Sex is fun, there is no doubt about it, but it isn’t without some risks. While most people tend to think the risks of getting down and dirty are an unwanted pregnancy, an STD or getting caught with your pants down, there are some very real injuries that can happen during sex. 

Full disclosure, we are talking about those people who have a penis and injuries that can occur to the penis and the testicles. 

Now before we jump into it, don’t go thinking that these injuries are only possible when two or more parties are involved. We will be talking about some alone time problems as well.

Time for the good stuff. Everything mentioned below can occur with a partner or during a particularly vigorous masturbation session. Positions play a real factor when we talk about penile damage and with the entire Kama Sutra, Porn Hub and your own imagination at your disposal there are a lot of interesting manoeuvres that you can get into trouble with. 

Most injuries occur because of a slip up, literally, so before we get into the specifics, let’s outline the top positions to not only try, but to try to avoid injury.

Doggy Style 

A lot of tail wagging fun … too much? Often hailed as a man’s favourite and one the Bloodhound Gang let us know allows for multitasking, it is the most common position to cause penile and testicular injury.  

As a fantastic side note it is one of the best ways to change penetration depth and angle, which is one of the best ways to maximise orgasm with a partner so it is a good one to try out and master. 

However, with the wrong position and wrong angle the penis can be forced into a situation that does not allow for adequate movement and can result in a broken penis, or penile tearing. Wincing yet?

Also note that trying to use doggy style to enter a different entrance without permission also tends to result in injury for a (w)hole different reason.

Cowgirl and Reverse Cowgirl 

This well known position has the partner on top facing towards or away, while thrusting upwards. Similar to the above issues, if the penis slips out and misses re-entrance or your partner twists and loads in a different way this can result in a penis fracture. 

Cowgirl anal sex also tends to be harder for the partner on top to maintain support so ensure you add additional measures to reduce injury risk. A bed head or straps do the trick.    


Classic and often overlooked, but if your partner has a shorter vaginal canal or it sits at a different angle, the penetration can result in a sudden impact with a vaginal wall or miss and hit the surface below.

Standing, sitting and any hard surface 

It makes sense that if you change up the location and head out of the bed, added risks are involved. None of this should put you off trying to have sex on anything that seems fun (and sturdy) but work on your aim and take a little care to not miss and hit said surface. 

So, on to the specifics of each injury.

Broken Penis

For those who are a bit of a disbeliever, yes it is possible to break your penis. While humans do not have a penis bone, the two thick chambers in the penis, the corpus cavernosum, that fill with blood during an erection have a fibrous sheath surrounding them. During extra vigorous coital sessions blunt force trauma can occur causing what we call a broken penis.

The most common situation is during vaginal penetration. This occurs when the penis is fully removed from the vagina and in a rapid manner to reinsert it you miss, either hitting your partner’s pubic bone, or the surface below. 

Due to the nature of this injury most men do not seek immediate treatment as they are embarrassed and hope that it will just ‘fix’ itself. Hate to burst your bubble but yeah, look, that doesn’t happen.

Doggy style accounts for almost half of all penis fractures, with missionary (man on top), cowgirl and reverse cowgirl rounding out the top four, and self-inflicted (read: masturbation) the number five cause. 

With men increasing their use of masturbation sleeves (flesh-lights) and real-feel sex dolls, these injuries are just as possible solo as with a partner. The tip with any of these devices is to use lube, and lots of it. 

So you have broken your penis – what do you notice? Severe pain, an instant loss of erection and even a loud ‘pop’, but usually the instant discomfort is enough to alert you that something is not right. 

A quick surgical repair is required following a penis fracture and the good news is that in about eight weeks you can resume light sexual activity. 

Keep the good supporting underwear on hand though as you will need this for many months to come.            

Torn Frenulum, aka the banjo string 

If the above has not yet brought tears to your eyes, this one will. A frenulum tear is a tear to the small band of tissue that runs from the bottom of the glans of the penis (the head) down the shaft. 

Similar to above, this injury tends to happen during vigorous sexual activity, repeated penetration or masturbation without adequate lubrication, causing the skin to get stuck and small tears to occur. 

It can start with a feeling of a gentle tug along the tip of the penis and then continue along the shaft, a quick image search can fill you in on all the gory details. For reference, if you have ever eaten string cheese and pulled a string all the way down, similar concept.  

Due to the location and anatomy, a frenulum tear will usually bleed a lot. The level of pain and amount of blood is not indicative of severity so just remember to stay calm. 

This one can be managed at home, control the bleeding, keep it clean, no sex or masturbation until healing has occurred. 

The major focus after this injury is to prevent infection, once the skin looks good then you can resume normal activity. Just remember if you have had this injury once you can get it again so use a lot more lube to help prevent any sticking and tearing. 

Left Sides Testicle Pain and Varicocele

If you have ever used the expression ball-slapping sex or you are a fan of that very distinct slapping sound, there is something you should know. Yes, you can hurt and bruise your testicles. Sorry to be the bearer of bad news but you can cause them to swell up to over double their normal size. 

Basic review of testicular anatomy quickly: we have veins and arteries that lead into the testes, but the veins in the left teste hang lower, and his means that some conditions are more common on the left-hand side. This is what is known as a Varicocele, or basically a varicose vein in the testicle. These can be very painful and often you can see a distended and swollen vein along the bottom of the testes. 

Basic treatment is to wear good and supportive underwear, reduce testicular impact and rest. In more severe cases a visit to a urologist and surgery may be needed. 

Doggy style, partner on top or just a bit too much aggressive foreplay can cause testicle injury. Please don’t overlook them and always remember to regularly check yourself out for lumps and bumps – early detection can help identify testicular cancer.  

There are a lot of unique injuries that can occur to the penis, most of which don’t require more than just a degree of good hygiene and good support to help heal. If you have any concerns, always contact your doctor and get checked out. 

Remember that if you manage to hurt yourself while having sex don’t feel embarrassed, it’s an injury that comes with a good story. 

To prevent almost all of them, let me leave you with this: there is no such thing as too much lube.    

This article was contributed by Alex Mackay, a Senior Physiotherapist who specialises in musculoskeletal, pelvic health and pelvic pain at Brisbane’s Ironside Sports and Physiotherapy.  If you want to hear more from Alex you can follow him on Twitter @MackayPhysio.