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Dysorgasmia (pain with ejaculation)

What is dysorgasmia?

This problem refers to pain that occurs before, at or soon after orgasm.1 The pain is usually located in the penis, testicles, perianal region or lower abdomen. For the majority of patients, the pain is mild and represents a nuisance. However, there are occasional patients who have severe pain. The pain typically lasts minutes but rarely can last for hours. The belief is that this pain is the result of pelvic floor spasm after radical prostatectomy or prostate radiation.

How common is dysorgasmia? While the literature discussing this problem is scant, around 15% of men after prostatectomy and perhaps somewhat less after radiation therapy experience this problem.

What is the impact? Dysorgasmia is can impact upon the quality of the man’s or the couple’s sexual relationship.

How can it be treated? For the majority of patients with this problem, observation is the best course of action as a it is generally self-limiting and typically resolves within months and nearly always within the first 12 months of prostate cancer treatment. However, for those patients for whom the pain is bothersome, the pain is generally responsive to alpha-blocker therapy such as using alfuzosin or tamsulosin.2 Patients who are experiencing this problem should consult with their urologist or a sexual medicine specialist. Patients and partners facing this issue may also benefit from individual or couples counseling, sex therapy, or participation in a prostate cancer support group (see list of resources).


[1] Matsushita K, Tal R, Mulhall JP. The evolution of orgasmic pain (dysorgasmia) following radical prostatectomy. The journal of sexual medicine. 2012;9: 1454-8

[2] Barnas J, Parker M, Guhring P, Mulhall JP. The utility of tamsulosin in the management of orgasm-associated pain: a pilot analysis. European urology. 2005;47: 361-5


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