Medically reviewed by Katelyn Hagerty, FNP
Written by Our Editorial Team
Last updated 5/11/2022
It’s very, very, late in the evening and, after turning into a human kickstand as you tried to roll over, you realized that something wasn’t correct downstairs. You have a painful erection.
Maybe it was a double dose of erectile dysfunction medication or some of those gas station sex pills. Maybe it was nothing but physiology. But whatever is going on — whatever the cause of penile pain is for you — it needs to stop.
Having a painful erect penis is not always a sign to panic, but chances are, if you’re Googling answers to questions about it and it’s still hard, you might be in need of some medical assistance. To figure out whether that’s the case, let’s go over some basics.
Counter to what the locker room chatter might have informed you, a painful erection in the medical sense is not the result of absolutely too much sex.
Sure, every part of your body might get sore from an epic night of lovemaking, but that’s not really what people are talking about when they warn you about a painful erection.
For starters, painful erection isn’t the whole picture: in the medical sense, a painful erection is an erection that was — and still is — painful, because it hasn’t gone away. Painful erection is an interchangeable and common name for a condition called priapism, which is a painful erection lasting longer than is normal.
Generally, the amount of time these painful erections last has to be at least four hours for a common diagnosis, but there are subtypes of painful erection that may have different resulting problems after that.
For instance, while we generally think about painful erection as the result of misused erectile dysfunction medications, priapism can occur when there is a trauma to the penis or supporting tissues, as well — injuries resulting in the same interrupted inflow and outflow of blood from the erectile tissues.
Aside from priapism, there may be several other causes for pain during an erection, including penile fracture, urethral rupture, complications from a penile implant, foreign body insertions, certain drugs, paraphimosis and other sources of trauma or injury to your genitals.
As for priapism, two main causes account for more than half of cases.
On the one hand, you have blood disorders like sickle cell disease. Sickle cell anemia can affect the flow of blood and is particularly predominant in African American men at both young and old ages. People with sickle cell are at an increased risk of priapism.
On the other hand, you have risk factors from medically or drug-induced blood flow issues caused predominantly by medications designed to treat the symptoms of erectile dysfunction.
These medications are great at getting you up, but getting you down can be a whole other issue.
Both of these conditions result in injury and, in some cases, permanent damage.
Depending on the kind of painful erection you have, the condition could be benign, but it’s much more likely that it’s something worth taking a closer look at.
In the case of priapism, an ongoing or long-lasting painful erection is definitely dangerous. If this is happening right now, you can go ahead and close your browser and head to the hospital.
If your erection is painful for a different reason and you don’t know what it is — you haven’t already talked to a healthcare professional about it or been diagnosed — you’re going to want to talk to see your healthcare provider sooner than later.
Penile injuries can lead to issues down the road that, even absent the problems created by priapism, can cause you to lose full or partial function to your penis, or see changes to your function as you see scar tissue form.
You don’t really want to read this part, but you should anyway.
Painful erections lasting four hours or more are going to be treated as medical emergencies because as the severity worsens, so does the treatment — and the risk of permanent damage to erectile tissue.
Priapism is generally treated with medication at first, but things can quickly switch to surgical intervention, where varying levels of extreme might see some very sharp objects where you do not want them. Feel free to Google “corporal snake maneuver,” but we’ll spare you descriptions of 10-inch shunting blades and blood vessels.
The best way to deal with erection pain and priapism is to keep your medical care up to date, complete regularly scheduled checkups and talk to a healthcare provider about erectile dysfunction and other issues you may be having in your intimate times.
Leave it to the professionals.
Cards on the table, there are two reasons you clicked on this story link. You either:
Have erection pain right now and want to know what’s going on, or
Are worried about the worst-case scenarios for medications that treat erectile dysfunction.
If you’re in category one, just make the appointment to speak with a healthcare provider. You can no more diagnose your own erection problems than you can fix a space shuttle (literal rocket scientists, disregard this metaphor).
If your penis has been hurting recently, talk to a healthcare provider. If it’s hurting right now for the fourth hour in a row, go to the emergency room and seek medical attention.
Now, if you fall into category 2, here’s some advice: talk to your healthcare provider, too.
Erectile dysfunction affects an estimated 52 percent of men in the U.S. between the ages of 40 and 70 — as many as 50 million men nationwide. That’s nothing to be ashamed of, and it’s nothing to hide from everyone — least of all, your healthcare provider.
Talking to a health care provider about your erectile concerns and medical history is the best way to find supporting treatment options that will help you in a safe and penis pain-free way.