Causes & Treatment Options for Painful Ejaculation

Painful ejaculation may affect sexual pleasure and can cause distress, anxiety, and lower self-esteem. Learn about the cause and treatment options.

If you suffer from painful ejaculation, here’s some information to help you determine the cause and what treatment options are available.

What is Painful Ejaculation?

Painful ejaculation is when painful, burning sensations are felt during or following ejaculation. Pain can be felt in the perineum (the area between the anus and the genitals) and the urethra (a tube that runs from the bladder to the end of the penis). The condition can cause discomfort in the testes and interfere with sexual pleasure.

What causes Painful Ejaculation?

Painful Ejaculation is not an uncommon condition and there are a number of causes including:

• Prostatitis, an inflammatory condition of the prostate gland which can make the prostate feel sore and irritated
• An infection (including sexually transmitted infections) that may inflame the area around the penis
• Urethritis, swelling within the urethra
• Nerve damage to the penis
• Blockages in the ejaculatory duct
• Psychological problems

How is the cause of Painful Ejaculation found?

To find the cause of painful ejaculation, a semen sample and urine sample after ejaculation may be taken. A urethral swab may be taken to see if there is an infection, such as a sexually transmitted infection. A test that looks at the inside of the bladder and urethra (cystoscopy) may also be done, although this is uncommon. For some men, it can be hard to describe the exact location of the pain.

Men should go see a doctor if they experience pain during or following ejaculation to determine if a cause can be found.

How is Painful Ejaculation treated?

All causes of painful ejaculation should be investigated by a doctor so the best treatment can be given.

If no physical cause is found, some behavioural techniques to relax the muscles in the pelvic area may help some men. When the cause is prostatitis the use of medications such as ‘alpha-blockers’, muscle relaxants, analgesics, and some anti-inflammatory drugs may help. Specific antiviral and antibiotic medications can be given if the cause of painful ejaculation is due to an infection.

If the cause is psychological, counselling may help deal with any underlying concerns.

How can Painful Ejaculation affect the quality of life?

Painful ejaculation is not life-threatening, but may affect sexual pleasure and can cause a man distress, anxiety and lower self-esteem. If a man is in a relationship, both the man and his partner may be affected by his experience of painful ejaculation.

For more information about painful ejaculation, speak with a doctor.

What’s my 10-year outlook for Erectile Dysfunction and other health concerns?

Check your health and see where you stand with YouCheck – the free and confidential online health assessment tool for men. No strings attached.

Prostatitis – NHS

Prostatitis is inflammation (swelling) of the prostate gland. It can be very painful and distressing, but will often get better eventually.

The prostate is a small gland that lies between the penis and bladder. It produces fluid that’s mixed with sperm to create semen.

Prostatitis can come on at any age. But usually between 30 and 50.

There are 2 main types of prostatitis:

• chronic prostatitis – where the symptoms come and go over several months; it’s the most common type
• acute prostatitis – where the symptoms are severe and come on suddenly; it’s rare, but potentially life-threatening and requires immediate treatment

Symptoms of prostatitis

Acute prostatitis

Symptoms of acute prostatitis include:

• pain, which may be severe, in or around your penis, testicles, anus, lower abdomen or lower back – pooing can be painful
• pain when peeing, needing to pee frequently (particularly at night), problems starting or “stop-start” peeing, an urgent need to pee and, sometimes, blood in your urine
• not being able to pee, which leads to a build-up of urine in the bladder known as acute urinary retention – this needs urgent medical attention
• generally feeling unwell, with aches, pains and possibly a high temperature
• lower back pain and pain on ejaculation

See a GP straight away if you have these symptoms so that the cause can be investigated.  

Chronic prostatitis

You may have chronic prostatitis if you have had some of the following symptoms for at least 3 months:

• pain in and around your penis, testicles, anus, lower abdomen or lower back
• pain when peeing, a frequent or urgent need to pee, particularly at night, or “stop-start” peeing
• an enlarged or tender prostate on rectal examination
• sexual problems, such as erectile dysfunction, pain when ejaculating or pelvic pain after sex

These symptoms can have a significant impact on your quality of life.

But in most cases, they’ll gradually improve over time and with treatment.

When to get medical advice

See a GP if you have symptoms of prostatitis, such as pelvic pain, difficulty or pain when peeing, or painful ejaculation.

They’ll ask about the problems you’re having and examine your tummy.

You may also have a rectal examination. This is where a doctor inserts a gloved finger into your bottom to feel for anything unusual. You may have some discomfort during this examination if your prostate is swollen or tender.

Your urine will usually be tested for signs of infection, and you may be referred to a specialist for further tests to rule out other conditions.

See a GP straight away if you get sudden and severe symptoms of prostatitis.

You may have acute prostatitis, which needs to be assessed and treated quickly because it can cause serious problems, such as suddenly being unable to pee.

If you have persistent symptoms (chronic prostatitis), you may be referred to a doctor who specialises in urinary problems (a urologist).

Treating prostatitis

Treatment for prostatitis depends on whether you have acute or chronic prostatitis.

Acute prostatitis

Acute prostatitis (where symptoms are sudden and severe) is usually treated with painkillers and a 2- to 4-week course of antibiotics. 

Hospital treatment may be needed if you’re very ill or unable to pee.

Chronic prostatitis

Treatment for chronic prostatitis (where symptoms come and go over several months) usually aims to control the symptoms.

Depending on how long you have had symptoms, your doctor may suggest:

• painkillers, such as paracetamol or ibuprofen
• a medicine called an alpha-blocker if you have problems peeing; alpha blockers can help relax the muscles in the prostate gland and the base of the bladder
• antibiotics
• a laxative, if pooing is painful

The aim is to reduce symptoms so they interfere less with day-to-day activities.

What causes prostatitis?

Acute prostatitis is usually caused when bacteria in the urinary tract enter the prostate.

The urinary tract includes the bladder, kidneys, the tubes that connect the kidneys to the bladder (ureters), and the urethra.

In chronic prostatitis, signs of infection in the prostate gland cannot usually be found. In these cases, the cause of symptoms is not clear.

Risk factors for prostatitis

You’re more likely to get acute prostatitis if you have:

You’re more likely to get chronic prostatitis if you:

• are older – men aged between 50 and 59 are 3 times more likely to get it than men between 20 and 39
• have had prostatitis before
• have other painful abdominal conditions, such as irritable bowel syndrome (IBS)
• have been sexually abused

Outlook

Acute prostatitis

Acute prostatitis usually clears with a course of antibiotics. It’s important to take the full course to make sure that the infection clears completely.

Rarely, other complications of acute prostatitis can happen.

Acute urinary retention

Because peeing can be very painful, urine can build up in your bladder, causing pain in your lower tummy (abdomen) and not being able to pee at all.

A catheter (a thin, flexible, hollow tube) can relieve this.

Prostate abscess 

If antibiotics are not effective in treating prostate infection, rarely an abscess can develop in your prostate gland.

A doctor may suspect this if your symptoms do not improve despite antibiotic treatment.

Further tests will be needed to confirm an abscess, such as an ultrasound scan or a CT scan of your prostate gland.

If an abscess is present, you’ll need an operation to drain it.

Chronic prostatitis

Chronic prostatitis can be challenging to treat because little is known about what causes it.

Usually there is gradual recovery with treatment, but this can take several months or years.

Some people with prostatitis find their symptoms return and require further treatment.

Prostatitis is not prostate cancer and there’s no clear evidence that it increases your chances of getting it.

Page last reviewed: 11 March 2020
Next review due: 11 March 2023

The Prostate Prognosis | NIH News in Health

October 2010

Print this issue

Don’t Ignore an Uncomfortable Problem

Most men probably don’t like thinking about their prostates, but it’s worth doing once in a while. Problems with the small gland are common in men past the age of 50. The good news is that most prostate conditions can be successfully treated.

The prostate is about the size of a walnut. It wraps around the urethra, the tube that carries urine out of the bladder. During sexual climax, or ejaculation, the prostate adds fluid to sperm to create semen, which also leaves the body through the urethra.

For men under 50, the most common prostate problem is prostatitis. It can cause a burning feeling when you urinate or an urge to urinate more often. You might have a fever or just feel tired.

Prostatitis is caused by the prostate becoming inflamed or irritated. Some kinds of prostatitis are caused by bacteriaTiny organisms that can cause infection or disease.. If you have bacterial prostatitis, your doctor can spot it by looking at your urine through a microscope. Bacterial prostatitis can usually be treated with an antibioticA medicine that kills bacteria..

But most of the time, there’s no clear cause for prostatitis. Researchers have yet to identify a clearly effective treatment when the cause is unknown. You may have to work with your doctor to find a treatment that works for you. Changing your diet or taking warm baths may help. No single solution works for everyone.

For men over 50, the most common prostate problem is prostate enlargement, or benign prostatic hyperplasia (BPH). The prostate naturally grows larger as you get older. As it grows, it squeezes the urethra. The pressure can affect bladder control.

BPH can lead to more serious problems, such as urinary tract infections. In rare cases, the constant urination problems can lead to kidney damage.

Several treatments are available for BPH. In recent years, scientists have developed medicines that can shrink or relax the prostate to keep it from blocking the bladder opening. Researchers have also developed devices that allow doctors to remove parts of the prostate without major surgery. The procedures can usually be done in a clinic or hospital without an overnight stay. More invasive surgery is also an option.

The symptoms of prostate cancer, in which cancer cells form in the tissues of the prostate, can be similar to those of BPH. However, most of the time patients are diagnosed with prostate cancer after results from a blood test prompt a prostate biopsy.

Prostate cancer is the most common cancer in American men after skin cancer. But most men with prostate cancer don’t die from it. Many prostate cancers never even cause symptoms or become a serious threat to health. That’s because prostate cancer tends to grow more slowly than many other cancers. A prostate tumor may grow for 30 years before it gets large enough to cause symptoms. Several treatment options are available.

Certain risk factors have been linked to prostate cancer—for example, eating a high-fat diet. NIH-funded scientists are now looking at how prostate cancer can be prevented. NIH also has many research programs aimed at finding treatments for BPH and other prostate problems.

See your doctor right away if something doesn’t seem right to you down there. And if you can’t urinate at all, get medical help immediately.

Burning After Ejaculation: Is It an STD?

We realize that painful ejaculation is not exactly a popular topic of conversation between men. And despite whatever social stigmas surround the issue, the truth is that experiencing some degree of tingling or burning after ejaculation is more common than you think. While any degree of pain after ejaculation might have you thinking “STD”, that’s simply not always the case. Believe it or not, painful ejaculation can be a sign of many different STD and non-STD conditions.

The silver lining here? Most ailments known to cause a post-ejaculation burning sensation are completely treatable and many are even 100 percent curable. The downside, of course, is that because painful ejaculation can be indicative of so many vastly different conditions (both sexually transmitted and otherwise), self-diagnosis is extremely challenging and on the verge of  impossible. You should never be afraid or embarrassed to consult with your physician on sensitive matters like these. In addition, if you suspect you might have contracted a sexually transmitted disease, you can never go wrong by seeking out reputable STD testing services.

What Causes Burning After Ejaculation?

Generally, painful ejaculation or pain after ejaculation is brought upon by some sort of physical ailment, infection, or inflammation of the genitals or internal organs directly involved in ejaculation. These types of infections may or may not be transmitted sexually. In many cases, a man experiencing burning after ejaculation will feel the same discomfort after urination. In some instances, experiencing pain after ejaculation can be caused not by a physical ailment or infection, but by an underlying psychological condition. In any case, it’s best to consult with your physician to obtain a proper diagnosis and to begin the right treatment process(es).

STDs That Cause Painful Ejaculation

Keep in mind, there are many different kinds of STDs and no two are known to display identical signs. Furthermore, even a single STD can cause varying signs (or ranging severities of the same symptom). And to make matters even more perplexing, certain STDs are known to cause no signs whatsoever. Remember, when it comes to properly diagnosing an STD, your best bet is going to be proper STD testing. All that being said, there are certain STDs for which pain or burning after ejaculation is a key sign. STDs including…

Chlamydia

Arguably the biggest offender in this case is chlamydia, which happens to be the most commonly transmitted sexual disease in the United States. For men who have contracted this STI and are symptomatic, burning after ejaculation (or during urination) is one of the more common chlamydia symptoms. It’s often accompanied by a milky discharge from the penis and/or swelling of the scrotum. Luckily, this STI is a bacterial infection and can be treated with a course of antibiotics. This does not, however, bring about any sort of immunity. This infection can be contracted at any time (even after previous diagnoses and treatment regimens).

Trichomoniasis

Trichomoniasis (or “trich” for short) is another very common sexually transmitted infection in the United States. While trich is more common in women than men, men can certainly contract it and endure its associated trichomoniasis symptoms. Men who do experience signs may notice pain or burning after ejaculation or urination, itching, or unusual penile discharge. Like other STIs, trich can be treated and cured fairly easily and (unfortunately) contracted again down the line. 

Gonorrhea

A third STD that can cause pain and burning after ejaculation is gonorrhea. Unlike trichomoniasis, men are more likely to contract this STI than women. Typically, the most common of gonorrhea symptoms is pain and burning in the genital tract (which directly correlates to a burning sensation in men after ejaculating). This can be accompanied by a thick, yellow discharge from the penis, as well as painful urination. Gonorrhea can be cured, but again, no known treatment can prevent a person from contracting this STI a second (or third, fourth, etc. ) time.

Non-STD Causes For Pain After Ejaculation

Of course STDs aren’t the only explanation for unusual post-ejaculation sensations or discomforts. Burning or pain after ejaculation can be the result of any of the following instances:

Prostatitis

Prostatitis, or inflammation or infection of the prostate gland, can cause pain during or immediately after ejaculation or urination. A urinary tract infection can be the cause behind prostatitis.

Prostate Cancer

Difficult or painful ejaculation or urination, as well as bloody discharge may be an early sign of prostate cancer (especially in men over the age of 65).

Nerve Damage

Nervous disorders can negatively affect muscles and nerves in and around the penis, making ejaculation and urination both rather unpleasant.

Radiation Therapy

Recent radiation therapy to the pelvic region can cause a number of unusual (although temporary) side effects including painful ejaculation.

Kidney Stones

More times than not, kidney stones can be passed without interfering with the ejaculatory duct, but such is not always the case. Kidney stones can be the reason behind a number of painful penile sensations, not just ejaculation.

Psychological Conditions

If your doctor cannot pinpoint a physical ailment as the cause of your post-ejaculation discomfort, the problem may be psychological. For instances such as this, you’ll want to seek the services of a professional therapist.

Diagnosing Painful Ejaculation Conditions

Because burning after ejaculation and painful ejaculation in general are so common, and yet indicative of so many different possible conditions, there is no blanket solution for diagnosis or treatment. If you’re experiencing additional signs in line with a particular STD, or even if you’re asymptomatic but feel you may have been exposed, you can always take an STD test. Of course, hosting an open and honest discussion with your physician is always a reliable course of action.

Living With Painful Ejaculation

It’s perfectly normal and completely understandable for grown men to be at least a bit embarrassed about a condition such as this. Just know that it is nothing to be ashamed of and, unbeknownst to you, it has probably impacted (or is currently impacting) a number of your own friends and family members. It is far more common than people think. Fortunately, most of the conditions that can cause painful ejaculation are treatable if not curable. So if you are experiencing a burning after ejaculation, just know that it likely will not last forever (providing, of course, that you meet with your doctor and follow their prescription regimen accurately and fully). Your best bet is going to be to meet with your physician as soon as you notice something is out of the ordinary.

Treatment Options to Relieve Painful Ejaculation

STDs

Chlamydia, trichomoniasis, and gonorrhea are all treatable and curable, typically through a regimen of antibiotics and your physician will be able to determine the best treatment regimen for you. It’s important that you abstain from sexual activity with partners until you’ve completed your regimen fully and the infection has completely subsided. In addition, if you do test positive for any STD or STI, you’ll want to notify any and all recent sexual partners so they can get tested and, if appropriate, begin treatment of their own. Remember, these STDs may cause no noticeable signs whatsoever. For this reason, reputable STD testing is highly recommended.

Non-STDs

Depending on the specific condition responsible for your ejaculation discomfort, your physician will be able to prescribe and guide you through the right treatment option(s). Some conditions can be cured by way of a simple injection or pill while others will require more complex plans of attack (surgery, radiation, etc.).

How to Minimize Your Risk

Unfortunately, certain conditions that cause pain after ejaculation are simply unavoidable and there’s no way around that. However, you can minimize your risk of developing certain conditions by maintaining a healthy diet, exercising regularly, and generally taking care of your body. Regular checkups with your trusted physician are always suggested as well. In addition, you’ll want to always adhere to safe sex practices to help reduce the risk of contracting or spreading STDs.

In Summary

Experiencing pain after ejaculation is nothing to be embarrassed about. And as uncomfortable as it may be to address it openly, it is in your best interest to alert your physician as early on as you can. The sooner you consult with your physician and/or take a reliable STD test, the sooner you can start treatment and get back on the path to wellness. And if you’re looking for trusted STD testing services in your area, we can help.

Prostatitis | HealthLink BC

Topic Overview

What is prostatitis?

Prostatitis is swelling or infection of the prostate gland. It often hurts. The prostate gland sits just below a man’s bladder and makes part of the fluid for semen. In young men, the prostate is about the size of a walnut. It usually grows larger as you grow older.

There are several types of prostatitis. They vary based on how long a man has had the problem and what kind of symptoms he has.

What causes prostatitis?

Sometimes prostatitis is caused by bacteria, but often the cause is not known.

What are the symptoms?

Symptoms of long-term (chronic) prostatitis are often mild and start slowly over weeks or months. They may include:

• An urge to urinate often. But you may pass only small amounts of urine.
• A burning pain when you urinate.
• A problem starting the urine stream, urinating in waves rather than in a steady stream, urine flow that is weaker than normal, and dribbling after urinating.
• Waking up at night to urinate often.
• A feeling of not completely emptying your bladder.
• Pain in your lower back, in the area between the testicles and anus, in the lower belly or upper thighs, or above the pubic area. Pain may be worse during a bowel movement.
• Some pain during or after ejaculation.
• Pain in the tip of your penis.

Symptoms of acute prostatitis are the same, but they start suddenly and are severe. They may also include a fever and chills.

Some men may have no symptoms.

How is prostatitis diagnosed?

A doctor can often tell if you have prostatitis by asking about your symptoms and past health. He or she will also do a physical examination, including a digital rectal examination. In this test, the doctor puts a gloved, lubricated finger in your rectum to feel your prostate. You may also need blood and urine tests to find out which type of prostatitis you have or to look for another cause of your problems.

How is it treated?

Prostatitis caused by bacteria is treated with antibiotics and self-care.

Home treatment includes drinking plenty of fluids and getting lots of rest. Taking over-the-counter pain relievers can also help.

Your doctor may prescribe medicine to control pain and reduce swelling. He or she may also prescribe medicine to soften your stool and relax your bladder muscles.

Surgery is rarely used to treat prostatitis.

Cause

Chronic prostatitis

Most men with prostatitis have chronic prostatitis, which may also be called pelvic pain syndrome. The cause of this type of prostatitis is not known.

Acute prostatitis and chronic bacterial prostatitis

Bacteria infecting the prostate cause acute prostatitis and chronic bacterial prostatitis. Bacteria most likely enter the prostate by:

• Travelling through the urethra.
• Being present in the urine because of a bladder infection.
• Being introduced through the use of a urinary catheter.

Symptoms

The symptoms are similar for all forms of prostatitis, with the exception of acute prostatitis.

Symptoms of chronic prostatitis may include:

• A frequent urge to urinate, although you may pass only small amounts of urine.
• A burning sensation when urinating (dysuria).
• Difficulty starting urination, interrupted flow (urinating in waves rather than a steady stream), weaker-than-normal urine flow, and dribbling after urinating.
• Excessive urinating at night (nocturia).
• A sensation of not completely emptying the bladder.
• Pain or discomfort in the lower back, in the area between the testicles and anus, in the lower abdomen or upper thighs, or above the pubic area. Pain may become worse during a bowel movement.
• Pain or vague discomfort during or after ejaculation.
• Pain in the tip of the penis.

With acute prostatitis, symptoms are severe, come on suddenly, and include fever and chills. Signs of chronic bacterial prostatitis may be milder and come on suddenly or gradually over weeks or months, and the symptoms may come and go. Symptoms alone cannot be used to determine the type of prostatitis you have.

Other conditions, such as a bladder infection or benign prostatic hyperplasia (BPH), can cause symptoms similar to those of prostatitis.

What Happens

Prostatitis, especially if it continues for a long time, can cause stress, anxiety, and depression.

Chronic prostatitis

Chronic prostatitis often gets better over time without serious complications. But the symptoms sometimes return unexpectedly.

Acute prostatitis

Men with acute prostatitis have severe pain and fever. Most men recover fully when treated with antibiotics. Delaying treatment increases the risk of complications, such as sepsis or an abscess in the prostate.

Chronic bacterial prostatitis

Chronic bacterial prostatitis can be difficult to treat, because some medicines have a hard time reaching the prostate.

Men with chronic bacterial prostatitis commonly have repeated urinary tract infections. The infection may spread to the epididymis.

The presence of infected prostate stones ( prostatic calculi) can make treatment of chronic bacterial prostatitis more difficult.

What Increases Your Risk

Things that can increase your risk for prostatitis include:

If you have had chronic bacterial prostatitis, you have an increased chance of developing it again.

When should you call your doctor?

Contact your doctor immediately if you have sudden fever, chills, and urinary symptoms, such as pain or burning with urination or blood or pus in the urine. These symptoms may point to acute prostatitis.

Call your doctor if you have:

• Urinary symptoms and persistent pain in the low back, scrotum, penis, or the area between the scrotum and anus, or if you have pain with ejaculation or with a bowel movement.
• Recurring urinary tract infections (UTIs).
• Discharge from your penis or sores on your genitals.
• Problems urinating, such as excessive nighttime urination, trouble starting urinating, decreased urinary stream, or frequent urination that is not related to drinking lots of fluids.

Watchful waiting

Most men will have some discomfort in their prostate (prostatitis) at some time during their lives. If you do not have a fever and chills or extreme pain, you may try home treatment for a few weeks. Take non-prescription pain medicines, such as aspirin, ibuprofen, or acetaminophen, to relieve pain. But if your urinary symptoms and pain continue, be sure to see a doctor.

Who to see

Your family doctor or general practitioner can evaluate and treat prostatitis. You may be referred to a specialist, such as a urologist.

Examinations and Tests

If your doctor suspects that you have prostatitis, he or she will begin with a complete medical history and physical examination. The type of prostatitis that you have cannot be determined solely from your history and symptoms. Your doctor will do tests to find out the cause of your prostatitis.

Acute prostatitis is the least common type but the easiest to diagnose. If acute prostatitis is suspected, a urine culture will be done to test for the presence and type of bacteria.

If your history and physical examination show that you do not have acute prostatitis, a pre- and post-massage test (PPMT) or expressed prostatic secretions test may be done to find out which type of prostatitis you have. An expressed prostatic secretions test is not done if acute prostatitis is suspected, because when the prostate is inflamed or infected, massaging it to obtain a sample for tests is very painful and possibly dangerous. Some doctors believe that massaging an infected prostate increases the risk of developing a bacterial infection of the blood (septicemia).

More tests may be needed if:

• Your symptoms do not improve with treatment.
• You continue to have prostate infections.
• The symptoms could be caused by bladder or prostate cancer.
• Your doctor suspects you have a complication related to prostatitis, such as an abscess.

Tests that may be done include:

Treatment Overview

Treatment for prostatitis usually begins with taking an antibiotic for several weeks. If you begin to feel better, you may have to take the medicine for 2 to 3 months. If you do not get better while taking antibiotics, more tests may be done.

Chronic prostatitis

You may need to try more than one treatment. There isn’t a standard treatment that works well for all men.

• Antibiotics are tried first. If your symptoms do not improve, treatment with these medicines is usually stopped.
• Muscle relaxants and alpha-blockers may be used if muscle spasms are causing pain or problems urinating.
• Medicines to reduce inflammation, such as non-steroidal anti-inflammatory drugs (NSAIDs), may relieve pain.
• 5-alpha reductase inhibitors, medicines that slow the growth of the prostate, may be used.
• Physical therapy, exercise, or massage therapy may help some men.
• Counselling, biofeedback, or relaxation techniques may help reduce stress that is contributing to the pain
• Certain plant extracts, such as bee pollen extract (Cernilton) or quercetin may provide some relief.^{footnote 1}

Acute prostatitis

Treatment for acute prostatitis is aimed at curing the infection and preventing complications. Acute bacterial prostatitis is treated with antibiotics, pain and fever medicine, stool softeners, fluids, and rest.

• If you are unable to urinate or need intravenous antibiotics, you may be admitted to a hospital for a short time for treatment.
• Most men get better quickly. Treatment (usually at home) lasts for 4 to 6 weeks.

Chronic bacterial prostatitis

Treatment for chronic bacterial prostatitis is aimed at curing the infection and preventing complications. Antibiotics are given for 6 to 12 weeks. Long-term antibiotic treatment may be needed if the infection returns.

• Infected prostate stones (prostatic calculi) can make the infection more difficult to cure. They may need to be surgically removed.
• Surgery may be needed if urinary tract problems, such as narrowing of the bladder neck or urethra, are causing the prostatitis.
• Surgical removal of the prostate (prostatectomy) for repeated infections is rarely used and is used only as a last resort.

Prevention

You may be able to prevent prostatitis.

• Practice good hygiene, and keep your penis clean.
• Drink enough fluids to cause regular urination.
• Seek early treatment of a possible urinary tract infection.

Home Treatment

Prostatitis is usually treated with antibiotics and other medicines prescribed by your doctor. But there are some things you can try at home that may help you be more comfortable:

• Take non-prescription pain relievers, such as non-steroidal anti-inflammatory drugs (NSAIDs) or acetaminophen. Be safe with medicines. Read and follow all instructions on the label.
• Sit in a tub of warm water with the water just covering your buttocks, or try a sitz bath.
• Take care of yourself. Get plenty of rest, and drink lots of fluids. This can help you feel better and may speed your recovery.
• Eat plenty of high-fibre foods, such as fruit, vegetables, and whole-grain breads and cereal. And drink enough water to avoid constipation. Straining to pass a bowel movement may be very painful when your prostate is inflamed, so use a stool softener if needed.
• Be physically active. Exercise, especially aerobic exercise, seems to help.^{footnote 2}
• Avoid any foods or activities that make your symptoms worse.
• Try stress management: deep breathing, relaxation, light exercise, and elimination of stressful circumstances.

Medications

Treatment of prostatitis usually begins with antibiotics and possibly other medicines to relieve symptoms. If you begin to get better, you may have to continue taking antibiotics for 2 to 3 months. During this time, be sure to take the antibiotics as prescribed. If you do not begin to get better while taking medicines, your doctor may want you to have more tests.

Medicine choices

Chronic prostatitis

Chronic prostatitis is usually treated first with antibiotics based on the possibility that you have an infection that didn’t show up during testing (false negative). But experts advise against long-term treatment with antibiotics unless an unusual bacterial infection is suspected.

Medicines that may be used to treat chronic prostatitis include:

• Antibiotics. If the symptoms begin to improve, it is possible that an undiagnosed infection is responsible for the symptoms.
• Medicines that reduce pain and inflammation (non-steroidal anti-inflammatory drugs [NSAIDs]).
• Medicines that relax muscles throughout the body (muscle relaxants) or that relax muscles in the prostate (alpha-blockers).
• Medicines that slow the growth of the prostate (5-alpha reductase inhibitors).
• Certain plant extracts, such as bee pollen extract (PollenAid) or quercetin. They may provide some relief.

Acute and chronic bacterial prostatitis

Antibiotics are central to treating acute or chronic bacterial prostatitis. Your doctor may prescribe certain antibiotics based on your medical history, symptoms, and other factors such as your age. Other medicines may also be used to help control symptoms, including:

Chronic bacterial prostatitis may require long-term antibiotics, especially if the symptoms return. Some men need treatment with low doses of antibiotics over a long period to control infection and prevent repeated urinary tract infections (UTIs).

Surgery

Surgery for prostatitis may be needed to treat chronic bacterial prostatitis that does not respond to long-term antibiotic treatment and that causes repeated urinary tract infections. Surgery may be done to remove part of the prostate or to remove infected prostate stones ( prostatic calculi). But this does not always cure the infection, and it may make the symptoms worse. Surgery is typically done only if all other treatments have failed.

Surgery choices

Surgical removal of part of the prostate to remove prostate stones or to treat an infection that does not respond to antibiotic treatment is called transurethral prostatectomy.

Surgery to remove part of the prostate that is blocking urine flow is called transurethral resection of the prostate (TURP). This type of surgery may be done in men with benign prostatic hyperplasia (BPH) who are having problems with prostatitis.

Other Treatment

Other treatments that may be helpful for prostatitis include:

References

Citations

1. Anothaisintawee T, et al. (2011). Management of chronic prostatitis/chronic pelvic pain syndrome. JAMA, 305(1): 78–86.
2. Nickel JC (2012). Prostatitis and related conditions, orchitis, and epididymitis. In AJ Wein et al., eds., Campbell-Walsh Urology, 10th ed., vol. 1, pp. 327–356. Philadelphia: Saunders.

Other Works Consulted

• Gupta K, Trautner BW (2015). Urinary tract infections, pyelonephritis, and prostatitis. In DL Kasper et al., eds., Harrison’s Principles of Internal Medicine, 19th ed., vol. 2, pp. 861–868. New York: McGraw-Hill Education.
• Powell CR (2015). Prostatitis. In ET Bope, RD Kellerman, eds., Conn’s Current Therapy 2015, pp. 1008–1010. Philadelphia: Saunders.

Credits

Current as of:
May 28, 2019

Author: Healthwise Staff
Medical Review:
E. Gregory Thompson MD – Internal Medicine
Donald Sproule MDCM, CCFP – Family Medicine
Adam Husney MD – Family Medicine
Christopher G. Wood MD, FACS – Urology, Oncology

Current as of: May 28, 2019

Author: Healthwise Staff

Medical Review:E. Gregory Thompson MD – Internal Medicine & Donald Sproule MDCM, CCFP – Family Medicine & Adam Husney MD – Family Medicine & Christopher G. Wood MD, FACS – Urology, Oncology

Prostatitis: inflamed prostate can be a vexing health problem

When it comes to prostate trouble, the lion’s share of attention goes to prostate cancer and an enlarged prostate. A third condition, prostatitis, flies under the radar even though it affects up to one in six men at some point in their lifetimes. It triggers more than two million visits to doctors and untold agony each year.

Prostatitis, which means inflammation of the prostate gland, is an equal opportunity disorder. Unlike prostate cancer and benign prostatic hyperplasia (BPH), which predominantly affect older men, prostatitis affects men of all ages.

Prostatitis refers to a loose assemblage of syndromes characterized by urinary problems such as burning or painful urination, the urgent need to urinate, trouble voiding, difficult or painful ejaculation, and pain in the area between the scrotum and rectum (known as the perineum) or lower back. Although it causes some of the same symptoms as BPH and can occur at the same time, prostatitis is a separate condition.

Some types of prostatitis are caused by bacterial infection. These cases are often accompanied by the classic symptoms of infection, such as fever, chills, and muscle pain along with urinary problems. As a result, they are relatively easy to diagnose and treat, and they usually respond well to antibiotics. Unfortunately, such straightforward forms of prostatitis are the minority.

Physicians aren’t sure what causes the rest. Potential culprits include difficult-to-detect bacteria, inflammation, depression and stress, and mechanical or neuromuscular problems in the pelvic muscles that irritate the general area. This uncertainty is what can make the treatment of prostatitis so maddening.

Types of prostatitis

Prostatitis is classified into four categories, each with its own treatment approach

Acute infection of the prostate

This sudden-onset infection is caused by bacteria that travel from the urethra, and perhaps from the rectum, to the prostate. It’s the least common but most dramatic form of prostatitis, beginning abruptly with high fever, chills, joint and muscle aches, and profound fatigue. In addition, you may have pain around the base of the penis and behind the scrotum, pain in the lower back, and the feeling of a full rectum. As the prostate becomes more swollen, you may find it more difficult to urinate, and the urine stream may become weak. (If you can’t urinate at all, it’s a medical emergency; this usually means the prostate is so swollen that it’s completely blocking urine flow. Depending on the severity of symptoms, hospitalization may be necessary.)

Antibiotics are the standard treatment and are highly effective for this form of prostatitis Typical choices include fluoroquinolones—such as ciprofloxacin (Cipro), levofloxacin (Levaquin), and ofloxacin (Floxin)—and trimethoprim/sulfamethoxazole (Bactrim, Septra, Cotrim). It’s important to continue your medication for the entire prescribed course, even if you are feeling better. This will help prevent your infection from returning.

To help ease any discomfort, try sitting in a hot bath, take stool softeners, and use over-the-counter pain relievers, such as aspirin or ibuprofen. Drinking plenty of fluids can help flush the bacteria from your system, too.

Chronic bacterial prostatitis

This type of prostatitis is also caused by bacteria. It’s more common in older men who have BPH. It sometimes follows a bout of acute bacterial prostatitis. Unlike the acute form, however, chronic bacterial prostatitis is a subtle, low-grade infection that can begin insidiously and persist for weeks or even months.

A man with chronic bacterial prostatitis usually doesn’t have a fever, but is troubled by intermittent symptoms such as a sudden urge to urinate, frequent urination, painful urination, or the need to get up at night to urinate. Some men have low back pain, pain in the rectum, or a feeling of heaviness behind the scrotum. Others have pain after ejaculation, and the semen may be tinged with blood. These symptoms wax and wane, and they are sometimes so understated that they aren’t noticeable.

Treatment requires the same antibiotics used for the acute form, usually for one to three months, but even with the prolonged treatment, the infection often recurs. If this happens, the recurrence can usually be controlled with another course of antibiotics.

Chronic nonbacterial prostatitis

Chronic nonbacterial prostatitis, also known as chronic pelvic pain syndrome is the most common form of prostatitis. Its symptoms resemble those of chronic bacterial prostatitis. Yet no bacteria are evident, and pinpointing a cause or causes has been difficult.

Research suggests that chronic nonbacterial prostatitis may result from a cascade of interconnected events. The initiating event may be stress, an undetectable infectious agent, or a physical trauma that causes inflammation or nerve damage in the genitourinary area. Over time, this may lead to heightened sensitivity of the nervous system. In other words, CP/CPPS may be an overactive pain syndrome. What’s more, some physicians and researchers are beginning to think that the condition may affect the entire pelvic floor—all of the muscles involved with bowel, bladder, and sexual function—not just the prostate gland.

Because men often suffer from multiple symptoms simultaneously—such as pain and difficulty urinating—they may require several types of medication or other therapy, depending on the pattern of symptoms. These include antibiotics, Pain relievers, a medication to reduce the urge to urinate, a medication to ease urine flow by relaxing the muscles at the neck of the bladder, and even some alternative therapies such as myofascial release. (HarvardProstateKnowledge.org will explore treatments for chronic nonbacterial prostatitis/chronic pelvic pain syndrome in a future article.)

Asymptomatic inflammatory prostatitis

This is usually discovered during tests for another medical condition, such as infertility or other prostate disorders. White blood cells are present in the urine or prostate secretions, but there are no symptoms. With no symptoms and no known cause, it isn’t treated.

As a service to our readers, Harvard Health Publishing provides access to our library of archived content.
Please note the date of last review or update on all articles. No content on this site, regardless of date,
should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

Commenting has been closed for this post.

Prostatitis – A Patient’s Guide — Mount Sinai Hospital

This guide is to help men better understand what prostatitis is all about and how to deal with it in the most effective way.

Please do not use this guide for self diagnosis. You should always consult your doctor before attempting any kind of treatment.

1. What is the prostate gland?

2. What is Acute Prostatitis?

3. What is Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS)?

4. What causes Chronic Prostatitis?

5. How do we diagnose Prostatitis?

6. If I am diagnosed with Chronic Prostatitis, what treatment options are available?

What is the Prostate Gland?

The prostate is a gland about the size and shape of a walnut. It is situated just underneath the urinary bladder (just under bladder neck) and surrounds a portion of urethra (prostatic urethra). The urethra is a tube that allows the passage of urine from the bladder through the penis when you pee.

The prostate gland consists of hundreds of tiny glands (acini) that secrete a fluid called prostatic fluid. Numerous tiny channels (prostatic ducts) merge into larger ducts (like creeks into a river) and drain prostatic fluid into the urethra. The entire prostate is surrounded by smooth muscles that cannot be controlled by will.

Prostatic fluid gets squeezed out during ejaculation with the help of muscular contractions, and mixes with other fluids to make the semen. This prostatic fluid consists of many elements that help to make the sperm fertile.

The prostate gland is a hormone-dependent organ. Prostate development and function are influenced by the male hormone testosterone. This hormone is mainly produced by the testicles and released into the bloodstream. Once the testosterone enters the prostate it promotes prostate growth. Without testosterone, the prostate gland shrinks to a fraction of its normal size.

We often see low levels of testosterone in men aged 40 or older. Low testosterone levels may, in turn, affect the function of the prostate, lead to sexual dysfunction or be responsible for a number of other health problems. In general terms, this is referred to as Andropause.


Most common prostate problems:

• Prostatitis (inflammation of the prostate)
• Benign Prostatic Hyperplasia (BPH)
• Prostate cancer

Prostatitis is divided in two major categories: Acute Prostatitis and Chronic Prostatitis (CP).

What is Acute Prostatitis?

Acute Prostatitis is not very common in modern western society. Usually it affects younger men who have never had any prostate problems. Symptoms of acute prostatitis include pain in the lower pelvic area, testicles and perineum (area between scrotum and anus), high fever and the frequent urge to pee, accompanied by a burning sensation. Occasionally, a swollen prostate blocks the urinary passage, making it difficult for you to pee even though you have a full bladder. This condition is referred to as Acute Urinary Retention (AUR).

Acute prostatitis occurs when bacteria are introduced into the prostate. Bacteria may reach the prostate from the urinary tract or travel via the bloodstream from other areas such as the lower portion of large bowel (rectum), gallbladder, infected teeth or gums.

If you develop any of these symptoms, you should see a doctor as soon as possible. This condition can be cured with prompt treatment using antibiotics.

If you develop Acute Urinary Retention (AUR), you need to be treated immediately in a hospital. A catheter will be inserted into your bladder through the penis to relieve the obstruction. This may be followed up by several weeks of antibiotics. With proper treatment, you can be completely cured after a few weeks of therapy. Chronic Prostatitis patients require a longer, more comprehensive treatment.

What is Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS)?

This is a very common condition worldwide. It has been suggested that up to 25 per cent of all men have experienced symptoms of prostatitis at some point in their lives. At any one time, about 10 to 14 per cent of men in the community experience some prostatitis-like symptoms.

Prostatitis symptoms include:

• Pain
  
  If you have CP, you may experience a dull, throbbing pain, a sensation of irritation or heaviness. It may be located anywhere in the lower pelvic region (groin, pubic area, perineum, and lower back), genitals (penis, scrotum). Sometimes it travels to hips, thighs or upper abdomen. Usually the pain comes and goes, and varies in intensity. You may have “good” days alternating with “bad” days. You often don’t know what has triggered a “bad” day.

• Voiding
  
  The most common symptoms are: frequent and urgent need to pee, burning when you pee, weak flow, feeling of an inability to empty your bladder completely, and the need to get up more frequently than normal at night to pee. These symptoms often interfere with daily activities.

• Sexual dysfunction
  
  You may also have difficulty getting and/or keeping an erection during sexual activity, and have low sexual desire.
  
  You may also experience rapid (premature) ejaculation, and pain or discomfort upon or soon after ejaculation. Up to 50 per cent of men with prostatitis symptoms complain about ejaculatory or post-ejaculatory pain.

• General symptoms
  
  You may experience fatigue, lethargy, headaches, low energy level, aches and pains all over the body, particularly during “bad” days. You may also feel unhappy or depressed.
  
  Several surveys have confirmed that the quality of life among men suffering from prostatitis symptoms is very poor and can be compared to the quality of life of patients who suffer from severe health problems such as heart attack, unstable angina, Inflammatory Bowel Disease, congestive heart failure or severe form of diabetes.

• Asymptomatic prostatitis
  
  Some men with inflamed prostates do not have any symptoms. They are usually diagnosed with prostatitis while being checked for something else such as an elevated Prostate-specific Antigen (PSA), which is a blood test to screen for prostate cancer, BPH (Benign Prostatic Hyperplasia), or male infertility.

What Causes Chronic Prostatitis?

Unfortunately, it is not known exactly what causes chronic prostatitis. The oldest and most widely accepted theory suggests that chronic prostatitis is caused by a bacterial infection. Others have suggested that prostatitis may be due to autoimmune conditions or chemical irritation of the prostate. Most likely, there is no single cause of prostatitis but rather multiple conditions that lead to an inflammation of the prostate resulting in chronic prostatitis.This theory is supported by patients responding well to antibiotics.

Nevertheless, there are many men who do not respond well to antibiotics. In these cases, we need to look for other potential causes to the problem or factors that may predispose men to this painful condition.

Here is a list of other possible causes and contributing factors:

• Possible anatomical abnormalities within urogenital tract (e.g. tight bladder neck, urethral narrowing, tight/inflamed foreskin, BPH)
• History of sexually transmitted diseases (Gonorrhea, Chlamydia, Trichomoniasis, etc.)
• Sexual behaviours (engagement in unprotected sex with multiple sexual partners, excessive sexual activities)
• Gastro-intestinal disturbances (Irritable Bowel Syndrome, colitis, constipation, etc. )
• High stress level (marital discord, unemployment, demanding job, etc.)
• History of mechanical trauma to the lower pelvis area (excessive cycling, boating, operating heavy machinery, and/or horseback riding)
• Overall compromised immune system due to other chronic illnesses and/or medications

In addition, there are a number of factors that may make prostatitis symptoms more severe. These include:

• Dietary habits (spicy, marinated or pickled foods)
• Consumption of alcohol, caffeinated beverages
• Stress
• Some sport activities (cycling, running, heavy weightlifting)
• Excessive sexual activities

We have listed just a few important factors that can play a role in prostatitis and prostatitis-like symptoms. A thorough assessment by your doctor is necessary to determine what particular factors are relevant in your case.

How do we diagnose prostatitis?

One of the most important tools for diagnosing prostatitis is a detailed history of your symptoms, medical history, sex life, lifestyle, and dietary habits. These are very important and help the clinician choose the potential therapies.

A focused physical examination of external genitalia and pelvic area may provide your physician with many clues.

The next step is to have your prostate gland examined by performing a Direct Rectal Examination (DRE). A physician inserts a lubricated, gloved finger into your rectum and examines the prostate, which lies very close to the surface of the rectal wall. This exam is important because your doctor can often establish a diagnosis by assessing the shape, texture and the size of the prostate. Urine samples are usually collected before and after the prostate examination. The results of these tests may help to determine whether you have a problem in your urethra, your prostate or your bladder.

In order to make the diagnosis even more accurate, the prostate is gently pressed using a special technique. This can yield some prostatic fluid from the opening in the urethra at the tip of the penis. This fluid is examined under the microscope in order to identify cells of inflammation or other clues, and/or is sent to the lab for further testing.

Please be aware that the latter tests usually are performed in specialized urology clinics as are other, more invasive procedures such as a Cystoscopy, where the doctor looks inside your urethra and bladder in order to rule out possible abnormalities within the lower urinary tract (e.g. urethral narrowing, Urethritis, bladder tumor, etc.).

If your physician has trouble diagnosing prostatitis or the symptoms do not exactly fit the prostatitis profile, you may be asked to undergo other specialized tests or referred to another specialist.

If I am diagnosed with Chronic Prostatitis, what treatment options are available?

The good news is that there are a variety of treatments available, both traditional and non-traditional. The challenge is to identify the best treatment for you.

If bacteria are the cause of your symptoms, antibiotics would be the first line of therapy. They could be combined with an anti-inflammatory medication, and prostatic massages/drainages (as described earlier).

If you are having problems peeing, alpha-blockers are often prescribed. They help to relax the smooth muscles within the prostate and the bladder neck, and therefore, improve your ability to pee.

If you have constant pain in the perineum as well as trouble peeing, you may have pelvic floor muscular tension. In this case, you may benefit from physiotherapy, stretching exercises, yoga, biofeedback and acupuncture. Please remember that it is very important to be thoroughly assessed before embarking on alternative therapies.

Phytotherapy (herbal therapy) is growing in popularity. There is a long list of herbal remedies suggested for CP. The best known are: Saw Palmetto, Pygeum Africanum, Quercetin, Flower Pollen Extract, Stinging Nettle, Pumpkin Seed Extract and Uva-Urzi.

We have found that this kind of therapy is most helpful in cases where your symptoms are mild and you only need therapy to make the prostate healthier. Phytotherapy usually requires a few months of continuously taking supplements.

Lifestyle adjustments and diet are two of the most important factors in ensuring a healthier environment for the prostate. As examples, we often suggest that men reduce coffee intake, reduce stress, and avoid citrus fruits. In order to determine what type of adjustments you might require, please consult your doctor.

You may wonder how it is possible that one small gland can inflict so much misery on so many men. We know that prostatitis does not kill, but it can make life quite unpleasant. Since the beginning of the 20th Century, many physicians have regarded the prostate as a second heart in men. That statement is still valid. We need to maintain good prostate health just as we try to maintain good heart health.

For more information, please contact:

Ilia Kaploun

Clinical Trials Nurse

Prostatitis Clinic

Murray Koffler Urologic Wellness Centre
416-586-4800 ext. 3982

90,000 Itching after intercourse – what to do?

Itching after sexual intercourse can occur in men and women for various reasons, and this symptom cannot be ignored – you must consult a doctor (gynecologist, dermatovenerologist or urologist). The doctor will conduct an examination, take smears from the mucous membrane of the genitals and send them to the necessary tests.

If you endure discomfort or self-medicate, the disease will turn into a chronic form that is difficult to treat, or complications will arise, including infertility. So do not wait for the itching and burning sensation to disappear and contact a specialist.

Why do men and women experience itching after intercourse?

Itching and burning after intercourse may appear immediately or after a while. If the discomfort is associated with microdamage to the mucous membrane of the vagina or penis (for example, due to violent sex), then it will soon pass without consequences.

Also, these signs can disturb the patient due to:

• non-compliance with personal hygiene;

90,017 frequent use of antiseptics when washing the genitals;

• wearing low-quality synthetic underwear that impedes air circulation, as a result of which an environment favorable for the growth of bacteria is created.

If these factors are excluded, then burning and itching after intercourse can cause infectious diseases, incl. sexually transmitted diseases. But not all of them are venereal. For example, vaginal candidiasis (a pathology of a fungal nature) can occur due to uncontrolled prolonged use of antibacterial drugs or a decrease in immunity. In this case, the discomfort will be accompanied by white cheesy discharge.

Causes of an infectious nature that cause itching after sex in both sexes include:

1. Chlamydia.With this pathology, women experience bloody spotting after coitus. Also characteristic are pain in the lower abdomen and lower back, purulent discharge from the vagina. When urine is diverted, the urethra itches. Men are worried about pain in the scrotum and lower back, as well as purulent discharge from the urethra.
2. Trichomoniasis. This disease is manifested not only by the desire to scratch the vulva or penis, but also by discomfort during urination, the presence of uncharacteristic foaming discharge of yellow or yellow-green color with a fishy odor. In men with trichomoniasis, red spots appear on the penis due to constant irritation of the mucous membrane with pus.
3. Mycoplasmosis and ureaplasmosis. Burning and pain when urinating, discomfort in the vagina during and after coitus, pain in the lower abdomen, yellow discharge with an unpleasant odor are symptoms of pathology in women. In men, mycoplasmosis is manifested by slight pain in the groin and scanty discharge from the urethra.
4. Genital herpes. The main signs of the disease are a strong desire to scratch the genitals and the presence of bubbles with watery contents on their mucous membrane.Patients may complain of headache, deterioration of health and fever.
5. HPV. With this pathology, women may experience excruciating itching against the background of the formation of genital warts or thickening of the skin or mucous membrane. In men, the rash on the head of the phallus does not itch.
6. Pubic lice. The intensity of discomfort in this pathology is individual. The second sign of the presence of lice is spots on the skin of a steel color, which are of medium size (up to 1 cm in diameter).
7. Helminthiasis. The eggs of parasites from the anus can enter the vestibule of the vagina and provoke severe discomfort.
8. Infections of the intestinal group – staphylococci, Escherichia coli, streptococci. Unpleasant sensations often occur with dysbiosis. First, the anus itches, after – the external genitals and the vagina.
9. Scabies. With this pathology, not only the vulva (penis) itches, but also the lower abdomen, thighs. The patient notes the appearance of a small rash.

A burning sensation, redness of the genitals and itching in a woman after intercourse without a condom can be a symptom of a semen allergy. In this case, it is necessary to pass allergy tests. Dryness of the mucous membrane makes you want to scratch the perineum. Another discomfort worries the fair sex if, for various reasons, an inflammatory process develops – vaginitis, colpitis or vulvovaginitis.

In women, the vagina may itch with endometritis (due to irritation of the mucous membrane with exudate), as well as with urethritis during urine diversion (due to irritation of the urine canal).

In men, after intercourse, the penis itches in case of allergy to the lubricant or latex condom used. In this case, red spots appear on the phallus. These symptoms disappear after taking an antiallergic drug and stopping contact with the allergen.

There are cases when the tests for STIs are negative, the woman monitors the hygiene of the genitals properly and does not wear synthetic underwear, and she is worried about itching. Why? In women after 45 years, namely during menopause, vaginal tissue begins to thin out.This process can progress in the presence of autoimmune diseases. Atrophic changes lead to the development of the following pathologies:

• Kraurosis of the vulva. The occurring age-related changes in the mucous membrane are manifested by itching and dryness of the entrance to the vagina, its stenosis, changes in the clitoris and labia of a sclerotic nature.
• Atrophy of the vaginal mucosa. At the same time, dryness, the desire to scratch the vagina and painful sensations occur during and after coitus.
• Urogenital fistulas. Typical for women with a history of gynecological or urological surgery, delivery by cesarean section.

There are a number of pathologies in which the genitals itch, while the cause of the discomfort is not associated with the genitourinary system. Among them are diabetes mellitus, frequent stress and overwork, disorders in the functioning of the thyroid gland, kidneys or liver, cystitis and blood pathologies.

What to do if itching worries after intercourse?

If itching occurs after intercourse in men or women, then the most important thing is to see a doctor.The doctor will be able to diagnose the disease and draw up an effective treatment regimen.

It is important here:

• Strictly follow the instructions of the attending physician, taking all drugs according to the scheme.
• Ensure sexual rest during and after therapy, until test results indicate complete recovery.
• Pass a diagnosis to a sexual partner in order to identify an ailment (some pathologies at the initial stage are asymptomatic or less pronounced, so a person does not think about the need to see a doctor).
• 30 days after the last pill is consumed (injection, ointment, etc.), take tests and show the results to the attending physician.

Do you want the itch to never bother you after intercourse? Do not have sex with partners in whose health you are not sure – avoid casual relationships. After all, even a condom does not give a 100% guarantee of protection against genital infections.

If any symptoms of the disease appear, do not postpone a visit to a specialist. Be healthy!

The author of the article is Sergey Yuryevich Melnikov, chief physician, dermatovenerologist, urologist, mycologist, andrologist of the highest medical category.

Read also:

90,000 10 things that happen to your body right after sex – HEROINE

When you and your partner just lay down on different sides of the bed after rough sex, you do not pay attention to reddened cheeks or the fact that you literally want to cry from anything. This is fine. Let’s discuss what else can happen to you when you recover from intimacy.

1. Your vulva itches

You may feel itching in the lower abdomen, thighs or outer labia – most likely this is how your body reacts to inappropriate condoms, lubricant or partner sperm.This often happens when you are trying to switch to new foods, but allergies can come on suddenly. If you experience scabies once or twice, then it’s okay – it will go away on its own. In case the itching does not subside or is even accompanied by hives and swelling, consult a doctor.

2. Sperm flows out of you

If you and your partner are trying to conceive or are using a non-barrier method of contraception, do not be surprised that no semen lingers in your body. Take a shower after sex and everything will go away.

3. You become sensitive

And at the same time you can be angry, agitated or even feel something similar to depression – this is called postcoital dysphoria. Usually, after orgasm, dopamine levels rise sharply, and then just as rapidly drop, the level of dopamine, which creates the difference in mood. Family therapist Katie Ziskind claims that this is normal: after sex, a woman can feel happy, cry with joy, or be emotionally aroused.If it does not interfere with sexual intercourse and does not bother you personally, then everything is in order. Otherwise, you can visit a psychotherapist and understand why exactly this condition occurs.

4. You really want to go to the toilet

Even if you visit the bathroom before sex, you may feel the urge again afterwards. The reason is simple: during intimacy and orgasm, the pelvic muscles contract, affecting the bladder and creating spasms in it. Once you empty it, everything will pass.

5.You smell strange

Sex is not a bad kind of physical activity, so it makes sense that you sweat. Plus, your scent is likely to mix with your partner’s scent, so you might even stink. The same goes for the vulva and underwear, especially if you prefer bareback sex. Usually, no one pays attention to this, the main thing is to make sure that the negligee does not smell like fish or rotten meat – this is a sign of infections.

6. Vagina bleeds

If this is an isolated case, then, most likely, you and your partner either started too abruptly, or do not converge in size.There is nothing to worry about: use lubricant next time. However, when there is too much blood, it goes for no reason, or the bleeding continues for more than a few hours, then this is a reason to visit a gynecologist and check if you have an STI or other problems with the reproductive system.

7. There are burns and irritation on the pubis

This is also called “carpet burns” – they can appear from friction of the skin on rough surfaces. Perhaps you both have pubic hair, or your partner, while doing cunnilingus, did not shave off three days of stubble.Nothing to worry about, unless traces remain.

8. Air comes out of the vagina

With rapid frictions, air accumulates in the vagina, which can then come out when you take a break or you have an orgasm. But, if you had sex in positions that do not involve high activity, or the vagina “farts” even when it’s over long ago, this may indicate weakened pelvic floor muscles.

9. Cheeks flushed sharply and turned white

It is generally accepted that after sex the cheeks of both partners literally burn red, but the assistant professor of obstetrics and gynecology at the University of Ohio Jonathan Shaffir thinks differently: she claims that the blush appears only during arousal.After orgasm, the blood vessels relax – and the skin of the chest, neck and face turns white.

10. It hurts to go to the toilet

It is important to urinate immediately after sex: sexually transmitted infections can enter the urethra, and urinating helps to get rid of them, provided that you visit the toilet within a few hours after intimacy.

Sometimes at the same time you can experience a burning sensation and tingling: most likely, during sex you did not have enough lubrication, because of which the vulva and vagina were irritated, which was transmitted to the ureter.If the discomfort continues, you may have an STI or bacterial infection.

Related Read: 8 Amazing Things Your Body Can Do

Add to favorites

Related articles:

90,000 main reasons why “there” burns

Every third woman has ever experienced a burning sensation inside the vagina.Cosmo, with the help of experts, identified the main reasons why “there” burns, and with what it is connected.

Experienced gynecologists have explained the most common reasons why you may feel a burning sensation inside the vagina during or after sex.

Have you ever experienced a burning sensation during or after intercourse? Poll Options are limited because JavaScript is disabled in your browser.

• Yes 95%, 41381 vote

  41381 vote 95%

  41381 vote – 95% of all votes

• No 5%, 2407 votes

  2407 votes 5%

  2407 votes – 5% of all votes

Total votes: 43788

14.06.2019

×

You or from your IP have already voted.

one

It is possible that your washing powder or rinse aid is to blame for everything

Felice Gersh, MD, Director of the Integrative Medical Group and Gynecologist, explains that certain ingredients in laundry detergents can cause vaginal burning. Colors, fragrances, enzymes, parabens, solvents, emulsifiers and other chemicals can directly irritate the skin or cause an allergic reaction.Gersh adds that chemical odors in detergents are common causes of skin rashes or burns.

The best way to determine if a detergent is to blame is to stop using it immediately. To relieve the burning sensation, apply aloe gel or shea butter. Try substituting detergents with fewer chemicals in the form of dyes or fragrances. If irritation persists within a few days, it is best to see a doctor.

2

Perhaps it’s all about your underwear

Do you like to wear thongs? We’ll have to stop loving. Gersh says thongs can irritate the vagina and lead to inflammation. Chronic inflammation can lead to an overgrowth of bacteria, which, in turn, is a “co-trigger” for urinary tract infections. Another fun fact: the thong is attached to your anus, and fecal bacteria can move to the vagina, which can also trigger an infection.

3

Stress is one of the triggers

According to Lauren Garcia, MD and editor of the women’s intimate health blog, stress can affect the release of natural vaginal lubrication. Any alarming circumstance can cause vaginal dryness, which can later turn into a burning sensation. To avoid these unpleasant moments, calm down first. Sex is the best stress reliever, so use a water-based lubricant the next time you have intercourse.

4

Tampons

Janelle Luc, co-founder of Generation Next Fertility, says there are many reasons why using a tampon can cause a burning sensation in the vagina. If you insert a tampon incorrectly, insert it too deeply and do not change it often, then these things directly irritate the vaginal mucosa and lead to a burning sensation. In this case, stop using tampons and switch to pads.

five

Throw away soap and other intimate hygiene products

Never, know that you should never wash yourself with soap! Neither for children, nor household, nor liquid, nor any other:

“There are mechanisms inside the vagina to maintain the pH level,” says Dr. Dweck.It is best to rinse the tender area with water.

6

Depilation

When you remove unwanted hair through deep depilation, it can cause irritation. Try shaving in the direction of hair growth, not against. It should be the same with wax or sugar.

7

Irritation from lubricant or condom

Some girls may feel a burning sensation from using some lubricants or condoms. Gynecologist Lea Milheiser advises getting rid of lubricants that contain glycerin.This is especially highly recommended for those with sensitive skin. If you are hypersensitive to lubricants, the natural alternative is coconut oil.

eight

Rarely, but sperm irritation occurs

Some girls are sensitive to semen. “There are women who have a reaction to semen. Some may even have allergies, ”says Dweck. Use a condom in this case, or even better, visit a gynecologist to rule out the facts of vaginal dysbiosis, STIs and thrush.

nine

It could be an infection

Thrush and bacterial vaginosis can cause inflammation of the vaginal mucosa, which provokes a burning sensation. If you like to stick fingers, toys or other things in there, it is better to postpone it. These infections are accompanied by secretions, so you may be feeling a burning sensation.

Urinary tract infections or UTIs not only make you feel uncomfortable while urinating, but can also cause a burning sensation during sex.If you are diagnosed with a UTI, you will need antibiotic treatment for two weeks.

Symptoms of STIs cause burning during and after sex. Infections in the form of gonorrhea and chlamydia can cause inflammation of the mucous membranes, which turns into a burning sensation every time you have sex or walk around.

When should I see a doctor?

Pay attention to the duration of the burning problem in the vagina. If this is an isolated incident, then you have nothing to worry about.If you experience discomfort every time or after sex, then you should sound the alarm. Run to the doctor. Remember that sex should bring pleasure and joy, not pain and burning.

Read also

90,000 Male diseases: urethritis (urethritis)

2020.10.25

Urethritis refers to inflammation of the urethra (urethra). Urethritis is most often, though not always, caused by sexually transmitted infections. Urethritis can also occur in a stable relationship. This is a common condition in men. Urethritis is of infectious and non-infectious origin. Infectious urethritis is most often caused by bacteria and viruses: gonococci, chlamydia, ureaplasma, mycoplasma, gardnerella, Trichomonas, herpes viruses, as well as staphylococci, streptococci, intestinal coli, fungi.

The incubation period (the time from infection to the onset of symptoms) ranges from 2 to 30 days, depending on the pathogen.

Recently, urethritis caused by chlamydia and ureaplasma predominates.

Main causes of infectious urethritis:

• Gonorrhea is a type of STI that can cause urethritis. It is a sexually transmitted infection (STI) caused by the bacteria Neisseria gonorrhoeae, which enters the body through the mucous membranes (genitals, mouth, rectum) during intercourse (vaginal, oral, anal).In 2-7 days after infection, the infection occurs in men. purulent discharge from the urethra, burning sensation, pain when urinating, sometimes pain in the testicles

• Non-gonococcal urethritis (NGU) is the term used to describe urethritis caused by a non-gonorrheal infection. This includes other microorganisms that normally live in the throat, mouth, or rectum. They can cause nonspecific urethritis, they can penetrate into the urethra. This can often happen during oral or anal sex.NGU can also be caused by Trichomonas vaginalis, other bacteria such as mycoplasma, urinary tract infection, herpes simplex virus, adenovirus that causes a sore throat, or an eye infection. In most cases, the pathogen is not detected.

Non-infectious causes of urethritis:

The causes of nonspecific urethritis, not associated with infection, are the influence of certain factors that also cause inflammation of the urethra. These may include: irritation from products used on the genital area such as soap, deodorants or spermicides, certain damage to the urethra during sex or masturbation, or insertion of a catheter (thin plastic tube) during medical procedures.

Both together:

Some men can have both gonococcal and non-gonococcal urethritis at the same time.

Three out of ten men with urethritis have no apparent cause.

Any man can get urethritis. However, it most often occurs in sexually active men under the age of 25 who have recently changed their sexual partner. Urethritis is more likely if you have unprotected sex (without a condom).

Symptoms

• Discharge from the tip of the penis (pus, whitish odor, foul odor, involuntary discharge) is a common complaint, although not in all cases.

• Pain or burning when urinating. This does not necessarily mean a urinary tract infection, but it is best to consult a urologist.

• There may be pain or irritation inside the penis or a frequent urge to urinate.

• In some men, urethritis never shows any symptoms. For example, nearly half of men with chlamydial infection are asymptomatic.

How does urethritis progress?

Symptoms can sometimes go away without treatment, but this can take months.If the urethritis is caused by an infection, even after the symptoms of the germs (bacteria) have disappeared, you can still remain infected, so it is likely that you will still be infected and pass the infection on to your partners. One type of infection that usually causes urethritis in men only (eg chlamydia) is a serious problem for women. It is important that you get tested and treated if necessary to avoid complications for yourself and others in the future.

What if you notice symptoms of urethritis?

• If you suspect you have urethritis, contact urologist , dermatovenerologist or general practitioner .

• You may be asked to get tested for HIV, hepatitis and syphilis, as people with urethritis sometimes have these conditions as well.

• Men who have sex with men may need to have throat and rectal swabs.

• The medicines you will be treated with are called antibiotics. They usually treat the infection. The type of antibiotic prescribed depends on the type of agent and the course of the disease. They are selected by a doctor depending on the type of pathogen and the course of the disease.Be sure to complete the course of treatment.

• If the urethritis is caused by gonorrhea, it is very important to get another test after treatment to make sure the infection has cleared up. This is usually done seven days after treatment.

• Advise your sexual partner (s) to see a doctor, even if they have no symptoms. Many women with sexually transmitted infections have no symptoms.

• Do not have sex (including oral and anal) until you and your sexual partner (s) are tested and treated. You must wait seven days after treatment to prevent transmission.

Do not treat yourself as antibiotic-resistant infections have spread recently. If recovery is not controlled, you may remain a carrier of the infection and / or face serious complications of an untreated infection at a later date.

Fomin’s Clinic – a network of multidisciplinary clinics

Postcoital cystitis is a type of cystitis that develops within 24 hours after intercourse.

Urges to the toilet, which cannot be tolerated, pain when urinating, painful sensations in the lower abdomen may indicate cystitis. If you go to the toilet more than 8 times a day and there is blood in your urine – all this is a reason to consult a urologist.

Sex is a risk factor. 60% of all urinary tract infections occur after intercourse. Cystitis is called honeymoon disease because intercourse more than three times a week increases the risk of getting the disease three times than if there was no sex at all.

During sexual contact, movements of the penis displace the opening of the urethra. Because of this, it can be inseminated by bacteria, primarily Escherichia coli. E. coli “captures” the external genitalia, the mouth of the urethra, the walls of the bladder and causes inflammation.

Women are more likely to suffer from cystitis, including due to the peculiarities of the anatomy. Their urethra is wider and shorter, so the path for microbes is convenient. Yes, and between the urethra and the anus there is no Chinese wall, there is little that prevents E. coli from being in the wrong place.It is logical that the closer the urethra lies to the anus, the easier it is for bacteria from the rectum to “get” to the opening of the urethra.

If cystitis is caused by bacteria, the urologist treats it with antibiotics. The tactics may differ, the doctor selects it depending on the course of the disease. When inflammations recur, he may prescribe long-term antibiotic therapy. Women who have cystitis only after sex may be prescribed another scheme: prophylactic administration of the drug immediately after sex.

Urethral transposition is a surgical treatment for postcoital cystitis if conservative methods do not work. The essence of this operation is to reduce the mobility of the urethra. As a rule, if during the operation the doctor notices that the external opening of the urethra is greatly expanded, then simultaneous plastic surgery of the external ring of the urethra is possible.

There is no exact scientific evidence that going to the toilet immediately after sex will save you from cystitis. But this will definitely not make anyone worse.

No, cystitis does not occur if you sit on a cold one. Research has refuted this myth.

Treatment of cystitis after intimacy

If after sex you often go to the toilet, feel pain when urinating, itching bothers you, then you may have postcoital cystitis. This disease is characterized by the onset of an acute inflammatory process in the bladder after intercourse.

What causes the disease

The main reason is the structural features and location of the urethra (urethra).In women, this organ has a shorter and wider structure than in men. This makes it easier for pathogens to get inside.

In addition, the external opening of the urethra is located close to the vagina and anus. Sexual frictions lead to its displacement inside the vagina, which also contributes to infection and inflammation.

Intimate filling is used to eliminate the cause of postcoital cystitis.

Additional provoking factors include:

• wearing thongs, as well as synthetic tight underwear;
• a large number of sexual partners or their frequent change;
• Inadequate hygienic care before and after sex;
• presence of gynecological diseases;
• frequent use of spermicidal contraceptives;
• “dry” sex, that is, intimacy without a sufficient amount of natural lubrication.

The risk of developing the disease increases many times if a woman has hormonal disorders or metabolic problems.

How to understand that you have postcoital cystitis

The first painful manifestations appear the next day after sex or after 2 days. Sometimes the disease is accompanied by rare episodes and goes away on its own, but in most cases, cystitis is prone to recurrence. The chronic course is characterized by the appearance of painful symptoms every time after sex.

Symptoms of the disease can be as follows:

1. Frequent urge to urinate.
2. Urine is excreted in small portions.
3. Discomfort in the lower abdomen.
4. Pain, burning sensation while going to the toilet.

Deterioration in general well-being is rare. Temperature rise is not observed in most cases. Often women complain of false urge to use the toilet, and there is also an increase in pain at the end of urination.

Treatment and diagnostics

The urologist and the gynecologist are involved in the diagnosis and prescription of optimal therapy.The following types of examinations are recommended:

An external examination is mandatory. Sometimes the external opening of the urethra is located below normal, its excessive mobility is observed. Previously, surgery was performed – transposition of the urethra. Quite a traumatic operation. Now we have learned how to properly use special fillers, which are injected by injection to correct the configuration and location of the external opening of the urethra. In the absence of an abnormal location or with its insignificant severity, drug therapy is recommended.

Make an appointment with a gynecologist!

If there is a suspicion of cystitis after intimacy, we recommend that you contact our clinic for the advice of a urologist or gynecologist.

Leave your phone number.
The clinic administrator will call you back.

If cystitis is diagnosed after sex, treatment should only be prescribed by a specialist. Do not self-medicate, contact the French Clinic for an appointment. Correct laboratory and instrumental examination will allow you to go through all the studies in the shortest possible time and in one place.The sooner you see your doctor, the easier it will be to cope with the disease.

Frequently Asked Questions

1. What to do if cystitis comes back?

It is necessary to find out the cause of the exacerbation of the disease. Be sure to consult a urologist or gynecologist. Take the full course of prescribed medications and follow preventive recommendations.

2. Is it true that it occurs most often due to hypothermia?

The disease is always associated with sexual intercourse, hypothermia can aggravate the inflammatory process, but will not cause it.

3. Is this diagnosis possible in men?

Postcoital cystitis mainly affects women. Cystitis in men is possible, but extremely rare.

Why cystitis torments many women and how to overcome it – Wonderzine

Antibiotics and Kegel Exercise

The most common cause of cystitis is a bacterial infection, and in order to cure it, you need to destroy the pathogens. Ideally, it is necessary to donate urine for inoculation on a nutrient medium and determine the sensitivity of the pathogen to antibiotics – this will help to understand which bacteria caused the cause and which antibiotic is needed.True, with the classic picture of cystitis, treatment is often prescribed without tests. The Russian Society of Urology believes that the right choice is a single dose of three grams of fosfomycin trometamol (this drug is sold in a single-dose package). In principle, this option can be chosen if cystitis is found where it will not be possible to get to the doctor quickly – but after returning it is better to see a specialist.

The American Urological Association has issued guidelines to help physicians choose the correct antibiotic, dose, and duration of therapy. On some points, these recommendations differ slightly from the European ones, but in general they are similar. If the inflammation recurs, long-term antibiotic therapy may be recommended, up to six months or even up to a year – of course, such treatment can only be dealt with by a specialist who will take into account a variety of factors. And if cystitis occurs after sexual intercourse, then the optimal tactic may be prophylactic antibiotics within two hours after sex – this is a more gentle way in relation to the intestinal and vaginal microflora than long-term prophylactic antibiotics.

Sometimes an unexplained situation arises: there are symptoms of cystitis, the urine, according to the results of the analysis, is sterile, but a course of antibiotics helps quite well. The possible answer is that there are bacteria, but they are not enough to form a visible colony.

In addition to antibiotics, the doctor may recommend normalizing the tone of the pelvic floor muscles (Kegel exercises are suitable for this) and determine the level of estrogen: if it is low, the doctor may prescribe replacement therapy.