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Priapism: an Erection that Won’t Go Down


We’ve all heard the warnings: “Seek immediate medical help for an erection lasting more than four hours.”

Men make jokes about the warnings… until it happens to them.

Priapism1 is a serious condition. The penis – like every other part of the body – depends on blood flow to carry oxygen to the tissues. When blood is trapped in the penis, there is no flow, and no oxygen, and the tissue begins to die, resulting in permanent damage.

What Are the Symptoms of Priapism?

Priapism simply means an erection that won’t go down. Symptoms may include:

  • Erection lasting more than four hours
  • An erection that is unrelated to sexual interest or stimulation
  • Rigid penile shaft, but a soft tip (glans)
  • Painful erection

What Causes Priapism?

Recurrent priapism is rare, but can be caused by several medical conditions, including sickle-cell anemia, some prescription medications, injuries to the spinal cord or genitals, and certain insect bites. (See our article “Can Spider Venom Treat ED?“)

For most men with Erectile Dysfunction, priapism is caused by an over-dose of ED medications, including oral ED medications such as Viagra and Cialis, or penile injections.

What to do if You Experience Priapism?

If you experience an erection lasting 2-3 hours, there are some self-help measures that may reduce the erection:

  • Take a normal dose of an over-the-counter antihistamine such as Sudafed or Benedryl. (Keep the “immediate effect” type on hand, rather than time-release.)
  • Walk or jog to divert blood flow from the penis
  • Place an ice bag (or a bag of frozen vegetables) on the scrotum

If your erection does not go down with 3-4 hours, get immediate medical help.  Priapism can cause permanent damage to your penis.  

A doctor will treat your condition by injecting a drug called phenylephrine directly into your penis to relax your erection, or by using a syringe to withdraw blood from the penis. 

  1. The word priapism comes from the ancient Greek god Priapus, a fertility figure who was frequently depicted with a large erection.

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