were.
posted by Rock Steady at 9:02 PM on June 30, 2007

Definitely get a referral to a urologist. I'm extremely surprised that your PCP said he'd never heard of post-ejaculatory pain, so I'm wondering if perhaps there are other symptoms that are making your situation unique.

Along with epididymitis and prostatitis, varicose veins can also be a somewhat common problem for men. Do you wear tight briefs and/or tight pants? Two friends of mine were able to drastically reduce their post-ejaculatory pain by switching to boxers, and noticed improvement after a short time (I don't remember how long it took, but it wasn't immediate.)

I wish I had more to contribute, but I wanted to chime in & strongly encourage you to see a urologist, not a proctologist. And it is quite common. I don't have testicles myself, but a lot of the people I know who have them have confided this kind of discomfort to me.
posted by Iamtherealme at 10:03 PM on June 30, 2007

"I'd look into psychosomatic origins for something like this, especially considering the duration."

I'd exhaust the physical possibilities first.
posted by BrotherCaine at 2:58 AM on July 1, 2007

Do a google on the following terms :

Chronic pelvic pain syndrome
Interstitial Cystitis
Chronic prostatitis

Check out this book :

A headache in the pelvis

I have a similar problem as you, only I have it a lot worse. You probably don't want the details, but feel free to email me if you want to talk about it.

Urologists can be helpful, but only if they are familiar with the problem. A lot of times, they will give you tons and tons of antibiotics, which do fuckall good because your problem most likely isn't bacterial in nature.

I've been diagnosed with all three problems, by different doctors. The last urologist I went to diagnosed me with Interstitial Cystitis, and proscribed Elmiron and Elavil for me. It's been difficult to say if they've been helpful or not.

To be honest, the most helpful thing for me was to stop drinking caffeine and alcohol. Now my symptoms are far more under control then they've ever been.

Tell me - does alcohol and caffeine seem to affect your symptoms? I've personally found that if I drink caffeine or alcohol and then have an orgasm that same day, I'm almost guaranteed to have a "flare-up."
posted by Jake Apathy at 6:21 AM on July 1, 2007 [1 favorite has favorites]

Seconding everything in Jake Apathy's post. I wrote a reply to a similar post here.
posted by wireless at 12:13 PM on July 1, 2007

IANAD, I initially ruled out testicular torsion because you said that the problem corrected itself in a few hours, but it turns out that testicular torsion can be intermittent at first.

Is the pain in both testes or just one? Are your testes oriented front to back or kind of sideways when you are in pain?
posted by BrotherCaine at 1:52 AM on July 2, 2007