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Pain after masturbating at night

Dear Alice,

Sometimes I masturbate before I go to sleep at night. Usually nothing is wrong, but sometimes (and this always occurs at night, I've found) after I masturbate, a few minutes later I have to urinate. And when I do, it is usually very painful. The feeling doesn't pass either. My scrotum usually gets very tightened up, and there is painful feeling above my crotch. Usually I just sit there, drink some water until the feeling goes away. ANY idea what this is?

— Bad Dreams

Dear Bad Dreams,

It's no fun having an uncomfortable feeling following a usually pleasurable sensation. Pain during or after urination and/or ejaculation is sometimes a symptom of an infection of the urethra, the pathway for urine and semen. This type of infection, known as urethritis, is one of the more common infections in men. Besides pain, other symptoms may include a burning sensation during urination or erection and a discharge from the urethral opening at the tip of the penis. (It's most likely a coincidence that your symptoms occur only at night — some of these infections can have periodic flare-ups rather than continuous symptoms.)

Have you noticed a discharge? Could the discharge be confused with your ejaculate, since your symptoms occur after masturbation? Do you have any other symptoms that might indicate a possible infection? There are several possible causes of urethritis, including urinary tract infections (UTIs), chlamydia, and gonorrhea. It is also possible for an infection in your urethrea to travel to your bladder, kidneys, prostate and/or testes, which could explain the pain you describe. Additional symptoms of an infection that has moved past your urethra may include swelling or a feeling of "heaviness" in the scrotum and testes.

Pelvic pain during urination and after ejaculation may also be caused by problems with the prostate, a gland that surrounds the urethra below the bladder and secretes a fluid that forms a major part of ejaculate. Infection or otherwise, it's critical to get medical attention when you experience unexplained pain. Your primary health care provider or a urologist can conduct an evaluation.

Hopefully you'll be back on the path to pleasant and pain-free masturbation soon!

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Last updated Apr 27, 2015
Originally published Apr 01, 1994

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