What is priapism?

The causes & treatments of abnormally prolonged and painful erections


I am guessing that this would be the question to come from the majority of men (and women) when asked if they would like such a cure. For men suffering from priapism, the answer would be ME PLEASE! Priapism is far from a joke to the sufferer, in fact, it is a medical emergency.

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What is priapism?

In order for a normal erection to occur the blood flow to the area must be normal so that when a man becomes aroused, the blood supply to the pelvis and penis increases whilst at the same time, the veins that drain blood away close and so the blood is trapped in the penis and pelvic area. After the climax, the veins will open and the blood flows away.

Priapism is ‘an abnormally prolonged and often painful erection’ that can even cause damage to the penis if it is not treated soon enough. Now you can see that the need for a cure to a 4-hour erection is not as strange as it may seem at first.

The erection will last more than four hours and it can happen to males of all ages including newborn babies


Symptoms of priapism

  • A painful erection that lasts longer than four to six hours and is not relieved by orgasm
  • A partial erection that lasts longer than several days but may not be painful

The actual symptoms may vary slightly depending on which type of priapism is being experienced.


Types of priapism

  • Low flow or ischaemic priapism -  this type of priapism occurs when blood becomes trapped in the erection chambers.  On the whole, there is no clear cause for this but it can affect men who suffer from sickle cell disease, leukaemia or malaria.  It is vital that the sufferer seeks immediate attention as the condition can lead to scarring of the tissue and permanent erectile dysfunction. Symptoms experienced in this form of priapism are:

    1. Erections last more than four hours

    2. The shaft of the penis is rigid whilst the tip is flaccid

    3. The penis is painful

  • High-flow or non-ischaemic priapism - this is a more rare form of priapism than the ischaemic type and tends to be less painful.  It is often caused by an injury to the penis or to the area between the scrotum and penis, or perineum. An injury in this area can rupture an artery which affects the blood flow into the penis. Symptoms experienced in this form of priapism are the same as those for low flow priapism but the pain will either not happen or will be much reduced.


Causes of priapism

As discussed earlier, a normal penis erection involved increased blood supply to the area. The blood in the area is ‘trapped’ there when the veins close and when the climax is reached, the veins reopen and the blood empties from the area and the erection subsides.

As we know, is priapism there is a problem with the blood flow to the penis and different conditions will affect the ‘outflow’ of blood in different ways.

The disorders include:

  • Sickle cell anaemia - about 42% of adults with the disease will suffer from priapism at some point in their lives
  • Leukaemia
  • Multiple myeloma

Alcohol abuse, marijuana and other recreational drugs may result in priapism alongside a long list of prescription medication:

  • Medication prescribed for erectile dysfunction
  • Antidepressants
  • Alpha-blockers
  • Medication for anxiety disorders
  • Blood thinners
  • Hormone therapy
  • Medications for ADHD
  • Carbon monoxide poisoning
  • Black widow spider bite
  • Metabolism disorder
  • Neurogenic disorder
  • Cancers involving the penis


Diagnosis of priapism

Getting a diagnosis from your GP in these cases is very important. The doctor will want to take a case history from you including use of medication, prescribed and not prescribed, and alcohol, whether you have sustained an injury in the area as well as how long you have had the erection and how long you would ordinarily have an erection. He will also check for any localised cancer.

Your doctor will also want to run some diagnostic tests  to determine which type of priapism is causing the problem

  • Blood gas measurement - in order to measure this your GP will need a sample of blood drawn from your penis.  If the sample shows a low oxygen content, this indicates that you are experiencing low-flow priapism and if it has a high oxygen contact, the culprit is high-flow priapism
  • Blood tests - as priapism can be related to blood disorders and other disorders, blood tests can be used to check for any possible diseases or conditions that may be related to the problem
  • Toxicology tests - your GP may ask for a urine sample in order that he can test for drugs.  The reason for this is because of the close connection priapism has with drug abuse
  • Ultrasound - this is used to measure blood flow to the penis as well as helping to show whether trauma or injury may be the cause of the priapism


Treatment for priapism

The type of treatment required will be down to the type of priapism that is being experienced:

Low-flow priapism - excess blood can be removed from your penis using a syringe. This will relieve the pain and prevent involuntary erection.

Medication designed to reduce the size of blood vessels which supply the penis as well as expanding the vessels which take the blood away can be injected into the penis; the increased blood flow can reduce the erection.

The last resort would be surgery to aid the flow of blood away from the penis

High flow priapism - in this case, treatment is not likely to be urgent as it is in the case of low flow, as high-flow will often go away on its own. The GP is likely to check the condition before prescribing any treatment.

In some cases, surgery to reduce blood flow to the area or to repair arteries that may have been damaged by an injury

There are also some medications that may be considered when the priapism is recurrent:

  • Decongestant called phenylephrine which will reduce the blood flow to the penis
  • Hormone blocking medication
  • Medications for erectile dysfunction
  • If other conditions are the root of the problem, these conditions can be addressed as a way of preventing recurrence of priapism



Provided swift attention is sought there is a very positive outlook for the sexual health of the sufferer. Whatever the cause of the condition and whatever the type of the condition it is still important that medical attention is sought in order to ensure the long term health of the individual.

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