Why do I have pain during ejaculation only in sleep at 34?

Question

Hello doctor,

I am a 34-year-old man. During my sleep, I sometimes have spontaneous ejaculation, which is normal. The problem is that most of the time, I wake up spontaneously right before ejaculation, and sometimes I feel pain or a burning sensation during ejaculation.

The process is that when I wake up, my attention goes to my pelvic muscles, and if I tighten them, it might stop ejaculation, which I do not want to do, and if I do not do anything or relax my muscles, the ejaculation will be a little painful.

So I switch between tightening and loosening my muscles, then I also realize that the erection is decreasing, but the semen is about to ejaculate, and finally I feel pain in my penis during ejaculation at sleep time. It never happens during masturbation or any other sexual activities. Only during sleep.

What is the problem? Is there any treatment?

Please help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

Thanks for explaining this so well. I do see what you are describing from time to time, and it is usually nothing to worry about.

Occasional nocturnal emissions (wet dreams) are perfectly normal. Chances are that in your case, falling asleep mid-process leads to you clenching and unclenching your pelvic muscles without meaning to. This “stop-start” pattern can cause a brief spasm of the muscle or uncoordinated ejaculation, which can cause the burning or pain you notice.

It is comforting to know that this does not happen during masturbation or normal sexual activity. This means that infection or any structural problem is not the cause.

This is most likely due to temporary overactivity or lack of coordination of the pelvic floor muscles during sleep, rather than an underlying disease.

What you can do.

If you wake up, try to avoid consciously tensing your pelvic muscles; allow the process to finish naturally.
Practice pelvic floor relaxation (not Kegel exercises) as well as slow deep breathing during the day.
Stay well hydrated as concentrated semen can sometimes increase irritation.
Don’t go to bed with heightened sexual arousal or anxiety about this issue.

Consider further evaluation if pain occurs with normal ejaculation, is more frequent or severe, or is associated with burning on urination or any discharge. Then it would be appropriate to look for conditions such as prostatitis (inflammation or infection of the prostate gland, which causes pain in the lower back, pelvis or genitals, as well as urinary urgency, frequency, and burning) or urethral irritation.

This is a benign functional issue related to muscle control during sleep, not something harmful. A little awareness and relaxation will often improve it in time.

Also, if you are low on vitamin D, taking appropriate supplements may help, preferably after you confirm the dose with your doctor.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

I understand your concern.

The purpose of pelvic relaxation exercises is to reduce overactivity of the pelvic floor muscles and to improve the natural coordination of these muscles.

Diaphragmatic breathing is the most helpful start. Get comfortable. Breathe in slowly through your nose, so that your abdomen rises (not your chest), and then breathe out gently while consciously relaxing your pelvic area. This can make a noticeable difference over time, especially if you do it for around five to ten minutes a day, before bed.

Along with this, work on pelvic floor relaxation (or “drop” technique). Instead of clenching the muscles (so hold off on Kegels for now), try to gently visualise the pelvic muscles softening and dropping downward. The aim is to relax rather than to develop strength.

Simple supportive care may also help. Taking a warm shower or sitz bath before bed may help lower baseline muscle tension and promote general relaxation, which can ease symptoms.

Try these things regularly for a couple of weeks, and you’ll get a better sense of how your body is reacting. If you want, you can keep us posted on your progress or changes you observe. I’d be happy to review and further guide you.

I hope this helps answer your question.

Thanks.