Hello Doctor Herazy, I have been getting a painful erection each night (sometimes a few times a night) for the last few months.  What worries me is that the pain is slowly getting worse.  The pain when I am erect wakes me up at night and I do not know what to do about it.

I have no idea what started this to act up.  I have not injured myself and my penis is not bruised.  My erections are as strong as usual, and I have no pain when I urinate or ejaculate.   Speaking of ejaculation, I have a very vigorous and active sex life, but sex is getting to be a problem since the pain makes it difficult to keep an erection. Sometimes the painful erection is so severe that I just go limp in the middle of intercourse.

I called my medical doctor and he suggested some tests that sound expensive.  Instead of doing that I went to the internet and Googled “painful erection” and found your website.  I have learned that pain while erect is a sign of Peyronie's disease, and would like your thoughts about this as a possible explanation for my problem.

Can you please help me understand what is making my erections so terribly painful suddenly? If it keeps up much longer I will have to go see a doctor I suppose.

T. K.

Greetings T. K.,

There are a few conditions that can explain your current problem of pain while being erect:

• Trauma – you deny any injury
• Priapism – persistent or prolonged erections; can last for hours at a time; not related to night
• Phimosis  – constriction of penis by foreskin or prepuce
• Peyronie's disease  – a possibility
• Lichen sclerosis – leathery skin condition
• Disease of the penis – chlamydia, genital warts
• Cancer  – very rare

You do not mention any other complaints that are going on with you for me to have an indication of what might be going on in your situation.  I suspect you can probably eliminate several of these possible causes since you are aware of other aspects of your history.

The most common complaints associated with Peyronie's disease are:

• Nodule or bump under the surface of the shaft caused by a mass of fibrous tissue (like a scar).
• Penile distortion while erect caused by the same mass of fibrous tissue.
• Reduced penis length and diameter cause by fibrous tissue contracting penis.
• Painful erection caused by inflammation of penile tissue, as well as  the presence of the fibrous tissue in the deep layers of the penis.
• Reduced erection quality, again caused by the presence of the fibrous tissue that prevents full closure of the penile veins that create the hydraulic pressure of an erection.

Some of these complaints related to Peyronie's disease, like painful erections, are not always seen in a case of Peyronie's disease.  The only mandatory finding to confirm a diagnosis is the presence of a mass of fibrous tissue.   Many times the loss of penis size does not occur early when Peyronies is present, and many men do not notice the telltale lump of Peyronie's disease.  What I am saying is that it is possible to have Peyronie's disease and not be aware of it except for a painful erection.

My suggestion is that you should go to a urologist for an examination to get to the bottom of your complaint.

You might also be interested in reading Nine causes of pain in the penis.

If it should turn out that you do have Peyronie's disease I suggest that you undergo an early round of self-directed natural treatment of Peyronie's disease to determine if you can reduce the internal scars without the need of drugs or surgery.    TRH