Men’s health issues, especially those related to sexual health, are often not discussed openly. Many men feel shy or embarrassed to talk about private problems, which can lead to serious conditions being ignored. One such condition is priapism. While it may sound unfamiliar to many, priapism is a medical emergency that can have lasting effects if not treated quickly. It involves a prolonged erection that isn’t related to sexual activity and can even happen while sleeping. Understanding priapism and knowing when to seek help is important for every man.

What Is Priapism?

Dr Rishikesh Velhal, Consultant Urology, Apollo Hospitals, Navi Mumbai, explains, “Priapism is a condition that can look dramatic and rare, but it actually creeps in quietly, and can be quite devastating if ignored. It refers to a prolonged penile erection that lasts beyond four hours, without any sexual stimulus, and it's not just a nuisance; it’s a medical emergency.” If an erection lasts more than four hours without sexual arousal, it’s not normal and needs urgent care.

ALSO READ: Happy and Heavier: Why Women in Healthy Relationships Experience the 'Happy Weight' Effect

Types of Priapism

Dr Velhal points out two main types:

Ischemic Priapism (Low-Flow):

Blood gets trapped in the penis and cannot leave. “In the ischemic variety, blood gets trapped in the corpora cavernosa (two sponge-like cylinders of erectile tissue in the penis that fill with blood to enable an erection) with no exit path. This condition is far more dangerous than the non-ischemic type. The penis becomes rigid and painful, and as time ticks by, the oxygen in the trapped blood depletes, leading to tissue death. It would not be an exaggeration to say that delay in hospital care may result in a man losing his ability to ever have a natural erection again.” In India, many cases are linked to sickle cell disease and thalassemia. Other causes include erectile dysfunction medicines, recreational drugs, and psychiatric medications. Young men often delay seeking help due to embarrassment.

Non-Ischemic Priapism (High-Flow):

Usually caused by injury to the pelvis or perineum. “In contrast, non-ischemic priapism, usually caused by trauma, often a pelvic or perineal injury, presents differently. It is not as painful, and the urgency is lower since the erection is semi-rigid. These patients typically don’t face an emergency, but they need evaluation nonetheless.”

Can Priapism Occur While Sleeping?

Yes, it can. Dr Velhal says, “Now to the question that surprises many people, can priapism occur during sleep? Absolutely. In fact, that’s when many of these episodes begin, especially in patients with recurrent or ‘stuttering’ priapism. This is a pattern most commonly seen in sickle cell disease. These patients often wake up in the middle of the night or early morning with a painful erection that doesn't subside. Unlike normal nocturnal erections that occur during REM sleep and resolve spontaneously, these erections persist and escalate. It can disturb sleep, cause fatigue, and even affect mental health.”

Teenagers may hide this problem out of embarrassment, using cold showers or exercise to cope. Repeated episodes can quietly damage the penis, and families may not realize the seriousness until it’s too late.

How Is Priapism Treated?

Treatment depends on the type and how long the erection has lasted. “For ischemic priapism, aspiration of blood from the penis comes first, followed by an injection of the alpha-adrenergic agonist variety (usually phenylephrine). Again, time is truly of the essence. If conservative steps fail, surgical shunting or, in chronic cases, implantation of a penile prosthesis may be necessary.”

ALSO READ: Even Men Have PMS Symptoms! Exploring The Irritable Male Syndrome (IMS)

Why Awareness and Early Action Matter

Priapism is not just a urology issue. It needs attention from different medical fields, including blood disorders and mental health. Dr Velhal says, “Priapism is a bridge between urology, haematology, emergency medicine, and psychology. It demands a sensitive ear and a firm clinical hand. People should recognise the red flags, especially nocturnal episodes, so that they can initiate early, effective treatment, which can make the difference between a one-time scare and lifelong sexual dysfunction. In the Indian context, awareness and timely medical care remain the biggest challenges and the most powerful tools.”

Conclusion

Priapism is a serious condition that should never be ignored. It can happen to any man, even during sleep. Quick action and open conversations can save men from long-term problems. If you or someone you know experiences a prolonged, painful erection, seek medical help right away. Breaking the silence about men’s health can make all the difference.

What Is Priapism, A Condition in Men, And Can It Occur While Sleeping?