Priapism is a condition that causes long-lasting and sometimes painful erections. Priapism occurs when an erection lasts for four hours or more without sexual stimulation. While priapism is uncommon, it can have many different causes, and requires emergency health care to prevent damage to the penis. If you suspect you are experiencing priapism but it has not reached the four hour mark then there are things you can try at home first. If your erection has lasted for four hours or more then it is extremely important for you to seek emergency intervention. If you experience frequent episodes of erections lasting without sexual stimulation but resolve before the four hour mark it is important that you speak with your doctor about any and all concerns, daily medications, and possible underlying conditions.
What is Priapism?
Understanding what priapism is and when it becomes an emergency situation is extremely important in protecting your ability to get future erections and the health of your penis. There are three different types of priapism:
- Ischemic Priapism (Low-Flow Priapism): Also referred to as low-flow priapism. Ischemic priapism occurs when blood is not able to leave the penis after an erection. The majority of priapism cases are ischemic.
- Recurrent Priapism: This is a type of ischemic priapism also referred to as recurrent or stuttering priapism. This form of priapism usually occurs in individuals with sickle cell disease.
- Non-ischemic Priapism (High-Flow Priapism): Also referred to as high-flow priapism. This form of priapism is caused by poorly regulated blood flow in the penis.
The symptoms of priapism vary depending on whether you experience ischemic priapism or non-ischemic priapism. If you have ischemic priapism, or low-flow priapism, you may experience:
- erections lasting for more than four hours without sexual stimulation
- an erection with a soft tip
- painful erection
Low-flow priapism, or ischemic priapism, can become a recurrent condition and occurs when blood becomes trapped in the penis. When symptoms of low-flow priapism begin, involuntary erections may only last for a short amount of time. As the condition of low-flow priapism progresses, involuntary erections may last longer and could become emergent.
If you have high-flow priapism, or non-ischemic priapism, you may experience some of the same symptoms of low-flow priapism, however, pain does not occur with high-flow priapism and could be caused by a possible injury.
Any erection that lasts longer than four hours is a medical emergency and requires medical interference to protect the health of the penile tissue and save you from permanent erectile dysfunction. Seek immediate medical attention for any erection lasting longer than four hours.
What Causes Priapism?
An erection occurs when sexual stimulation allows the blood vessels in the penis to relax and open up for blood to flow and fill the penis. Ejaculation is a reflex action triggered by the central nervous system and causes the penis to contract and then relax letting the blood flow back out of the penis. Priapism occurs when the blood gets trapped inside the penis and cannot flow back out. If priapism goes without treatment for more than four hours, permanent damage can occur causing permanent erectile dysfunction.
Priapism indicates that there is an issue with blood flow to the penis. Certain disorders and diseases can affect the blood flow in the body, including blood flow in and out of the penis. These disorders and diseases include, but may not be limited to:
- Sickle Cell Anemia
- Leukemia
- Mutiple Myelome
- Carbon Monoxide Poisoning
- Black Widow Spider Bite
- Metabolism Disorder
- Neurogenic Disorder
- Penile Cancer
Priapism can also be the result of taking certain prescription medications and/or the abuse of alcohol and illicit drugs. These medications include, but may not be limited to:
- Erectile Dysfunction Medications
- Antidepressants
- Anxiety Disorder Medications
- Blood Thinners
- Alpha Blockers
- ADHD Medications
- Hormone Therapies
Treating Non-Emergent Priapism at Home
If you are experiencing an unwanted erection or an erection lasting past the point of ejaculation but it has not reached the dangerous four hour mark, there are things you can try at home that may assist with non-emergent priapism. At home remedies inlcude, but may not be limited to:
- Gentle Exercise: A light jog, a slow pace on an exercise bike, or a bit of water aerobics to help circulate blood to other areas of the body
- Warm Bath: Soaking in a warm bath to help relax certain muscles may also help ease priapism
- Urination: Urinating may help relieve built up pressure in the penis
- OTC Medication: Over-the-counter medications such as Ibuprofen may help relieve some discomfort and decrease inflammation
If your erection lasts for four hours or more, you should seek immediate medical attention to protect the penile tissue from permanent damage which could also result in permanent erectile dysfunction. If you do require emergent medical attention, you may need to have the blood manually drained from your penis with a syringe or surgery to correct the blood flow in the penis. If your erection goes away with the assistance of any of the above activities but you continue to experience priapism then it is important to talk to your doctor and let them know what is going on so you can find and treat what could be causing the priapism.
Conclusion
Priapism occurs when there is a problem with blood flow to the penis and with the help of some at-home remedies, you may be able to resolve the priapism on your own. If you are experiencing an erection that has lasted four hours or more, seek immediate medical attention in order to protect the penile tissues so that permanent erectile dysfunction does not occur. Whether you are experiencing low-flow priapism (ischemic priapism) or high-flow priapism (non-ischemic priapism), you should discuss what could be causing the condition with your primary care physician in order to give yourself the best chance at recovery so permanent erectile dysfunction does not occur.
References:
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4458797/
- https://www.uspharmacist.com/article/emergent-treatment-of-ischemic-priapism-to-avoid-sexual-dysfunction
- https://my.clevelandclinic.org/health/diseases/10042-priapism
- https://www.mayoclinic.org/diseases-conditions/priapism/diagnosis-treatment/drc-20352010
