Max - Pain During Ejaculation
Name, picture and some elements in the case are fictional to protect the anonymity of the patient.
Saturday night is when things get hot and heavy. Max and his girlfriend enjoy having sex, often making love for hours and hours until early morning. Max has great stamina and can go at it for multiple rounds.
Max is a 28-year-old mechanical engineer and has a healthy, active lifestyle. He bikes and runs couple times per week and hits the gym. He says it keeps him physically active and it’s also a good de-stressor for him because his job is quite stressful.
His girlfriend is completing her residency in medicine and works outside of the city, and because of their busy schedules, they only get to meet every two weeks. The two love birds plan their bi-weekly meeting date with eagerness, which often results in passionate exchanges until the first light.
Several months before his consultation, one night, things suddenly changed. Max experienced something he’s never experienced. As Max orgasmed for the first time that night, he felt a sharp electric impulse cutting through his penis. The first time, it was brief, and it lasted only for a few seconds. But the pain was enough to cut through his moment of pleasure. He thought it was just a one-time thing. Little did he know…
As the night progressed, and as the weeks progressed, he started having more and more distinct pain during ejaculation and his shaft and balls would go numb, which would last for hours after sex. The doctor diagnosed him with prostatitis and gave him one course of antibiotics that had zero effects on his symptoms. This pain caused a major setback in his relationship. The deep and passionate moments of connections with his girlfriend were stolen by this pain.
The fact is Max told me that the pain was so sharp that he developed a fear of ejaculating. He would force himself to come faster and earlier to avoid the intense pain. Sometimes, Max would use his hand to squeeze on his penis to prevent strong contractions. Weirdly, he said he felt much less pain when jerking off. Another weird thing to him was that the same electric shock he felt in his penis as he orgasmed, he would feel a very similar electrical sensation in his right big toe every so often, and this started a couple weeks after he had pain during ejaculation.
During the examination, to check if we could recreate any of the symptoms that he mentioned, I asked him to do repeated pelvic thrusts movement. Consequently, he immediately mentioned having pain in both his penis and right big toe after completing those repeated pelvic thrusts. Then I had him do the reverse motion and almost instantaneously, the pain went away. He was so shocked and thought it was magic.
The thing is, during sex, men do many repeated pelvic thrust movements, which may irritate the nerve causing pain during ejaculation. Similar to repeated bending movements to pick up objects, which may cause people to experience pain in their leg or foot due to referred pain from the sciatic nerve because of overloading of the spine, this particular case also followed the load management principles. With a proper exercise program, Max abolished his pain during ejaculation within three weeks.
