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Urology/Ache after ejaculating after a period of abstinence


QUESTION: Hello Dr Leslie,

I have gone for prolonged periods (1-2 months) without ejaculation and did not experience any pain or "blue balls". However, after ejaculating, I sometimes experience discomfort for 15 mins and up to an hour if I have not done so for about 1-2 weeks+.

I have read about prostatic congestion and it seems to be due to the prostate getting swollen and painful and relieved by ejaculation. But my discomfort only occurs after ejaculation. What could be the causes?

I'm 27 with no known STDs and this has gone on since I was younger, but it's been more noticeable recently as I've gotten too busy for sexual activity. Thank you.

ANSWER: Gerald:

The most common cause for your symptoms would be prostatitis.  This may have been aggravated by the prolonged abstinence.  Try some hot sitz baths daily and check with your local physician.

---------- FOLLOW-UP ----------

QUESTION: Thanks for the reply. I understand you might not be able to give a diagnosis but what types of prostatitis could manifest with these symptoms? And why would aching occur only after ejaculation?


It could be any type of prostatitis, but the most common would be chronic bacterial prostatitis or possibly CPPS.

The pain after ejaculation would reflect inflammation at the bladder neck area which tightens during ejaculation to prevent the semen from going backwards into the bladder.


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Stephen W. Leslie, MD


Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.


Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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