Say no to painful sex if you’re TTC, guys! Find out what could be making you hurt down there…

Making love should be enjoyable for you and your spouse. Still, watch the enthusiasm since being overzealous when you “do the deed” may do more harm than good. The result? Injuries that can leave either one or both of you wincing, even screaming in pain.

Dr Joe Lee, director of andrology and male reproductive medicine at the National University Hospital department of urology, notes that having sex when the female isn’t adequately stimulated can increase a man’s risk of injuries. So, it’s important to take your time especially since women tend to take longer to achieve sexual arousal.

Gleneagles Hospital urologist Dr Ho Siew Hong says that zipper accidents are another common cause of penile injuries. Also, if you have a pre-existing health issues like diabetes or a tight foreskin, you may also experience painful intercourse. Both Dr Lee and Dr list common causes of painful sex and ways to treat them…

Bending an erect penis suddenly and forcefully can result in trauma to one or both of these tubes, resulting in a fracture.

1) Foreskin tear

THE SIGNS Pain or soreness during intercourse, beginning from the underside of the penis. Depending on the severity of the tear, it may cause bleeding.
CAUSES For uncircumcised men, the foreskin is connected to the underside of the penis by a small skin fold, called the frenulum — also commonly known as the “banjo string”. The skin fold can sometimes be tight during sex or masturbation and any vigorous movement results in a frenulum tear. Zipper accidents can also cause the frenulum to tear, Dr Ho notes.
TREATMENT AND PREVENTION Although abstaining from sex can help the tear to heal on its own, you should seek medical treatment, especially if there’s blood from beneath the foreskin. If this problem keeps recurring, ask your physician about frenuloplasty — a surgical procedure to lengthen the skinfold.

2) Tight foreskin

THE SIGNS A tight foreskin can cause discomfort or pain during intercourse, especially when the penis isn’t sufficiently lubricated.
CAUSES Generally at around age 2, the foreskin will start to separate from the glans in uncircumcised boys and can be retracted. For some men, the foreskin may be too tight to pull back and reveal the glans in a condition known as phimosis. Other men, who suffer paraphimosis, can retract the foreskin but it can’t roll back into position naturally.
TREATMENT AND PREVENTION Stretching and retracting the foreskin regularly from a young age can help to reduce the tightness, Dr Lee notes. If it cannot be stretched or is painful for you to do so, circumcision may be the only option.

3) Penile fracture

THE SIGNS When a man is sexually aroused, blood rushes to fill a pair of spongey cylinders in the penis called corpora cavernosa, which causes it to harden and become engorged. Bending an erect penis suddenly and forcefully can result in trauma to one or both of these tubes, resulting in a fracture. Hearing a crack sound during sex is the most obvious symptom. Needless to say, it is a very painful injury which can result in the immediate loss of an erection and bruising on the penis as the blood rushes out from the tube. If you’re not careful, the trauma may also affect the urethra — another “cylinder” which releases pee ― and cause it to bleed. Luckily, this is a fairly uncommon condition. Dr Ho says there are fewer than 10 reported cases of penile fractures in Singapore a year.
CAUSES Dr Lee points out that certain sex positions like the woman-on-top or forcing the penis back in after it slips out of the vagina can increase a man’s risk of sustaining this injury. Other than intercourse, forceful and aggressive masturbation can also lead to fractures.
TREATMENT AND PREVENTION Urgent medical attention is required as immediate surgery is needed to repair the fracture. Left untreated, the fracture can result in a deformities and erectile dysfunction.

4) Priapism (a prolonged erection)

THE SIGNS Depending on the type of priapism you suffer from, you may feel a surging pain in your groin — Ischemic priapism — or no pain at all — Nonischemic Priapism. The persistent erection also lasts for more than four hours and doesn’t subside even after intercourse.
CAUSES One of the most common causes of this condition is abuse of untested male fertility supplements, notes Dr Lee. Underlying health problems like sickle cell disease and diabetes can also cause a man to experience a prolonged erection.
TREATMENT AND PREVENTION In emergency settings, an injection will be given to bring one’s priapism down or have the blood withdrawn from the penis, Dr Lee states. Surgery may be required in severe cases. Left untreated, a prolonged erection leads to lifelong complications like erectile dysfunction.

If your groin sustains a direct injury, putting an ice-pack on the area can help but you should still seek medical help.

5) Swollen or bruised testicles

THE SIGNS Feeling pain in one or both of your testicles, which may appear swollen, feel tender and look reddish or purple.
CAUSES This is usually a symptom of an underlying condition rather than a problem on its own. That said, if you routinely play football, do take extra care in preventing any trauma to your groin, which can cause bruising or swelling. Scrotal skin infection, mumps or excess fluid, especially in patients with heart or kidney issues, are other causes. Also, sexually transmitted bacterial infections like gonorrhoea, chlamydia and syphilis can cause swelling.
TREATMENT AND PREVENTION To prevent a skin infection, wash the area with a mild soap during your shower and keep it cool and dry. Dr Lee says that treatment options really depends on the cause. “Infections can be treated with a course of oral or topical antibiotics.” If your groin sustains a direct injury, putting an ice-pack on the area can help but you should still seek medical help.

6) Sebaceous cysts

THE SIGNS From the outside, a sebaceous cyst looks like a lump or a bump “buried” under the skin’s surface. This lump, which can develop on the scrotum, is a sac filled with a greasy yellowish substance called sebum. These lumps can also be sore or painful to the touch, so any form of physical contact is likely to cause discomfort and pain.
CAUSES Blocked oil glands, often close to a hair follicle, are a common cause of sebaceous cysts.
TREATMENT AND PREVENTION Observing good hygiene lowers your risk of getting blocked oil glands, so be sure to wash the area well every time you shower. Also refrain from squeezing, scratching, cutting or puncturing the lump as it may even cause inflammation by driving any existing infection deeper into the skin. If the lump is red and sore to the touch, have your physician evaluate it. Dr Ho notes that antibiotics will be given to treat any form of infection, while surgical removal is usually advised for larger or recurrent cysts.

Photos: iStock

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