The underlying cause as well as the severity of pain determine the varied treatment approaches for a painful erection.

The initial and most effective step involves allowing the penis to return to its normal flaccid state. This may prove challenging if an injectable erectile dysfunction drug like Caverject (alprostadil) has been administered, or may necessitate medical assistance if priapism is present.

In non-emergency situations, applying a cold compress to the penis or perineum for 10 to 20 minutes can help reduce the erection and alleviate pain. However, caution must be exercised to avoid over-icing the skin, which can lead to frostbite and tissue or nerve damage.

If lingering pain persists, over-the-counter pain relievers like Tylenol (acetaminophen) or Advil (ibuprofen) can offer relief.

Addressing acute pain is just one aspect of treatment. Healthcare providers also prioritize treating the underlying cause to prevent complications and recurrence.

Treatment For Painful Erection

Treatment options vary according to the specific condition:

Peyronie’s disease

Options include Xiaflex (collagenase) injections to break up scar tissues, Verapamil 15% topical gel for many connective tissue diseases, penile traction therapy, and surgical interventions such as tissue grafts and penile implants.

Priapism

For ischemic priapism: Treatment may involve aspiration decompression to remove excess blood from the penis, Phenylephrine injection to narrow blood vessels quickly, or surgery if other methods fail.

For non-ischemic priapism: Ice application may suffice to reduce the erection, though surgery might be necessary in severe cases to control blood flow to the penis.

Penile fracture

Surgical repair addresses damage to the tunica albuginea and corpora cavernosa.

Sleep-related painful erection (SRPE)

Treatment options include Lyvispah (baclofen) as a muscle relaxant, Proscar (finasteride) to reduce testosterone effects and nighttime erections, Clozaril (clozapine) to slow neurotransmitter production associated with pain hypersensitivity, and continuous positive airway pressure (CPAP) to manage obstructive sleep apnea.

Penile tumors

Surgeons may use surgery or, less commonly, employ stereotactic radiation to remove the tumor.

Penile lichen sclerosis

Treatment may involve moisturizing lotions and creams, topical steroids to reduce inflammation, local steroid injections if topical treatments fail, ultraviolet light therapy, or circumcision.

Reference: James Myhre & Dennis Sifris, M. (n.d.). Signs that a painful erection may be serious. Verywell Health. https://www.verywellhealth.com/painful-erection-6455942