Penile Pain and Erection Issues: Causes and Solutions

Glans pain and erectile dysfunction?

In December, during intercourse, I unexpectedly experienced a loss of erection inside my partner.
Initially, I thought it was due to fatigue.
A few days later, when I attempted intercourse again, I clearly noticed a feeling of weakness.
I could achieve an erection, but the glans was noticeably less engorged and felt soft.
The penis was firm, but it didn't feel as rigid as before (it seemed like it wasn't fully engorged).
In subsequent sexual encounters, I felt that the duration of my erections was decreasing, and I even had some difficulty achieving an erection.
In January, I went to the urology department for a blood test (which came back normal).
The doctor prescribed medication for blood circulation, but it hasn't been very effective.
What additional tests should I consider? Furthermore, while taking the prescribed medication, I experienced pain near the left side of the glans.
It wasn't due to urethritis or external injury; I could feel pain just by touching through my clothing.
I was in so much pain that I asked the doctor during my follow-up visit, but he said it was unrelated to the blood circulation medication.
What could be causing this pain, which only occurs when touched through clothing? When I touch it myself, the pain isn't as pronounced.
It feels like an inflammatory pain, and it consistently affects the same side of the glans.
Thank you for your assistance.

Fanrao Ren, 30~39 year old female. Ask Date: 2016/02/07

Dr. Xu Wencang reply Urology

At your age, you should have few issues with sexual organs.
It's important to pay attention to your physical condition, avoid excessive fatigue, and refrain from smoking.
If you still experience erectile dysfunction, a small dose of Viagra can be used temporarily and should work well; sometimes, function may return after a period.
For pain issues, you can pause any blood circulation medications, and if the pain persists, you should visit a hospital for an examination.

Reply Date: 2016/02/07

More Info

Penile pain and erectile issues can be distressing and may stem from a variety of causes, both physical and psychological. Based on your description, it seems you are experiencing a combination of erectile dysfunction (ED) and localized pain in the glans (the head of the penis). Let's break down the potential causes and solutions.

Causes of Erectile Dysfunction and Penile Pain
1. Physical Causes:
- Vascular Issues: Erectile function relies heavily on proper blood flow. Conditions such as atherosclerosis (hardening of the arteries) can impede blood flow to the penis, leading to difficulties in achieving or maintaining an erection.

- Nerve Damage: Conditions like diabetes or nerve injuries can affect the nerves that control erections. This might explain the sensation of reduced firmness and the localized pain you are experiencing.

- Hormonal Imbalances: Low testosterone levels can impact libido and erectile function. Although your blood tests were normal, it might be worth checking hormone levels again, particularly testosterone.

- Infections or Inflammation: Conditions such as prostatitis or balanitis (inflammation of the glans) can cause pain and discomfort. Even if you do not have a urinary tract infection, inflammation in the area can lead to pain during sexual activity.

2. Psychological Causes:
- Anxiety and Stress: Performance anxiety or stress can lead to temporary erectile dysfunction. The psychological aspect can create a cycle where anxiety about performance leads to further difficulties.

- Depression: This can also affect libido and erectile function.

3. Medication Side Effects: Some medications, including those for blood circulation, can have side effects that impact sexual function. If you notice pain in the glans after starting a new medication, it’s worth discussing this with your doctor.

Suggested Actions and Investigations
1. Consult a Urologist: Since you have already seen a urologist, consider a follow-up appointment to discuss your ongoing symptoms. It may be beneficial to seek a second opinion if you feel your concerns are not being adequately addressed.

2. Further Testing:
- Ultrasound: A Doppler ultrasound can assess blood flow to the penis and help identify vascular issues.

- Hormonal Testing: Repeat testosterone and other hormone level tests to rule out hormonal causes.

- Nerve Conduction Studies: If nerve damage is suspected, these tests can help assess nerve function.

3. Pain Management: For the localized pain in the glans, consider discussing pain management options with your doctor. This could include topical treatments or medications that target nerve pain.

4. Lifestyle Modifications:
- Exercise: Regular physical activity can improve blood flow and overall health, which may help with erectile function.

- Diet: A heart-healthy diet can improve vascular health, which is crucial for erectile function.

- Stress Management: Techniques such as mindfulness, meditation, or therapy can help reduce anxiety related to sexual performance.

5. Consider Counseling: If psychological factors are contributing to your symptoms, speaking with a therapist who specializes in sexual health can be beneficial.

Conclusion
Erectile dysfunction and penile pain can be complex issues with multiple contributing factors. It is essential to approach this problem holistically, considering both physical and psychological aspects. Continue to communicate openly with your healthcare provider about your symptoms, and do not hesitate to seek further evaluations or alternative treatments if your current regimen is not effective. Remember, you are not alone in this, and many men experience similar issues at various points in their lives.

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