Dr Nicholas Antonakopoulos

Medically reviewed by

Dr Nicholas Antonakopoulos

Last reviewed: 28 Feb 2019

Priapism's causes, symptoms and treatments


Key takeaways

  • Priapism is when you have an erection that lasts for longer than 4 hours, usually causing pain

  • Priapism happens when the blood in the penis that is causing an erection is not able to leave

  • It can be caused by injury to your genitals or from an underlying blood disorder

  • Priapism is very rare but serious, and is more common in people taking erectile dysfunction medication, and among those with sickle-cell anaemia

  • Priapism is usually treated by draining the excess blood from the penis using a needle and syringe

What is priapism?

Priapism is a prolonged or persistent erection that lasts for more than 4 hours and is often very painful. This erection will not subside after ejaculation and may not be related to sexual stimulation at all. During the erection, the shaft of the penis will be rigid, but the glans (head of the penis) may be soft.

Priapism is potentially dangerous and should be treated as a medical emergency. If you have a painful erection that lasts for more than 4 hours, seek immediate medical attention. Left untreated for more than 24 hours, Priapism can permanently damage the penis and cause erectile dysfunction.

What are the symptoms?

The main symptoms of Priapism are:

  • a prolonged erection (lasting 4 hours or more)
  • a rigid shaft but soft head of the penis
  • (usually) a painful or tender penis

What causes it?

Priapism is caused when the blood that flows into the penis during an erection cannot flow back out of the penis or becomes blocked. Priapism comes in three main types:

  • low blood flow (ischaemic priapism), which is the most common and serious type of priapism, usually caused by a restricted blood flow or lack of blood flow to the penis
  • high blood flow (non-ischaemic priapism), which is rarer, usually caused by trauma or injury to the genital area
  • recurrent or intermittent (stuttering priapism), which can be either due to low or high blood flow, and is when you have recurrent, painful erections lasting around 2–3 hours at a time

Priapism can be caused by drugs or disorders that affect the central nervous system or blood flow to the penis. They can occur as an effect of:

  • sickle cell anaemia (a blood disorder)
  • certain antipsychotic or anticoagulant drugs

How common is priapism?

Priapism is extremely rare but more common in high-risk groups such as men with sickle cell anaemia, or men taking medical treatment for erectile dysfunction (like Viagra).

Up to 35% of men with sickle cell anaemia will experience an episode of priapism in their lifetime.

Fewer than 1 in 1,000 men will experience priapism as a side effect of their treatment for erectile dysfunction.

How is priapism treated?

If you ever experience an erection that is painful and/or lasts for more than 4 hours, seek emergency medical attention.

Treatment for priapism usually comes in the form of ‘aspiration’, when the trapped blood in your penis is drained using a needle and syringe. If aspiration is unsuccessful, your doctor will try injecting medication into the penis to force the blood vessels to expand and flow back out of the penis. Surgery will only be recommended if and when all other forms of treatment fail. The type of surgery will depend upon the type of priapism you have.

Diagnosing priapism

The treatment for priapism will depend upon the root cause.

If your priapism is non-ischaemic (due to a suspected injury or trauma to your genitals), you will usually be sent for a scan of the surrounding area to check the blood vessels of your penis, and for any long-lasting damage.

If your priapism is ischaemic, it could be the result of an underlying blood problem, such as sickle cell anaemia (lack of red blood cells), or an uncommonly high white blood cell count. You will be given a blood test to determine whether the priapism is a result of a blood problem.

Priapism and Viagra

Priapism is a (very rare) potential side effect of taking medication for erectile dysfunction, such as Viagra. Cases of priapism in men taking Viagra are virtually unknown, except in cases where Viagra is taken alongside another form of medication for impotence, such as injections of prostaglandin.

When used correctly, Viagra is safe to use and rarely has serious or long-lasting side effects. If your erection lasts for any longer than four hours while using Viagra, seek immediate medical attention.

Medically reviewed by:
Dr Nicholas Antonakopoulos

Dr Nicholas Antonakopoulos graduated from the University of London in 2006. He did his postgraduate training in hospitals in the London area, and he trained for four years in Trauma and Orthopaedic Surgery before completing his training in General practice in 2015.

Meet our doctors

Last reviewed: 28 Feb 2019

Erectile Dysfunction Treatments

ZAVA offers a convenient and discreet service to help men improve their erectile dysfunction. There are a number of treatments you can consider. Continue to our erectile dysfunction service page to learn about the treatment options available.

Customer reviews
trustpilot-ratings-4-halfstar (1794)
trustpilot-ratings-5-star by kel015, 04 Jul 2021
After problems at my GP surgery trying to get a repeat prescription for my contraceptive pill as due to the pandemic they didnt deal with my request in time so my prescription was not sent to the pharmacy and as my pill was due to run out I found these guys online and decided to give them a try, what can I say, the service was excellent from start to finish, the online questionnaire was simple to complete, my order was approved by a doctor and I was kept up to date every step of the way with regards to delivery, my parcel was delivered within a couple of days in perfect condition and fully branded packaging, would definitely use this service again
trustpilot-ratings-5-star by Victoria, 01 Apr 2021
Brilliant! Fast delivery. Thank you!
trustpilot-ratings-5-star by Anne, 25 Mar 2021
I’ve used Zava med quite a few times now and I always find them efficient, thorough, a fair price and easy to deal with if I have any queries or worries. I don’t often have time to get to doctors for repeat prescriptions or for appointments for repeat conditions where I know the cause and I know the treatment, and Zava is BRILLIANT for this. I love how you can contact their doctors at any time, and how they follow up an order to check everything is ok. Top marks Zava Med!!!
trustpilot-ratings-5-star by Danielle, 27 Feb 2021
Fantastic service
trustpilot-ratings-5-star by Keith Cunliffe, 03 Apr 2021
I got my medicine in a couple days all fine.

Authorised and regulated by