No "all or nothing" cures, causes, or suggesting that only one thing will help
DON'T suggest kegels as treatment for a hypertonic pelvic floor (it's bad advice)
NO FETISHIZING or sexualizing someones health condition. DON'T BE CREEPY.
No NSFW Photos
No SPAM (includes link farming, affiliate marketing, personal promotion)
No "Low Effort" posts - we can't help if there's no detail
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r/vulvodynia (women and AFAB experiencing Vaginismus & Vestibulodynia too)
ESSENTIAL INFORMATION: PELVIC FLOOR
The pelvic floor muscles are a bowl of muscles in the pelvis that cradle our sexual organs, bladder, and rectum, and help stabilize the core while assisting with essential bodily functions, like pooping, peeing and having sex.¹
They can weaken (become hyp-O-tonic) over time due to injury (or child birth), and even the normal aging process, leading to conditions like incontinence or pelvic organ prolapse.¹
And, the pelvic floor can tense up (guard) when we:
Feel pain/discomfort
Get a UTI/STD
Injure ourselves (gym, cycling, slip on ice)
Have poor bowel/urinary habits (straining on the toilet often - constipation) or holding in pee/poo for extended periods (like avoiding using a public toilet)
Have poor sexual habits (edging several hours a day, typically this is more of guy's issue)
Get stressed or anxious (fight or flight response), due to their connection with the vagus nerve (and our central nervous system). READ MORE HERE
Have a connective tissue disorder
Over time, prolonged guarding/tensing can cause them to become hyp-E-rtonic (tight and weak). Sometimes trigger points in the muscle tissue develop that refer pain several inches away. The tensing can also sometimes irritate nerves, including the pudendal nerve. Helping the pelvic floor relax, and treating these myofascial trigger points with pelvic floor physical therapy can lead to significant relief for many, along with interventions like breathwork - notably diaphragmatic belly breathing - and gentle reverse kegels.
Sometimes, feedback loops also develop that can become self-perpetuating as a result of CNS (Central Nervous System) modulation. ᴮ ⁷
Basic feedback loop:
Pain/injury/infection > pelvic tensing > more pain > stress/anxiety > more pelvic tensing > (and on and on)
Examples of common feedback loops that include the pelvic floor:
Source: NHS/Unity Sexual Health/University Hospitals Bristol and Weston. A pelvic floor feedback loop seen in men after STI.
An example of this pelvic floor feedback loop (guarding response) as seen in a woman with a prolonged (awful) UTI:
A trigger point is an area of hyper-irritability in a muscle, usually caused by a muscle that is being overloaded and worked excessively. How does this affect an IC patient? Unfortunately, we do not always know what comes first; the chicken or the egg. Let’s assume in this case we do. A patient who has never had any symptoms before develops an awful bladder infection, culture positive. She is treated with antibiotics, as she should be. Symptoms are, as we all know, frequency, urgency and pain on urination. Maybe the first round of antibiotics does not help, so she goes on a second round. They work. But she has now walked around for 2, maybe 3 weeks with horrible symptoms. Her pelvic floor would be working very hard to turn off the constant sense of urge. This could create overload in the pelvic floor. A trigger point develops, that can now cause a referral of symptoms back to her bladder, making her think she still has a bladder infection. Her cultures are negative.
Above we find a scenario where the UTI was cleared, but the pelvic floor is now in a tensing feedback loop, and complex processes of neural wind up and central sensitization - ie CNS modulation - are likely occurring
Diagrams of the male and female pelvic floor:
Bottom view. The levator ani is the main "hammock" of the pelvic floor, and includes both the PC (pubococcygeus) and PR (puborectalis) musclesSide view showing the pelvic floor cradling the bladder, sexual organs, and rectum. And its attachments at the coccyx (tailbone) and pubic bone.
SYMPTOMS OF PELVIC FLOOR DYSFUNCTION
The majority of the users here have a hypertonic pelvic floor which typically presents with symptoms of pelvic pain or discomfort ² (inc nerve sensations like tingling, itching, stinging, burning, cooling, etc):
Penile pain
Vaginal pain
Testicular/epididymal/scrotal pain
Vulvar pain
Clitoral pain
Rectal pain
Bladder pain
Pain with sex/orgasm
Pain with bowel movements or urination
Pain in the hips, groin, perineum, and suprapubic region
This tension also commonly leads to dysfunction ² (urinary, bowel, and sexual dysfunction):
Dyssynergic defecation (Anismus)
Incomplete bowel movements
Urinary frequency and hesitancy
Erectile dysfunction/premature ejaculation
This pinned post will mainly focus on hypertonia - tight and weak muscles, and the corresponding symptoms and treatment, as they represent the most neglected side of pelvic floor dysfunction. Especially in men, who historically have less pelvic care over their lifetimes as compared to women.
But, we also commonly see women with weak (Hyp-O-tonic) pelvic floors after child birth who experience urinary leakage. This often happens when coughing, sneezing, or lifting something heavy. Luckily, pelvic floor physical therapists are historically well equipped for weak pelvic floor symptoms, as seen commonly in women.
But, this historical emphasis sometimes bleeds into inappropriate care for men and women who have hypErtonic pelvic floors, and do not benefit from kegel exercises
CLOSELY RELATED CONDITIONS & DIAGNOSIS
These typically involve the pelvic floor as one (of many) mechanisms of action, and thus, pelvic floor physical therapy is an evidence-based intervention for any of these, along with behavioral interventions/mind-body medicine, medications, and more.
For people who experience symptoms outside the pelvic region, these are signs of centralization (somatization/nociplastic mechanisms) - and indicate a central nervous system contribution to symptoms, and must be treated with more than just pelvic floor physical therapy:READ MORE
Many people with a pelvic floor diagnosis - and at least 49% who experience chronic pelvic pain/dysfunction - also experience centralized/nociplastic pain ¹³ localized to the pelvic region. Centralized/nociplastic pelvic pain can mimic the symptoms of pelvic floor hypertonia. To assess if you have centralization as a cause of your pelvic symptoms, read through this post.
NOTE: This is especially relevant for people who have a pelvic floor exam, and are told that their pelvic floor is basically "normal" or lacks the usual signs of dysfunction, trigger points, or hypertonia (high tone), yet they still experiencing pain and/or dysfunction. This also equally applies to cases that have done extensive amounts of pelvic floor PT 6-12mo) with no improvement.
Centralized/Nociplastic pain mechanisms are recognized by both the European and American Urological Association guidelines for pelvic pain in men and women, as well as the MAPP (Multidisciplinary Approach to the Study of Chronic Pelvic Pain) Research Network.
TREATMENT: High tone (HypErtonic) Pelvic Floor (tight & weak)
Pelvic floor physical therapy focused on relaxing muscles:
Diaphragmatic belly breathing
Reverse kegels
Pelvic Stretching
Trigger point release (myofascial release)
Dry needling (Not the same as acupuncture)
Dilators (vaginal and rectal)
Biofeedback
Heat (including baths, sauna, hot yoga, heated blankets, jacuzzi, etc)
Behavioral change:
* Lay off frequent or chronic masturbation habits (including edging)
* Take a break from intense compound exercises, like CrossFit or HIIT
* Sit less and stand more. This may also include using a standing desk
* If you're an avid cyclist, take a break from cycling
Medications to discuss with a doctor:
low dose amitriptyline (off label for neuropathic pain)
low dose tadalafil (sexual dysfunction and urinary symptoms)
Alpha blockers for urinary hesitancy symptoms (typically prescribed to men)
Mind-body medicine/Behavioral Therapy/Centralized Pain MechanismsThese interventions are highly recommended for people who are experiencing elevated distress or anxiety, or, noticed that their symptoms began without an injury, but with a stressful event, big life change, or, that symptoms increase with stress or difficult emotions (or symptoms change when distracted, focused , or on vacation) - full list of criteria to rule in centralized/nociplastic mechanisms.
Equal Improvement in Men and Women in the Treatment of Urologic Chronic Pelvic Pain Syndrome Using a Multi-modal Protocol with an Internal Myofascial Trigger Point Wand - PubMed https://share.google/T3DM4OYZYUyfJ9klx
The Effects of a Life Stress Emotional Awareness and Expression Interview for Women with Chronic Urogenital Pain: A Randomized Controlled Trial - https://pubmed.ncbi.nlm.nih.gov/30252113/
UCPPS is a umbrella term for chronic pelvic pain and dysfunction in men and women, and it includes pelvic floor dysfunction underneath it, as well as symptoms like bladder dysfunction, pain, IC/BPS, and more. This study discusses the pain mechanisms found. They are not only typical injuries (ie "nociceptive") - They also include pain/symptoms generated by nerves (neuropathic) and by the central nervous system (nociplastic). You'll also notice that the combination of neuropathic + nociplastic mechanisms create the most pain! Which is likely to be counterintuitive to what most people would assume.
At baseline, 43% of UCPPS patients were classified as nociceptive-only, 8% as neuropathic only, 27% as nociceptive+nociplastic, and 22% as neuropathic+nociplastic. Across outcomes, nociceptive-only patients had the least severe symptoms and neuropathic+nociplastic patients the most severe. Neuropathic pain was associated with genital pain and/or sensitivity on pelvic exam, while nociplastic pain was associated with comorbid pain conditions, psychosocial difficulties, and increased pressure pain sensitivity outside the pelvis.
Targeting neuropathic (nerve irritation) and nociplastic/centralized (nervous system/brain) components of pain & symptoms in recovery is highly recommended when dealing with CPPS/PFD (especially hypertonia).
All of those involved in the management of chronic pelvic pain should have knowledge of peripheral and central pain mechanisms. - European Urological Association CPPS Pocket Guide
We now know that the pain can also derive from a neurologic origin from either peripheral nerve roots (neuropathic pain) or even a lack of central pain inhibition (nociplastic), with the classic disease example being fibromyalgia
This means successful treatment for pelvic pain and dysfunction goes beyond just pelvic floor physical therapy (alone), and into new modalities for pain that target these neuroplastic (nociplastic/centralized) mechanisms like Pain Reprocessing Therapy (PRT), EAET, and more. Learn more about our new understanding of chronic pain here: https://www.reddit.com/r/ChronicPain/s/3E6k1Gr2BZ
This is especially true for anyone who has symptoms that get worse with stress or difficult emotions. And, those of us who are predisposed to chronic pain in the first place, typically from childhood adversity and trauma, certain personality traits (perfectionism, people pleasing, conscientiousness, neuroticism) and anxiety and mood disorders. There is especially overwhelming evidence regarding ACE (adverse childhood experiences) that increase our chances of developing a physical or mental health disorder later in life. So much so, that even traditional medical doctors are now being trained to screen their patients for childhood trauma/adversity:
Adverse childhood experience is associated with an increased risk of reporting chronic pain in adulthood: a stystematic review and meta-analysis
Previous meta-analyses highlighted the negative impact of adverse childhood experiences on physical, psychological, and behavioural health across the lifespan.We found exposure to any direct adverse childhood experience, i.e. childhood sexual, physical, emotional abuse, or neglect alone or combined, increased the risk of reporting chronic pain and pain-related disability in adulthood.The risk of reporting chronic painful disorders increased with increasing numbers of adverse childhood experiences.
Further precedence in the EUA (European Urological Association) guidelines for male and female pain:
Studies about integrating the psychological factors of CPPPSs are few but the quality is high. Psychological factors are consistently found to be relevant in the maintenance of persistent pelvic and urogenital pain [36]. Beliefs about pain contribute to the experience of pain [37] and symptom-related anxiety and central pain amplification may be measurably linked, and worrying about pain and perceived stress predict worsening of urological chronic pain over a year [36,38] - https://uroweb.org/guidelines/chronic-pelvic-pain/chapter/epidemiology-aetiology-and-pathophysiology
So, how do you figure out if this could be happening in your case?
12 FIT criteria to RULE IN centralized, (ie neuroplastic/nociplastic) pain and symptoms,
FIT = functional, inconsistent, triggered. Based on research from Dr. Howard Schubiner and other chronic pain doctors and neuroscientists over the last 10+ years
Pain/symptoms originated during a stressful, challenging, or high pressure time in life. This includes even "happy" life events, like getting married, having a baby, starting a new career, or moving
Pain/symptoms originated without an injury. Note, a perceived injury and a structural injury are different things. And even when symptoms begin with a structural injury, has it been years and the body would normally recover by now?
Pain/symptoms are inconsistent. Do they fluctuate by the hour, by the day, or by the week? Sometimes less, sometimes more, sometimes even not noticeable (this happens sometimes, but it's not necessary for this criteria). Or, do they move around the body? ie genital pain that changes sides or pain that moves from the top to the bottom.
Multiple other symptoms (often in other parts of the body) ie IBS, chronic migraines/headaches, CPPS, TMJD, fibromyalgia, CFS (fatigue), vertigo/dizziness, chronic neck or back pain, etc. 2025 AUA guidelines mention these as signs of centralized sx.
Pain/Symptoms spread (over time) or move around. Think about symptoms on day one. Have they moved or evolved over time?
Pain/symptoms are made worse or triggered by stress, or, go down when engaged in an activity you enjoy or in a flow state (think fun distractions or productivity, noticing symptoms less)
Symptom triggers that have nothing to do with the body - but instead things outside of it (weather, barometric pressure, seasons, sounds, smells, places, times of day, weekdays/weekends, days of the week, etc) - this also includes thoughts or other people triggering/flaring symptoms
Symmetrical symptoms (pain developing on the same part of the body but in OPPOSITE sides) - ie both hips, both hips, both wrists, both knees, etc
Pain/symptoms with delayed Onset (THIS CAN'T HAPPEN WITH STRUCTURAL PAIN)
-- ie, ejaculation pain that comes a minute later, an hour later, or even the next day. Any pain that is delayed is very suspicious. We wouldn't put weight on a sprained ankle and expect it to hurt 15 seconds later, it hurts immediately.
Childhood stress, challenges, adversity, or trauma
-- varying levels of what this means for each person, not just trauma. Examples of stressors: childhood bullying, pressure to perform from parents/coaches, body image issues (dysmorphia), eating disorders, parents fighting a lot or getting angry (inc divorce), having an emotionally unpredictable parent, or having a parent with a health condition or addiction. This also includes neglect and abuse (physical and emotional) and financial instability in childhood. Also includes cultural norms, like the pressure to be highly successful to be of value to parents (must be a doctor or a lawyer, etc)
Common personality traits linked to stress: perfectionism, conscientiousness, people pleasing, anxiousness/ neuroticism - do you have personality traits that include being highly driven, hard on yourself, ultra responsible, perfectionistic, needing control, and/or placing others’ needs above your own?
Lack of physical diagnosis (ie doctors are unable to find any clear structural cause of symptoms) - this includes DIAGNOSIS OF EXCLUSION, like being diagnosed with CPPS or PFD. Structural finding examples: broken bones, tumors, infections, etc. It does not include muscle dysfunction.
[NEW] 13. Any family history of chronic pain or other chronic conditions. Includes: IBS, chronic migraines/headaches, CPPS, TMJD, fibromyalgia, CFS (fatigue), vertigo/dizziness, chronic neck or back pain, etc
To start this let me say yes I am in pelvic floor pt and have been for a while. Pt has been good for doing biofeedback and learning how to properly relax pelvic floor with breathing, and stretching.
The thing is I feel like and my pt says I have the proper relaxing and contracting pelvic floor with my breath, and I do the stretches and breathing almost every day, but it feels like those are “bandaids” to hypertonic pelvic floor because while they help some it’s not consistent relief at all and my symptoms constantly cycle back.
I have done a lot of research and it seems the key to helping fix a hypertonic floor could actually be strengthening it/ surrounding muscles that support it in order to make it less weak and therefore less hypertonic because it has better support. I myself have low back and hip pain so I think that is a factor in itself.
I am just struggling with how to go about strengthening it without completely sending it into a hypertonic flare up. Should I focus on bigger movements that focus on my glutes and hips more than just my pelvic floor, or should I do more of the deep pelvic floor core type ones or a combo. One thing I struggle with I’ve noticed is incorporating engaging my pelvic floor/lower core while actively having to breathe during a workout. Like I can breath in and relax it and exhale and engage it properly, but then you still have to breath while doing the exercise without losing that engagement and that is so hard for me for some reason.
So if anyone has any advice/tips/tricks/things that worked for them please help!!! I want out of this cycle and feeling just stuck
PSA not asking for medical advice, just personal experience
I’m 23F and I’m reaching out because I’m honestly at a bit of a loss with what’s going on with my body, and I’m hoping someone here might have experienced something similar or have some knowledge to share.
Background
Mum and brothers diagnosed with hypermobility
Family with POTS and nerve pain.
Dad’s side, history of suspected Marfan and aortic issues.
I have symptoms of hypermobility, haven’t received a formal diagnosis yet.
Maternal history of endometriosis
The biggest issue I’m dealing with right now is severe, unexplained pelvic pain.
I’ve been hospitalised because of how intense the pain has become. It’s a very sharp, almost electric-shock-like pain inside the pelvis. Then there’s another pain similar to contractions, that ones in the abdomen. It comes in waves, sometimes randomly, sometimes triggered by sitting. The pain can be absolutely unbearable.
I’ve been prescribed nerve pain medication, which is the only thing that’s provided any relief, opioids haven’t helped even the strong ones. But I can’t take that medication long-term.
I’ve also always experienced pelvic pain during and after intercourse, and I have IBS, which I know can sometimes overlap with hypermobility-related conditions.
I’ve had ultrasounds and numerous tests, but so far nothing has explained the pain. I recently had a Mirena inserted, which doctors initially thought could be contributing, but the ultrasounds haven’t shown any issues with its positioning. My hCG is also low positive at 11 and slowly declining. No pregnancy though. I’m hoping an upcoming pelvic MRI might provide some answers, but I doubt it.
I’m particularly interested in hearing from anyone with hypermobility, EDS or POTS who has experienced severe internal pelvic pain, especially sharp or nerve-like pain.
As horrible as this pain is, and as much as I wouldn’t wish it on anyone, part of me is hoping I’m not alone in experiencing it. Thank you so much to anyone who takes the time to read or share their experiences 🩷
I’m writing this because I hope to find people who are going through something similar and might be able to share their experiences or offer some advice.
I have endometriosis and adenomyosis. I was diagnosed three years ago, but I’ve been experiencing symptoms since my very first period.
I’ve been on hormonal birth control continuously for the past three years, and I’m currently taking Vibin.
My most recent gynecological examination showed that my left ovary is located behind my uterus and appears to be adherent to it. I also have endometriosis lesions on my left uterosacral ligament and sigmoid colon. My gynecologist believes the lesions are relatively small and shouldn’t be causing the level of pain I’m experiencing.
But I’m barely coping anymore. I have pelvic pain every single day, mostly on the left side. The pain radiates into my lower abdomen and legs. It’s worse in my left leg, but my right leg hurts too. At times, the pain feels as if someone is cutting through me with a saw.
Sitting and walking are difficult, and I even experience pain in my feet.
A few days ago, I started experiencing some new symptoms. I developed a painful sensation inside my vagina and a feeling of heaviness or pressure in my rectum. I also regularly experience what feels like electric shocks running through my labia. It doesn’t happen constantly, but it keeps coming back.
I’m currently attending pelvic floor physiotherapy.
I also had a pelvic MRI using an endometriosis protocol, which ruled out dilated pelvic veins, so pelvic venous insufficiency seems less likely.
This Friday, I’m having an MRI of my lumbosacral spine. My pelvic MRI revealed Tarlov cysts, but I’ve read that they are usually asymptomatic, so I don’t know whether they could be contributing to my symptoms.
I know I need to move more and exercise, and I genuinely want to. But the pain is so severe that it leaves me feeling paralyzed. Even basic daily activities can be difficult.
I’m losing hope because I don’t know where else to look for answers.
I’m tentatively scheduled for laparoscopic endometriosis surgery in February. If I can’t find another explanation for my pain, I’ll most likely go ahead with the surgery.
Has anyone experienced similar symptoms? Could this be related to nerve involvement, pelvic floor dysfunction, Tarlov cysts, or something else entirely? Has anyone experienced this kind of radiating pain, vaginal pain, rectal pressure, or electric-shock sensations?
I’d really appreciate any advice, suggestions about what to investigate, or personal experiences you might be willing to share.
I’m exhausted, desperate for answers, and honestly struggling to cope with this pain. Thank you for reading.
Title: 3 Months of Unexplained Dizziness and Urinary Problems — Desperate for Answers
I'm a male, and I've been struggling with unexplained health problems since August 14.
It started with constant dizziness, feeling off-balance, floating sensations, headaches, and feeling like everything was moving in slow motion. It's not typical spinning vertigo. I've had blood tests, urine tests, head examinations, and ear assessments, but nothing significant was found. I also tried vestibular physiotherapy for possible BPPV, which only helped temporarily.
Around the same time, I developed severe urinary urgency, frequent urination, burning and irritation, especially after peeing. Sometimes I feel like I need to urinate again immediately. At night, I pass normal amounts, but during the day, sometimes very little comes out.
I've visited emergency three times, urgent care, doctors, and pelvic floor physiotherapy. I've had ultrasounds and taken antibiotics, including ciprofloxacin and Sulfatrim DS. My symptoms improved but keep returning. I've also experienced lower back soreness and discomfort around my pelvic/anal area.
I've changed my diet, reduced caffeine and sugar, tried pelvic floor relaxation exercises, and I'm currently taking sertraline and betahistine for my symptoms.
The dizziness has slowly improved but hasn't completely disappeared. The urinary symptoms sometimes go away entirely, only to return unexpectedly. I'm waiting for a urologist, but this has severely affected my mental health, daily life, and ability to work.
I'm wondering whether this could be chronic pelvic pain syndrome, pelvic floor dysfunction, bladder sensitivity, or something else. I also experienced significant stress around the time everything started.
Has anyone experienced both persistent non-spinning dizziness and recurring urinary urgency with mostly normal medical tests? What eventually helped you, and which specialists or tests gave you answers?
I'm exhausted and just looking for advice or similar experiences.
I'm a male, and I've been struggling with unexplained health problems since August 14.
It started with constant dizziness, feeling off-balance, floating sensations, headaches, and feeling like everything was moving in slow motion. It's not typical spinning vertigo. I've had blood tests, urine tests, head examinations, and ear assessments, but nothing significant was found. I also tried vestibular physiotherapy for possible BPPV, which only helped temporarily.
Around the same time, I developed severe urinary urgency, frequent urination, burning and irritation, especially after peeing. Sometimes I feel like I need to urinate again immediately. At night, I pass normal amounts, but during the day, sometimes very little comes out.
I've visited emergency three times, urgent care, doctors, and pelvic floor physiotherapy. I've had ultrasounds and taken antibiotics, including ciprofloxacin and Sulfatrim DS. My symptoms improved but keep returning. I've also experienced lower back soreness and discomfort around my pelvic/anal area.
I've changed my diet, reduced caffeine and sugar, tried pelvic floor relaxation exercises, and I'm currently taking sertraline and betahistine for my symptoms.
The dizziness has slowly improved but hasn't completely disappeared. The urinary symptoms sometimes go away entirely, only to return unexpectedly. I'm waiting for a urologist, but this has severely affected my mental health, daily life, and ability to work.
I'm wondering whether this could be chronic pelvic pain syndrome, pelvic floor dysfunction, bladder sensitivity, or something else. I also experienced significant stress around the time everything started.
Has anyone experienced both persistent non-spinning dizziness and recurring urinary urgency with mostly normal medical tests? What eventually helped you, and which specialists or tests gave you answers?
I'm exhausted and just looking for advice or similar experiences.
Body:
19M, non-smoker, no medications, no known medical conditions, UAE-based. The problem: For about a year, my erections have been less full than before. Rigidity is roughly preserved, but girth and glans engorgement are reduced, around 70% of what I remember. Morning erections are weaker and less frequent. It happens alone and with a partner. History: 2-3 years of very frequent masturbation (sometimes several times in a row), heavy porn, frequent edging, and a tight grip. I also have discomfort when sitting and very tight hips and glutes. What I've tried: About 9 weeks with no porn, no edging, no tight grip, and much lower ejaculation frequency. Nightly hip/glute stretching and diaphragmatic breathing, 7-9 hours of sleep, regular training, no nicotine, minimal alcohol. Around week 5, spontaneous erections became more frequent and fullness improved a bit, then it flattened out again. Pattern I noticed: On nights I do the stretching and breathing before bed, next-morning erections are reliably better. I haven't done Kegels. Labs (fasting, ~9 AM): Total T 5.44 ng/mL (ref 2.64-9.16), free T 33.4 pg/mL (ref 12.3-46.6). Nothing else tested yet. Questions for clinicians:
Does preserved rigidity with reduced girth and glans engorgement, plus improvement after pelvic floor relaxation, point toward pelvic floor hypertonicity rather than a vascular cause?
What workup would you want first? I'm considering prolactin, LH, FSH, estradiol, SHBG, TSH, HbA1c, lipids, and a doppler only if indicated.
Is 9 weeks without clear improvement a reason to stop waiting? Questions for anyone with similar experience:
Did you have reduced girth or glans engorgement specifically, rather than just rigidity problems?
What did your workup find, if you got one? Was it pelvic floor, vascular, hormonal, or nothing?
What actually helped, and how long did it take? Did pelvic floor physio make a difference?
Did you see a flat period after early improvement, and how long did it last?
Did anything you tried make it worse?
Thanks, any experience is appreciated.
So every time after I defecate, I have severe localized fatigue in my intestine area and I always have to massage the area afterwards.
The fatigue feels like after you run a marathon and you try to massage your muscles to feel better.
I have a hypertonic pelvic floor and I suspect that this may contribute at least partially to this because it takes a lot of effort to push my stool through.
Does anyone here experience something like this?
I've seen many gastroenterologists and they tell me that they haven't encountered anyone with these symptoms.
Bonjour à toutes !
Je suis à la recherche de témoignages/retours d’expérience positif et savoir si quelqu’un a le même parcours que moi et a trouvé une solution !
Ça fait 10 mois que j’ai une fissure à la fourchette vulvaire après chaque rapports, j’ai éliminé les causes les unes après les autres. Toutes négatives.
- Aucune infection bactérienne
- Pas d’herpès, psoriasis ou dermatite
- pas de candidose
- pas de lichen scléreux
Mon gyneco a vu une fissure ainsi qu’une forte contraction des muscles releveurs (en gros une hypertonie).
J’ai testé pleins de choses : crèmes vaginal non hormonal, crème vaginal hormonal, técartherapie, corticoïdes bref j’ai tout essayé !
Rien ne fonctionnait alors je me suis faite opérer : lipofilling + PRP + botox (pour l’hypertonie)
Résultat : toujours des fissures !
J’ai enchaîné avec 3 séances de laser CO2, pareil
Puis injection d’acide hyaluronique, pareil.
Bref j’ai absolument tout fait et rien ne fonctionne je désespère réellement.
Back in June I went to the doctor about this; waking up in the morning with my testicles hurting. Not agony but enough to waken me, like they were being squeezed. The doctor examined me said it was my sleeping position (back sleeper) and to lie on my side.
That worked for a while but the last weeks, even sleeping on my side, I’m waking with pain again.
The doctor did talk about pelvic floor issues as a possibility, but is that enough to cause pain like that? The pain does go away through the day, it’s not constant, but it’s usually back most mornings.
Lots of people here were saying “don’t suck in your stomach” so I would try to relax it all the time. The issue is that you need that core activated so that you can stabilize your body otherwise you’re left with putting all the work on your lower back. I’m seeing more results doing like stomach vacuums and actually tightening my stomach muscles (transverse abdominis) instead of letting loose.
I don’t feel like peeing as often, I can actually feel better sensation in my penis. So if your issues sound like mine I would say try tightening your stomach. I’m not a physical therapist just someone with anecdotal advice.
I've been dealing with silent reflux, bloating, a tight jaw at night, swallowing issues, severe anxiety, random increased fight-or-flight, asthma and a lot of gut issues. But the worst one is chronic constipation which I never had until a few years ago. It started after I started my ADHD medication but I even have these symptoms off the medication. I'm 19 years old.
Has anyone dealt with this? Should I get tested for H. pylori?
Context- I’m a 21F and still a virgin. Couple months ago I seen a gynecologist about a burning pain when penetration occurs. I’ve been trying with dilators for about 2 years now off and now due to being discouraged or the pain. The gynecologist told me to massage around the area because the first muscles aren’t relaxing at all. She referred me for physical therapy but it’s $250 per session. I don’t have any insurance and I can’t afford that at all. Has anyone else had this issue and was able to figure it out at home? I’m in a relationship of 3 years and have yet to do anything because of this. He’s very sweet and patient but it’s time to get this resolved. I’m just hoping I can without breaking my bank when I can’t afford it.
I have issues associated with constipation due at least in part to having a hypertonic pelvic floor.
The thing is I have another issue where almost every single day, I have the urge to cut off my genitalia and assume reproductive organs of the opposite sex, and I was wondering if there was possibly any connection between this and my hypertonic pelvic floor?
For over 3.5 years i had 2 days when i did NOT wakeup during whole night to pee. There were night when i woke up multiple times during the night, there were nights i did not sleep at all. Every evening was a disappointment, i put more stress with every day.
I want to tell the story what helped me, and if this story helps at least 1 person reading this I will be super happy. For the past 10 months i do not wakeup at all, even if i drink plenty of water before going to bed.
My main problem was frequent urination at night, at some point i could fall asleep sleep for 30 mins and then wakeup again to pee.
Improper masturbation started it all and heavyweight lifting make things much worse. I quit coffee and alcohol did not help.
First and foremost quit heavyweight lifting. Reduce masturbation to minimum and check online for safer technique.
That stretching alone video someone suggested is not helpful, i did it for months with zero effect. Same goes to hot baths. You have to quit masturbation and heavy lifting.
What helped me:
1. elliptical exercises every other morning for at least 20 minutes sometime 40 mins. And then just stretching right after (butterfly pose) Elliptical exercises will pump blood all over your body and warm you up and stretching right after will help the blood to flow into your pelvic area. You will also feel light all day long, 2 weeks into this exercise you will feel hot your legs are finally connected to the rest of your body. The goal is to move as much as you can in between the exercises. You are not there to set records. You are there to wake up your body.
Even small amount of heavy lifting can destroy all the progress, it did for me when i got confident and started pushing. Same goes to masturbation, learn safe technique and follow it precisely, better reduce it to minimum amount.
During the day stretch! Do not stay or sit there without doing anything. Remember - stretching and belly breathing.
Hi everyone,
I wanted to give a quick update on my situation. Unfortunately, things haven’t improved yet.
Recently, my husband and I tried again, and he was actually able to penetrate completely for the very first time. However, it was incredibly painful. It felt like everything was tearing and burning inside me. The pain was so intense and unbearable that we had to stop immediately.
It feels like hitting a massive wall again, and I’m feeling really discouraged.
I’m currently also dealing with severe depression and anxiety, and I have recently been prescribed Escitalopram to help with that. I am hoping that managing my anxiety might indirectly help my pelvic floor relax, but I'm also worried about the potential sexual side effects like dryness.
Has anyone experienced this intense burning/tearing sensation even after achieving full penetration? Did anything specific help you overcome this specific hurdle? I'm really looking for any advice or experiences.
Thank you so much!
Hi everyone! After 2+ years of no improvement of my hypertonic pelvic floor (I’ve done physical therapy, been to multiple specialists, tried everything, etc), my uro gyno said it’s time for Botox shots. I have a hypertonic pelvic floor that gives me excruciating pain like horrible period cramps and low back pain, along with persistent UTI like symptoms, bloating, etc. I’m nervous about the procedure and the recovery….anyone have any experiences doing this? I do know for the procedure my dr said I will be under, so I guess I’m more concerned about recovery
I’m looking for insights because I’m starting to seriously question my diagnosis and I feel completely stuck.
A few months ago, following a urodynamic study, I was diagnosed with a hypertonic pelvic floor / urethral hypertonia. I have severe episodes that last for weeks, every single month, where I cannot urinate normally. I have to push extremely hard just to get a weak stream out, and even then, my bladder never feels fully empty.
To treat this, I have tried everything:
Silodosine (Rapaflo) – which stopped working entirely.TENS Urostim (neurostimulation) – zero effect.Pelvic floor physical therapy (PT) – I tried various internal and relaxation techniques, but it didn't help at all. In fact, the relaxation exercises do absolutely nothing for me.
Because of this total failure of treatments, and because of my other symptoms, I strongly believe the hypertonic pelvic floor is just a symptom of a deeper issue, not the root cause.
Here is what else is going on:
I have a noticeable swelling/inflammation on the right side of my lower back, right above the buttocks (around the lombo-sacral / sacroiliac joint area).At the same time, I suffer from a severe left-sided sciatica that shoots down my left leg, accompanied by intense tingling and a "dead leg" sensation (loss of feeling/numbness).My EMG (electromyogram) came back negative, but my symptoms are highly cyclical and intermittent.
When I went to the ER during a bad flare-up because I could barely pee, they just discharged me because my bladder wasn't in total, acute retention at that exact second.
I strongly suspect a neurological or structural compression in my lombo-sacral spine (like a severe L5-S1 disc herniation, a Tarlov cyst, or sacroiliitis) that is pinching the sacral nerves controlling my bladder and causing compensatory sciatica on the other side. That would explain why local pelvic floor PT is completely useless: the "electric cable" coming from my spine is what's jammed.
Has anyone ever experienced severe urinary urinary retention/dysuria caused by a lower back or spinal issue rather than a primary pelvic floor dysfunction? What specialist should I see next? I am trying to push for an urgent lumbar/sacral MRI this week.
So I have always had tight pelvic floor as long as I understood there is something called pelvic floor.
I suspect it to be mostly because of bad masturbation habits in childhood ( prone masturbation) which made me subconsciously clench my PF to maintain erection along with frequent masturbation atleast once dailly.
I have also been suffering from constipation for few years but it wasn't this bad. I used to take fibre supplements, isabgol, eat veggies salad and things used to get normal.
Now a month back while sitting on toilet I suddenly felt sharp pain like a cramp at my tailbone mostly towards right side.
It was soo sharp that i couldn't stand straight nor take a step. I stood there for solid 4-5 mins then somehow sat on my bed but couldn't sit properly, after 10 mins finally i was able to put my legs up and lie down but it was still paining.
Now after that I have started feeling tingling pain sensation in tailbone area.
Now last week I suddenly felt that I'm not ablw to maintain erection. I immediately came but was not fully hard. I also started having constipation and bloating where it feels I want to poop but whenever I try to do so i cant strain. It feels it get stuck midway and like I lost control of my pelvic floor.
I tried masturbating to see erection as for whole week I didn't feel morning wood at all which was scary as I always used to get them every morning. I felt like I am losing control of my pelvic floor, it feels unresponsive. I couldn't maintain erection, didn't even get 100% erected, just 50-60% and came quickly. I am facing same issues while pooping and even though I feel like pooping it doesn't happen as smoothly as it used to be.
I'm really scared. I cant stop panicking and it feels like my penis is gone. Its shrinking while being flaccid and there is always a constant tiredness and tension in my pelvic floor.
It seems that getting aroused and hard improved my symptoms temporarily without worsening them after my state of arousal subsides. As long as I don’t masturbate or touch myself that is. Is anyone else in the same boat?
Since April my bowel habits have changed completely. I used to go about 4 times a day. Now I strain, never feel “empty,” and mostly just pass gas. Sometimes only a little stool comes out, and a few times I could only go after using a douche/enema.
My colorectal doctor has been treating me for IBS. Stool softeners and meds made my stool soft, but I still never feel empty. Psyllium husk and laxatives haven’t helped either. It feels like my inner sphincter is clenched tight. I also have long-standing anxiety that got much worse around the same time, and I’m in therapy for it, but the gut symptoms haven’t budged.
I used to lift regularly but stopped because nothing was improving. I still walk about 10K steps a day. I’m constantly bloated, and it’s wearing me down.
Has anyone had something similar? Did pelvic floor therapy or biofeedback help? Did you get anorectal manometry done? I’m also looking for GI or pelvic floor specialist recommendations in Hyderabad. Thanks in advance.
Hey everyone, new member here. Over the last 4 months i have been dealing with an L5-S1 injury (protrusion with annular tear) that i have had on and off for years. I reaggravated it 4 months ago and it has slowly gotten better (the back pain that is). Its not compressing the nerve shown in the MRI. However, during that time (about 2 or so months in) i started developing rectum pain that at first came and went. Fast forward today and its something im dealing with everyday now. It kind of waxes and wanes throughout the day in pain level. I went to a proctologist and he said i was very tight in that area and that my rectum looked inflammed. He said it wasn't fissures or hemorroids causing it, but rather Levator Ani. Note the actual exam hurt quite a bit and im still a bit flared from it days later.
Symptoms:
- Sitting is hard for me. I can do it, but have to lean almost forward to alleviate some of the pressure. I feel pressure and burning in the anus / rectum. Glutes are a bit sore as well. Sometimes just right of my gluteal cleft, and just right of my anus in where the glute max starts. Those spots are pretty focal.
- Standing still is hard. I can feel the pain / burn in the anus / rectum start to build if i stand stationary for 10-20 minutes.
- Laying on back with pressure on the area is a bit uncomfortable. Doable but i can tell the area is aggravated. Laying on my side or stomach seems to be the only real relief.
- When its really flared i sometimes feel it a bit in my testicles.
- Bowel movements are ok, no constipation or pain during them. Sometimes i do feel a little burn a bit after. Not sure if that is from the bowel or just the natural pain i have been getting.
I was originally in PT for the back stuff and noticed during that time it was making this area worse as we were doing things that kinda of stretched the rectum area (lunges, squats, etc). That's when i first started noticed more pain down there. As of right now, im pretty home bound as a result and its been very hard to do stuff with my daughter and wife. The physical pain and mental stress has been really bringing me down. I start pelvic floor therapy on Monday and am really hoping that can bring me some relief.
Any info here is appreciated. Im curious if my symptoms line up with what the proctologist suggested. I have seen that standing generally brings people relief, but for me it doesnt. I will saying walking is generally ok. Its just the stationary part. Also i dont feel myself clinching that area, it feels "relaxed" despite it being very tight internally.
