Does balanitis cause erectile dysfunction? Many people are concerned that if you experience soreness, redness or swelling at the tip of your penis, that this will cause problems with getting or maintaining an erection.
Generally speaking, no. Balanitis does not cause erectile dysfunction as it is caused by irritation or inflammation of the skin at the tip of the penis. Erectile dysfunction is caused by issues with blood vessels, nerves and other structures.
However, there may still be some links. Painful sex, anxiety and underlying health conditions can all impact on sexual function.
Diabetes can cause you to be more likely to suffer from balanitis and erectile dysfunction. Long-term skin conditions such as genital lichen sclerosus can cause scarring which makes erection painful.
Below we look at how these issues can link, what symptoms to look out for and when to see a doctor.
So, Does Balanitis Cause Erectile Dysfunction?
Balanitis is inflammation and irritation of the head of the penis (glans) and may affect the foreskin in some cases, especially in uncircumcised men. During erection sexual stimulation sends messages between the brain and nerves. This will result in the penis relaxing its smooth muscles causing increased blood flow into the erectile tissue.
Balanitis mainly affects the skin on the surface so is generally not seen as a direct cause of erectile dysfunction. However, there are a few reasons why balanitis can be linked to erectile dysfunction:
1. Pain and Discomfort
Balanitis can cause redness, swelling, itching, soreness and discomfort around the head of the penis. This can make sexual activity uncomfortable.
If you are experiencing pain when getting aroused this can cause concern.
This concern can impact on your sexual arousal making it difficult to get and maintain an erection. Some men may also avoid being intimate due to their concern of experiencing pain.
This doesn’t necessarily mean that balanitis has caused damage to your erectile structures but could simply be due to physical discomfort and stress.
A course of treatment for the inflammation should help reduce any discomfort. However, if you still have issues with erection, then speak to your GP to look at other causes.
2. Scarring can lead to painful erections
Not always a result of infection or irritation.
A good thing to know about is genital lichen sclerosus. When this occurs on the penis it is called balanitis xerotica obliterans (BXO).
This is a chronic inflammatory skin condition that can lead to white patches on the skin, which can cause tightness and scarring in the glans and foreskin.
This causes tightness in the skin and makes it difficult to retract the foreskin. Some men may have pain when they get an erection or during sexual intercourse. More severe cases can cause scarring leading to a tight foreskin (phimosis) and issues during urination.
This issue is due to inflammation of the skin and the change in movement rather than reduced blood flow to the penis.
Early diagnosis and treatment may help prevent further scarring.
3. Diabetes can lead to both conditions
An important common risk factor for balanitis and erectile dysfunction is diabetes.
High glucose levels in blood cause increased glucose in urine and an altered immune response. This can cause an increased risk of yeast infections and inflammation in the genital area.
Diabetes can also cause damage to the blood vessels and nerves that are responsible for erections. This can result in erectile difficulty.
If you are suffering from frequent balanitis and erectile issues, you may have an issue with your blood sugar levels.
If you suffer from frequent balanitis, especially if you have other symptoms of diabetes, your GP may suggest you have some tests to check your blood sugar levels (for example an HbA1c).
It is important to manage your diabetes to improve your general health. This can also help decrease your risk of sexual health issues.
What Is Balanitis, and How Common Is It?
- Balanitis is when there is inflammation in the glans of the penis. The glans is the rounded head of the penis.
- If there is inflammation in the glans and foreskin then it is called balanoposthitis. If there is only inflammation in the foreskin then it is known as posthitis.
- Balanitis can affect men of all ages but is more common in uncircumcised men.
- It can occur due to infection, irritation of the skin, a skin disorder or due to certain health conditions such as diabetes.
Maintaining good genital hygiene, avoiding irritants and managing any underlying medical conditions can help lower your risk of developing balanitis (healthdirect Australia).
Balanitis Symptoms
Symptoms of balanitis can come on quickly or slowly and can affect either the head of the penis, foreskin or both.
Symptoms commonly associated with balanitis include:
- A rash and swelling: The head of the penis or foreskin may be red and inflamed.
- Itching: Persistent itching, soreness and irritation.
- Dry/ flaky skin: The affected area may feel dry, flaky and irritated.
- Red/pink patches: Red or pink patches may form on the glans or foreskin.
- Discharge: Some men will notice that there is some discharge under their foreskin.
- Unusual smell: Sometimes there might be an unusual smell, especially if there is an infection or discharge.
- Painful to pull back foreskin: The inflammation and scarring can cause the foreskin to be painful to pull back.
Not everyone will have all of these symptoms. Symptoms can vary depending on the cause.
See your GP if you are noticing constant redness, swelling, unusual discharge or pain.
Balanitis Causes and Risk Factors:
What causes Balanitis?
There isn’t always one cause. It can be caused by infections or irritation from normal substances or skin conditions.
You’re more likely to get balanitis if you have an uncircumcised penis, diabetes, trouble cleaning your genitals gently, or have a skin condition.
Infectious Causes
Balanitis can be caused by microorganisms causing irritation to the head of the penis/foreskin.
Common causes include:
- Fungal infection – This can be caused by a yeast infection known as Candida. This can cause redness, itchiness and soreness.
- Bacterial infection – Bacterial infections such as streptococci and staphylococci can irritate.
- Viral infection – Certain viruses can cause symptoms of the genital area. For example, herpes and the human papillomavirus (HPV).
Balanitis isn’t usually caused by a sexually transmitted infection (STI). However, if you have symptoms and/or sexual history, your GP may suggest you have tests for STIs.
It is important to find out what is actually causing the balanitis so you can treat it correctly. Different infections will need different treatment.
Non-infectious Causes
There are several non-infectious causes of balanitis:
- Contact dermatitis – irritation or allergy to soaps, detergents, perfumes and other products.
- Skin disorders such as eczema and psoriasis can cause irritation to the genital area causing redness, itching and inflammation.
- Lichen sclerosus – this is a chronic inflammatory skin disorder which can cause white patches, tightening and scarring.
- Lichen planus – another inflammatory skin disorder which can affect various parts of the body including the genital skin.
- Zoon's balanitis – this is a chronic inflammatory condition which usually affects the glans.
- Drug reactions – certain medications can cause localised skin reactions.
In everyday life, using products with strong perfumes can cause irritation. Washing the area too harshly or leaving moisture to build up under the foreskin can cause irritation.
Not all balanitis is due to poor hygiene or a fungal infection. A correct assessment will help determine what is going on.
When to See a Doctor and How Balanitis Is Diagnosed
See your GP if there are any unusual symptoms involving redness, swelling, itchiness, soreness, or discharge around the head of your penis.
See your GP if:
- Your symptoms are recurrent.
- Painful erection or sexual activity.
- Difficulty pulling back your foreskin.
- Unusual discharge or abnormal changes to the skin.
- You have diabetes or think you may have high levels of blood glucose.
The doctor will ask you about your symptoms, medical history, medications and sexual health. They may examine the area.
Further tests may be requested, including:
- Swabs for any fungal or bacterial infection.
- Testing for STIs based on your symptoms/sexual history.
- Blood glucose tests to determine whether you have diabetes, especially if you are suffering from recurrent balanitis.
- Biopsy - in selected cases, especially if symptoms are ongoing, or difficult to diagnose, or there are abnormal changes to the skin.
If there is a suspected underlying skin problem, you may be referred to a dermatologist by your GP.
Treatment of Balanitis
The type of treatment will depend on what is causing the inflammation.
Sometimes simply changing the way you care for your skin can help. However, sometimes you may need prescription medications or treatment for an underlying medical condition.
Self Care
A few lifestyle changes can help reduce symptoms if you have balanitis.
- Avoid using soap. Don't use regular soaps, shower gels or perfumed products whilst the skin is inflamed.
- Use warm water or a gentle soap-free wash. Do not rub the area.
- Clean and dry. If your foreskin can be gently pulled back, clean and dry underneath, then return the foreskin to its normal position over the head of the penis.
- Don't pull back foreskin. If the foreskin is tight or painful don't pull back forcefully.
- Avoid using perfumed wipes, deodorants or harsh products.
- If having sex causes any discomfort, avoid this until the inflammation settles. Follow your doctor's advice regarding when to resume sexual activity.
Sitting in a warm salty bath may help reduce swelling and discomfort. You may also find using a basic moisturiser such as white soft paraffin useful (Healthdirect Australia).
Treatment
The type of medicine you are prescribed will depend on the cause.
- Fungal infection – Your doctor may recommend using antifungal medication such as clotrimazole.
- Bacterial infection – If there is a bacterial infection you may be prescribed antibiotics.
- Contact dermatitis – Your doctor may recommend using a topical corticosteroid and avoiding the irritant.
- Other skin conditions – Some skin conditions such as psoriasis and lichen sclerosus will need targeted treatment based on the diagnosis.
Do not use any remaining antibiotics, steroid cream or antifungal products without medical advice. This can cause further irritation to the skin and prevent the correct diagnosis.
Circumcision
If you suffer from recurring balanoposthitis or the foreskin becomes too tight (phimosis) your doctor may talk to you about having a circumcision.
A circumcision is an operation where the foreskin is removed. In some cases where there are continuing problems with inflammation and/or foreskin issues then you may be offered a circumcision.
However, it is not usually the first choice of treatment for most cases of balanitis. Your doctor will take into consideration the symptoms you have been experiencing, any medical history you may have and how well you are responding to treatment.
Sex and Sexual Relationships
If you have balanitis you may need to refrain from sexual activity until your inflammation and irritation has subsided.
This will depend on your individual cause. Some infections have specific guidelines and precautions that you should take with your sexual partner.
However, usually balanitis isn’t caused by an STI so it doesn’t necessarily mean that your sexual partner would have an infection.
If an STI is suspected or confirmed then follow the guidelines given to you by your healthcare professional regarding your sexual partner.
Complications of untreated balanitis
Most cases of balanitis will be managed well once the cause has been identified and treated. However, long standing or recurrent balanitis can lead to some complications.
Possible complications include:
- Phimosis – scarring or tightness around the foreskin can prevent it from being pulled back.
- Paraphimosis – if the foreskin gets stuck behind the head of the penis and cannot be moved forward to cover it, go to an emergency department immediately.
- Narrowing of the urinary opening (meatal stenosis) – in some cases, chronic inflammation and scarring can narrow the opening of the urethra at the tip of the penis. This can make it difficult to pass urine.
- Skin changes on the penis. Chronic inflammation can cause changes to the skin.
- Long-standing skin changes – chronic inflammatory conditions such as lichen sclerosus increases the risk of penile cancer.
Not everyone will get complications. However seeking early medical advice can help determine the cause and reduce the risk of any long term issues.
Can you prevent Balanitis?
Whilst not all cases can be prevented, taking good care of the skin on your genitals can help.
- Wash the penis daily using warm water or a gentle soap-free wash.
- Avoid using highly perfumed soaps, shower gels and deodorants in the genital region.
- If you have a retractable foreskin, gently wash underneath it and pat it dry.
- Do not force back a tight foreskin. If it is tight or painful to pull back, see your GP.
- Try to avoid vigorous washing.
- Ensure any underlying health issues are well managed, including diabetes.
- If there is persistent inflammation or irritation, seek medical advice.
Whilst good hygiene cannot always prevent balanitis, by reducing unnecessary irritation and ensuring underlying health problems are well managed, you can help keep the skin healthy.
If Erection Problems Continue After Balanitis Clears
In most cases, once the balanitis has resolved and the pain/soreness has gone, you should find that you will experience less discomfort during erections, as this is due to the inflammation.
However, if you are still experiencing erectile dysfunction, you should not automatically assume it is due to your balanitis.
There are many causes of ED, including:
- Diabetes/raised blood sugar
- Raised blood pressure
- Raised cholesterol
- Cardiovascular disease
- Hormonal disorders, such as low testosterone
- Certain medications
- Stress, anxiety, depression
- Smoking, drinking too much alcohol or other lifestyle factors.
Sometimes erectile dysfunction can be an early indicator of a cardiovascular/metabolic disorder.
A general practitioner (GP) can help by examining you, asking about your symptoms and medical history, and advising on investigations. You may be referred to a specialist depending on what is found.
It is important to seek help for any ongoing issues with erections.
When to Seek Urgent Medical Help
Most cases of balanitis do not need urgent medical help. However, go to an emergency department immediately if your foreskin is stuck behind the head of your penis and cannot be moved forward to cover it, or if you cannot pass urine. Also seek urgent medical help if you have:
- Severe or sudden swelling and pain
- A temperature or feeling very unwell, along with signs of infection
- A foreskin stuck behind the head of the penis (paraphimosis) needs urgent treatment, as poor circulation to the area can damage the tissue.
Frequently Asked Questions: Does Balanitis Cause Erectile Dysfunction:
Can Balanitis cause erectile Dysfunction?
Balanitis is unlikely to directly cause Erectile Dysfunction. However, pain, discomfort and anxiety can occur due to Balanitis and can affect sexual function and your ability to get an erection.Having an underlying condition such as diabetes can contribute to both issues.
Can you get pain when getting an erection due to balanitis?
Yes. Soreness, swelling and irritation can cause discomfort during erection. Lichen Sclerosus on the genital area can cause scarring and tightening of the foreskin which can cause pain during erection.
Why am I getting balanitis and erectile dysfunction?
Sometimes both can be caused by an underlying issue, especially if you have diabetes. Balanitis can cause pain and anxiety which can therefore affect your erection. Both issues can be looked at by your GP to determine if there is any underlying health issues.
Is balanitis a sexually transmitted infection?
In most cases it will not be. Balanitis can be caused by infection, skin irritation or skin inflammation, but in some cases it can be caused by STIs. How you are tested will depend on your symptoms and sexual history.
How long does balanitis last?
It depends on the cause of the issue and whether you have been treated. If it is mild and caused by irritation then it may get better by stopping using the product causing it. However, if it is caused by infection or a chronic skin condition then treatment may be required. Talk to your GP if your symptoms are not getting any better.
When would I need to be circumcised?
If you have recurring balanoposthitis or a tight foreskin (phimosis), you may be offered a circumcision. This is not usually the first treatment offered. Speak to a qualified medical practitioner.
