What is priapism or prolonged erection?

A prolonged erection, also known as a priapism, is an erection that lasts longer than 4 hours. This type of erection is not caused by sexual arousal and it's often very painful.

There are 2 types of priapism:

• Ischaemic priapism — this is most common and happens when blood is trapped in your penis and is unable to drain out.
• Non-ischaemic priapism — this is when an injury to the blood vessels that supply your penis causes uncontrolled blood flow.

If you've had a prolonged erection before, you're more likely to experience it again.

What are the causes of priapism?

There are many possible causes of priapism, including:

• medicines used to treat erectile dysfunction
• sickle cell disease (abnormal red blood cells)
• use of recreational or illicit (illegal) drugs
• medical conditions such as cancer or blood disorders
• an injury to the blood vessels that supply blood to your penis
• certain medicines used to treat high blood pressure

Often the cause of priapism is unknown.

When should I see my doctor?

If you have a prolonged or painful erection, get medical help immediately. If you cannot see your doctor urgently, go to your closest emergency department. The sooner you get treatment, the better the outcome.

You should get emergency medical care if you have:

• an erection that lasts for more than 3 or 4 hours
• sickle cell disease and a painful erection that lasts for more than 1 hour

How is priapism treated?

Treatment of priapism may include:

• Medicines to help blood leave your penis
• Your doctor using a needle and syringe to release some of the blood from your penis. This is done under local anaesthetic.
• Surgery to drain the blood from your penis. This is done under general anaesthetic.

What are the complications of priapism?

The main complication of priapism is erectile dysfunction. The longer priapism lasts, the more likely you are to develop erectile dysfunction.

Having repeated episodes of priapism can cause anxiety about sexual activity. This may affect your:

• mental health
• sexual function
• intimate relationships

Surgery for priapism can cause complications including infection and erectile dysfunction.

Can priapism be prevented?

Priapism can't always be prevented. You can lower your chances of having a prolonged erection by:

• avoiding illicit drugs
• only using medicines for erection problems if they are prescribed by your doctor
• only buying your medicines from a registered Australian pharmacy — visit the Therapeutic Goods Administration (TGA) to check before you buy medicines online

You can help manage the symptoms of priapism by:

• having a warm bath or shower
• exercising gently
• drinking plenty of water
• trying to urinate (pee)
• avoiding masturbation
• avoiding alcohol
• avoiding smoking and vaping

Resources and support

For more information about the causes, symptoms, diagnosis and treatment of priapism, see the Healthy Male website.

To learn more about the effect of certain medicines on sexual function, visit the Therapeutic Goods Administration website.

The Family Planning Australia page offers factsheets on male sexual and reproductive health.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.