Anonymous on September 13, 2011

Every time I ejaculate, this chunky sperm comes out, then the pain either subsides or goes away for a few days or even months. What’s wrong?

Over the past year, I’ve had some really awful pain in my right testicle. I’ve been treated with Bactrim, but that doesn’t seem to work. Every time I ejaculate, this really chunky sperm comes out and the pain either subsides or goes away for a few days or even months. How can I get rid of this pain?

answered by Lisa Oldson, MD on September 13, 2011

Thanks for sharing your concern. I’m sorry about the pain you’re experiencing, and I’ll do my best to help.

There are several conditions that can cause pain in the testicles...all of which should be checked out by a doctor. So I would first encourage you to re-visit your doctor or urologist for an examination and to identify the root cause of your pain. Why? Because pain in the testicles isn’t normal and could indicate a serious health problem.

For example, one possible condition with symptoms of intense pain in the testicles is epididymitis, which is an inflammation of the epididymis (the tube that connects the testes to the vas deferens).

In men under 35, the most common causes of epididymitis are chlamydia and gonorrhrea infectionsChlamydia and gonorrhea are types of bacteria that are sexually transmitted and, if left untreated, can cause a painful infection in the epididymis. A different bacteria, E. coli ⎼ normally found in the digestive tract and that can also cause urinary tract infections (UTIs) ⎼ is the main cause of epididymitis in men who are over 35 years old. However, even if you’re over 35, chlamydia or gonorrhea infections are also possible.

How do you know if you have epididymitis? Again, you’ll need to visit your regular doctor for a physical exam, which will likely include getting a urine sample from you to be tested for specific bacteria. However, even before the results from those tests are available, the Centers for Disease Control and Prevention (CDC) recommend that you take two types of antibiotics to help mitigate your symptoms and reduce the risk of passing the inflammation to someone else.

Depending on the results of the urine test, your doctor may also prescribe some other antibiotics to make sure that all infection-causing bacteria are killed. (By the way, the antibiotic you took ⎼ Bactrim ⎼ is most often used to cure urinary tract infections. So when you see your doctor, make sure to be clear about your symptoms and diagnosis).

If you do have epididymitis caused by chlamydia or gonorrhea...I encourage you to notify your previous sex partner(s) so they can get tested, too, and treated if necessary.

Chlamydia and gonorrhea infections can be particularly harmful in women when left untreated because they can cause pelvic inflammatory disease (PID) that sometimes results in infertility. It's also a good idea to stop having sex with your current partner until you’ve both been treated for these STDs.

Other potential causes of pain relieved with ejaculation is a blocked ejaculatory duct or, less likely, prostatitis.

Finally, be aware that if you have one STD, you’re more prone to other STDs, too. So, to be on the safe side, you may want to consider getting tested for a full array of common STDs (e.g., HIV, syphilis, herpes 1 & 2, hepatitis B, hepatitis C and, of course, chlamydia and gonorrhea).

Hopefully this information has provided a good starting point for you. I hope that you and your doctor soon resolve the pain you’re experiencing.

Lisa Oldson, MD

Dr. Oldson is Medical Director of the Analyte Physicians Group. She is on staff at Northwestern Memorial Hospital, as well as Clinical Instructor at the Feinberg School of Medicine, Northwestern University. Her areas of expertise include STDs (with a particular clinical emphasis on herpes), women's health, preventive medicine, diabetes, obesity and weight management, and mood and anxiety disorders. Dr. Oldson was educated at Rush Medical College and completed her residency at Rush-Presbyterian-St. Luke's Medical Center in Chicago, IL.

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