Erectile dysfunction is a significant problem among many men globally. There several known conditions that affect the functionality of the penile muscles. Whereas many are treatable, some are still hard to manage. Scientific researchers are still grappling with such severe conditions. In this article, we will look at one such condition known as PRIAPISM. We will also check if you can get priapism in your sleep.

What is Priapism?

Priapism is a prolonged, persistent painful erection of the penis. A penile erection usually comes after blood flows through the penile arteries. When the blood does not flow in and out of the penile arteries, then a painful erection occurs. Since it is a condition that is not related to sexual stimulation, it can be a fatal medical condition. An erection that stays for more than four hours is probably priapism. If left alone, the state can damage the penile tissues causing permanent penile erection dysfunction.

Causes of Priapism

The cause of priapism is a debate that still rife in medical circles. Researchers are still grappling to better understand the condition. It is a situation that occurs in men of all ages. Though it is prevalent between the ages of 5 to 50, it can occur in newborn babies. The known causes of priapism include:

1. Prescription drugs sometimes narrow or block the blood arteries that supply blood into the penis during an erection. This is common with the abuse of antidepressants. When this happens, blood flows but does not drain from the penis.  Recreational drugs like cannabis, cocaine, and hemp can display similar effects as prescription drugs.

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2.  An injury to the scrotum or penis can cause substantial damage to penile arteries. This can cause a blockage resulting in priapism. Other injuries include an injury to the spine or a bite from the black widow spider.

3. Sickle cell anemia is another cause. Due to the abnormality in their shape, red blood cells may block the penile arteries. Some chronic blood disorders, like leukemia, can also contribute to priapism.

4. When malignant cells occur on the penile arteries, they can block the flow of blood, resulting in a painful erection.

Types of Priapism

The three types of priapism are:

1. Ischemic Priapism

This is the most prevalent form of priapism. It is a result of blood not flowing out of the penile arteries when an erection occurs. In some quarters, it is known as low-flow priapism.

2. Recurrent priapism

Also known as the stuttering priapism. It is rare and mostly manifests in patients with anemia.

3. Non-ischemic priapism

This is the opposite of the ischemic. It occurs when the arteries allow poor regulation of blood flow. It then results in a high flow of blood in the penis, causing priapism.

Can You Het Priapism in Your Sleep?

Having an erection is familiar with men during the night. This is mainly due to sexual arousal or the need to urinate. You can also get priapism in your sleep. As usual, they are painful and can last for over an hour. This situation can lead to an acute lack of sleep. The excruciating pain does not ease even with ejaculation.

In trying to manage the pain, some priapism victims ease themselves by urinating. Others walk around and get some relief. Though some get significant pain relief, the calmness usually is temporary. Often, priapism can occur twice or thrice in your sleep. That makes sleeping impossible. The after-effects are fatigue, irritability, and anxiety.

Stages of Priapism Treatment


The treatment of priapism involves a series of tests the doctor may prescribe. Blood gas measurement is the primary form of diagnosis. The doctor extracts a blood sample from the penis. This determines which type of priapism you have. If your blood is black and has little oxygen, then you have Ischemic priapism. On the contrary, if your blood is bright red with adequate oxygen, then you have Non-Ischemic priapism.

The second blood test checks on other blood diseases and disorders. The doctor will extract a sample for the laboratory test. With the revelation from the red blood cells and the platelets, the doctor will make a diagnosis. This test mainly focuses on cancer, anemia, leukemia, and the like.

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Since drug abuse can cause priapism, the doctor may order for your urine sample for laboratory tests. The results will reveal the existence of any drug that may cause priapism. Toxicology tests are standard on patients who are on other medications.

If you had an accident before the condition, the doctor might order a scan to ascertain the effect of the injury. With the results, the doctor will advise you whether the trauma from the injury is the cause of your priapism or not.


Having priapism in your sleep is a rare condition that can cause permanent tissue damage to your penis. Thus, you need immediate treatment if you experience a painful nocturnal erection that lasts above an hour. The treatment of priapism depends on the type and original cause.

Having decongestant drugs like baclofen, clonazepam, and clozapine is proper. They ease the flow of blood into the penile arteries. The medication reduces the frequency and intensity of the erections. For erections that persist after the decongestant, then other options will come in.

Cold therapy or ice packs placed on the penis can ease the swelling by freezing the nerves. This is effective for a short period while using decongestant medication. The numbing of the penis through an injection creates relief to the patient.

Surgery is the last but major option. The doctor drains blood for the arteries using a shunt. If the arteries are repairable, the doctor will unblock the passageways to ease the proper flow of the blood. If it is not possible, the doctor can also tie the arteries if they are beyond repair.


Priapism is a severe condition. If it is left alone, it can cause severe damage to your penile tissues. When you get priapism in your sleep, you must get medical attention. With proper diagnosis and treatment, you can manage the condition well.

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