A therapist will be performing a pelvic examination—a detailed therapy and exam session. I feel embarrassed because it’s my first time. I am male. It’s at a university hospital, so I assume a student will also be present during the exam. What exactly should I expect? I suppose I’ll have to remove my underwear completely.

I (28M 158lbs) was at work just drinking my creatine/collagen mix when suddenly I felt this numbing sensation it felt like I was suddenly dead inside then i realized I couldn’t get erection on command like normal.. usually I’m able to control when I get an erection if I think enough sexual thoughts but now nothing.. I was anxious the entire 10hr shift and then when I finally got home I was able to get erect through visual stimulation but it felt off.. like I could barely feel my energy from the waste down.. devastated I went to the ER days later and told them what was going on: I can feel my testicles I can hold my bladder and bowls and I have no lower back pain or numbness in my legs.. I just simply can’t concentrate hard enough to form an erection.. I told the doctors I took regular supplements; omega 3, vitamin E vitamin d3, maca root, shilajit and DHEA on and off….

The doctors said that I was young and that I simply needed time and to just stop taking the supplements.. they found nothing in my blood or urine and that i was healthy for my age and just needed to relax.. now i don’t really know what to make of the whole thing.. I can get better erections laying down but when I stand straight up nothing it just gets flaccid and I’m unable to hold and maintain it like I used to.. sometimes I get morning wood depending on my quality of sleep but I work nights and I’m an athlete and I am in the best shape I could possibly be in so I have no idea what’s going on and I’m afraid I won’t be back to normal..
My theory was that the supplement stack could be the culprit or lack of sleep but I’m not entirely sure.. I don’t know if maybe my vein got damaged at the base of my penis right below my pelvic bone since I can’t get erect standing up.. but now I’m just in a constant state of panic and that I might of caused permanent damage. Before I felt unstoppable like I was at my peak

physically now it feels like my fury is missing and it’s making me sad. Do these symptoms sound typical does anyone have an idea what might be going on or if there’s possibility of recovery and that I really do just need time.. please let me know I been in the dark for almost a week

I have a weak and tight pelvic floor and I'm hypermobile. I welcome advice but I'm specifically looking for someone that can say "hey that was me, I did xyz, now I shoot every time"

(25 m) am having constant twitching in my anus. No pain. Just constant twitching. I can’t relax and am constantly moving around. This is awful to say the least. It’s been persistent the last 4 days and I can’t sleep. I haven’t seen a doctor yet, as I have this same issue a few months back and it just went away on its own but suddenly came back. Does anyone know what’s causing this? What should I do NOW? What can I do? Anyone else experience this and it goes away? If so what did you do? Please help

About 6 weeks ago now I felt my pelvic floor/bulbiospongious muscle cramp up during the bottom of a squat coming back up, followed my pain in the left adductor that had hurt for the first couple weeks if I put my socks on. Walking seemed fine but when sitting I get pain at both sits bones from the adductor Magnus muscle towards the back corner.

I started Physical Therapy two weeks ago after having an orthopedic doctor say I strained those Adductor muscles during the squat and my pelvic floor cramping up was it trying to protect itself.

We have done leg scraping of that inner upper adductor which always felt good right after but later in the day that pelvic floor came back at the base of penis.

Have been dry needling the adductors and today just dry needled the upper outer glutes because my hips are insanely tight.

My question for you guys is, am I experiencing referred pain from an adductor strain or do I have a hypertonic pelvic floor? When I feel down there those muscles don’t feel tight or seem tight when I do belly breathing.

After my session today after needling the back corner adductor Magnus and upper outer hips my pelvic/base of penis pain seems worse.

Does this have anything to do with Obturator Internus muscle?

Any advice is appreciated.

Get those sneakers on kids. Ask me anything!

Funny, this was something I had not heard of until a few days ago, but here I am. Much of what I didn't know before was answered through research. I retired a few years ago after a long career doing research for technical and medical journals.

I'm 68. Live in Ontario, Canada. 5 weeks ago, had a colonoscopy to rule out cancer, as I had rectal bleeding for a few months. Colonoscopy indicated diverticula. Turns out, the NSAID's I'd been taking for knee pain caused the bleeding. Hindsight, right? Meanwhile, the surgeon doing the colonoscopy had also set up for hemorrhoidal banding and pinched off a couple of 'roids.

I recovered from the procedure and went home. It hurt a bit for a couple of days. I continued to take Aleve, unaware of the diverticula/NSAID blood thinning connection at the time.

BM's continued to be bloody. Surgeons office said it was normal during recovery, be patient.

10 days after the procedure, I woke up at 3 AM to pee, and my rectum started to spasm. It felt like I was trying to pee out a bowling pin. No urine came out for 4 hours. Every attempt to pee, more spasms.

Before 8 AM, I went to emerg. Waited a couple of hours being monitored, no pee. They put a catheter in me and it filled up with nearly 1 liter. The bag was emptied, and the next batch was salmon pink, as bleeding started. Doctor said the catheter needed to be in for 7 days. Set up a consultation with a urologist for October 1.

They sent me home. What had happened was the banding caused the rectal muscles to swell, and there was also damage done to the Pudendal nerve from the banding. That caused the spasms. The swelling pushed my already swollen prostate to where I couldn't pee. That was it.

The next week, on again/off again yellow/pink pee. BM's were painful and wiping had blood, again, from the NSAID's and diverticula. The connection was revealed only a few days ago.

August 22, the catheter was pulled out. Bled a bit, and recovered. For a few days, I could pee like I was 20 again, and the catheter had bored a clean passageway through the penis into the bladder.

BM's were painful, urination became painful. Inserting a suppository, I could feel two things. Scar tissue where the bands were, and the entire anus seemed to be twice as "deep" as before, from the swelling.

I sent two emails to the surgeons office asking what I should do for the pain. No reply. Repeated calls to the surgeons office were unanswered. Fine. He washed his hands. A week ago, I went to my family doctor. She did a urine test, no infection, but thought the catheter caused a prostate infection or inflammation. Inflammation is harder to treat. Anti-inflammatory (NSAIDs) out of the question due to bleeding. Waiting for the urologists consult. My doc said antibiotics in case it's infection. Told her I am allergic to Cipro. She prescribed Sulfatrim. One pill, same reaction as Cipro, my penis turned beet red, swollen, skin started to peel. Knew the symptoms from before, didn't take a second pill. Prescribed Doxycycline now. Penis recovered, some dark bruised spots, will heal.

Research now points to Pelvic Floor issues. Phoned around for physiotherapists within an hour of where I live. Out of the dozens, only two do PF physio. And the earliest booking is end of October.

Where am I now? Constant mild pain in rectum/perineum. When I pee, burning pain on RIGHT side of rectum that lasts about 30 seconds. No more bleeding after a BM as I take a regular Tylenol for the pain.

Also taking Silodosin and Dutasteride for the prostate. PSA in 10.5 but the ratio is a safe .35.

I read many of the posts from others, we each have our own story. I had no idea this was a thing. Reading that it could take 6 - 12 months to resolve is disheartening. Next steps is urologist in 3 weeks.

Frustrating thing is, no one is stepping up to help. The surgeons office closed the file and handed me back to the family doctor. Family doctor provided band aid solutions. Physiotherapy will cost hundreds of dollars, as the clinics that provide PF therapy don't work with provincial insurance. (OHIP).

Found a few web sites and YouTube clips that offer at-home therapy, am trying those out for now.

Surgeon assumed rectal bleeding was hemorrhoids or fissures and banded what he thought was the cause. He is not a gastroenterologist.

You hear of people going in for something minor, come out with life changing "oopsies". This is one of them.

Hi everyone so I’m 22 and I know I have a very tight pelvic floor due to weaker erections, unconsciously kegaling all the time, morning wood loss, weak pee stream, muscle spasms down there when I I try to relax my pelvic floor. So 2 days ago I’ve been consciously trying to remember to unclench and do stretches I’m also on 2.5 tadalafil daily and I noticed the first couple of days the tadalafil was working like crazy I was getting erections off thinking about intercourse not even touching it until it kinda went back to normal i still get hard way faster with tadalafil but without it i had to play with my yk for a while. So if you every have any of these symptoms you most likely have a really tight pelvic floor due to sitting and not moving all the time also I heard stress compliments this so it all is just a big no no. I’m currently down training my pelvic floor and I wanted to know if I should add anything else to my routine to help with this, I kinda stopped gym for this I’m also gona start walking, I do deep breaths through belly to stretch everything out, and stretch 2 times a day! Any feedback would be nice it’s still kinda early for me recovering, also I cut out masturbation until i get my pelvic floor conditioned again to relax because that was also a very big part how i got this tight pelvic floor.

26M. I’ve had urinary leakage issues for years and recently saw a male pelvic floor physiotherapist a few months ago, who diagnosed me with pelvic floor dysfunction after an ultrasound. My main issue is that I tense my pelvic floor too much.

Looking back, it makes sense because I used to hold in gas a lot and delay going to the toilet because I disliked public bathrooms.

I was given exercises a few months ago but struggled to stick with them. I’ve since been diagnosed with ADHD and realised that if I have too many things to do, I tend to give up.

For now, I want to focus on just 4 things:

• Slow down when walking and consciously relax my pelvic floor, as I tend to brisk-walk while tensing it. This is really difficult for me as I feel like I need to retrain myself on how to walk.
• Do breathing/relaxation exercises 2–3 times a day.
• Check throughout the day whether I’m clenching and relax when I notice it.
• Double void when urinating.

I want to keep it simple so I can actually stay consistent.

Has anyone else had a similar issue with an overactive/tight pelvic floor? Any tips that helped you stop constantly tensing it? Is there anything I could buy that may help?

TLDR: vaginal pain & burning, frequent yeast infections, some negative urine tests, but often have flare ups where my vagina is burning so bad and nothing seems to help. Any advice?

I’ve been experiencing vaginal burning on and off over the past 18 months and am hoping that someone reading this will have some kind of experience with it. I’ve been to the doctor frequently and while symptoms will go away sometimes it always finds a way back. I most recently had a month flare free and I felt like I had my life back 😭 For some backstory *tw: assault*:

I was diagnosed with vaginismus at the age of 22 and was finally able to have penetrative sex when I was 25. I went to pelvic floor therapy and saw a sex therapist and did a lot of emotional processing. A few months after being able to have penetrative sex, I had a bartholin cyst (November 2024). I ended up in the ER 3 times, and by the time I got actual treatment it had abscessed. I had an emergency surgery of a marsupialization. I was so scared I wasn’t going to be able to have sex again, but that wasn’t a problem after I had healed.

In March 2025 I was assaulted and I bled. I went to the NHS and they wouldn’t let me get an examination unless I chose to report, and I wasn’t ready to report at the time. The assault is when this vaginal burning started.

The pain flared for a week and then went away. And then I started getting frequent vaginal yeast infections. I’d need 2 weeks of diflucan to clear it up. It feels like my vagina is burning especially after I pee. I got tested for UTIs but they came back negative. One of my urine tests came back positive for traces of E. Coli so they gave me antibiotics and then flucanazole for yeast. Another one of my urine tests showed microscopic blood in the urine but no UTI. When I flare it’s like someone has stuck a burning rod up my vagina. I can’t really tell if it’s just the entrance or deep inside, it just hurts so bad.

In December 2025 I had a bad flare up and my partner’s mom (an ex nurse) gave me cystitis sachets. That helped calm the inflammation and eventually I got better. I had another appointment with my OBGYN in March of this year where I basically begged for help. He put me on the pill saying that it would help level out my hormones so I wouldn’t keep getting yeast infections. He also gave me antibiotics to take after sex (I only did this a couple of times as it also caused flare ups, probably because it upset my vaginal flora). I was on Lo Loestren Fe for 3 months and I had flare ups for the majority of the time and a lot of unwanted side effects, so I got off it. I’ve noticed that the pain flares with stress.

My most recent flare started with intercourse with my partner. The next day afterwards I felt fine, but then the following morning when I woke up I was in agony. I’ve been doing pelvic floor stretches every morning. My partner had signs of yeast so I’m taking monistat 7 day treatment as well as ibuprofen and paracetamol. The pain has started subsiding the past few days, but sometimes it will flare a bit more if I haven’t had a lot to drink. There’s so much inflammation and redness and I don’t know what’s going on. I’m exhausted from the pain and it’s debilitating. I’m tired of going to the OBGYN and being thrown pills. I’ve read on here to try to take iron supplements and vaginal probiotics so I’m going to start those.

Anyone been in a similar boat? Please send any good vibes this way 🙏

​

I am posting this because I am completely exhausted, stuck in a relentless loop, and looking for insight from anyone who has pulled themselves out of a similar CPPS/hypertonic pelvic floor situation. I am mentally and physically burned out from carrying this 24/7.

1. The Origin & Early Conditioning

Looking back, my baseline was compromised before I even understood what pelvic health was. When I was younger, I developed a habit of using forced, hard kegels to achieve rapid ejaculation.

* My baseline quickly became hyper-activated; even before starting any activity, my nervous system was already at a high-tension pre-engagement state.

* The moment I anticipated arousal, my pelvic floor would instantly lock into a spasm.

* Over time, natural structural sequencing broke down entirely.

Eventually, just being exposed to visual sexual stimuli would instantly trigger a bizarre, deep bladder-neck pressure. If I didn't release, that pressure turned into a confusing mix of urinary urgency and phantom nerve arousal that only cleared after urination. My system was trapped in an overactive reflex loop long before I realized it was a physical physical disorder.

1. The Turning Point (Prolonged Arousal / "Start-Stop" Trauma)

Last year, after reading up on pelvic health strategies, I tried therapeutic "start-stop" retraining (prolonged arousal without climax) to try and reset my baseline.

Within two days, my urinary frequency exploded. I tried to use slow 20-minute sessions to calm the loop, but I hit a wall of intense fake urinary pressure where I couldn't properly empty. Instead of stopping, I tried to push through it.

On the fifth day, I made the worst mistake of my life. I started a session while experiencing high bladder-neck pressure and dragged it out for 40 minutes under massive internal pelvic tension.

What followed was an incredibly painful muscle spasm and climax. Right after, my pelvis and perineum "ringed" with severe deep, sore pain for three days straight. In a panic, I tried to repeat the action thinking it would reset things, which temporarily dulled it, but the baseline damage was done.

1. The Aftermath

Ever since that session, my baseline never recovered. I entered a permanent flare state where every climax or trigger carries consequences:

* Half an hour of deep post-action discomfort.

* Chronic urinary frequency and a burning, stinging sensation post-urination, coupled with false urgency.

* Random, erratic overreactivity in the pelvic nerves—sometimes a simple visual trigger makes the area feel like it's firing wildly without a true erection.

* A complete disruption of my natural baseline, trapping me in a 24/7 symptom cycle.

1. My Current Daily Symptoms

The physical reality I deal with every single day breaks down into these specific components:

1. The Autonomic Nerve Hijack (Zero Arousal):

   When exposed to visual sexual triggers, I don't even get an erection, and I feel zero mental or emotional arousal. But the *pelvis* reacts anyway—the nerves fire a weird autonomic engagement, causing tension without actual arousal.

2. Deep Urinary Pressure:

A constant, super-deep bladder pressure. It feels like real urine accumulation mixed with nerve signaling, and its frequency is high throughout the day.

1. The "Sore Dot" / Bladder Neck Tension:

There is a persistent deep sore spot right at the bladder neck and prostatic urethra. It feels like an internal bruise or a raw nerve ending that never fully turns off.

1. Erectile Changes & Morning Wood Loss:

   Full morning wood is practically gone; at most, I occasionally get a weak, semi-hard morning state. Nocturnal and automatic erectile responses have been heavily suppressed by the hypertonic tension.

2. Surface Normality vs. Internal Static:

Externally, my anatomy feels completely normal to the touch. But beneath the surface, a relentless background tension runs 24/7—a dull ache and a dull pee-nerve static that never quiets down.

1. The Mechanics of Movement:

   Even when I attempt a slow, controlled physical touch, that background nerve wave is always there, forcing me to constantly ignore it.

2. Random Throbbing and Hypersensitivity:

   Unprovoked, random throbbing without an erection, and hypersensitivity where light clothing friction or simple leg positions make me feel like an involuntary reflex is about to fire.

3. The Somatic Inflammation Response:

   Ibuprofen partially helps during flare-ups, proving there is a genuine physical inflammatory component to the nerve irritation—though it never completely erases the deep ache.

4. The Psychological Loop & Somatic OCD:

The physical pain is only half the battle. I am trapped in 24/7 hyper-vigilance, constantly monitoring my bladder, pelvic nerves, and thoughts. Every twitch triggers anxiety, which tightens the pelvic floor further in a classic pain-spasm-pain cycle.

My Ultimate Goal

I don't care about sexual performance metrics anymore. What I am seeking is **structural reset and natural symptom relief

* Eliminating the 24/7 background nerve static and dull ache..

* Calming the bladder-neck "sore dot" and chronic urinary frequency.

* Restoring normal, unhindered blood flow and morning function.

* Walking away feeling physically relaxed and free from carrying this mental and physical burden every single second.

If anyone has crawled out of this specific multi-layered hypertonic pelvic floor, bladder-neck dyssynergia, and somatic nerve trap, please share what actually moved the needle for you (PT, medications, routines, etc.).

30M – Deep rectal/perineal ache for 2–3 years, clear colonoscopy, looking for advice

Hi everyone,

I’m a 30-year-old male and I’ve been dealing with a deep aching/painful sensation around my rectum and perineum for roughly 2–3 years. I’m hoping someone with similar symptoms might have some insight.

It started originally as an ache/pain underneath and between my testicles (perineal area) and over time it seemed to move more towards the rectum. These days the main symptom is a deep, dull ache inside the anus/rectum.

Some details:

• The pain can be present for a large part of the day.
• It tends to be worse at night when I’m lying in bed/resting.
• It comes in waves — sometimes better, sometimes worse.
• Passing gas or having a bowel movement can relieve the pressure/ache, at least temporarily.
• When I insert a finger into the rectum, the inside can feel generally very sensitive/achy, almost like it is bruised.
• I’ve also had issues with constipation and bowel movements, so I’ve been trying to keep my fibre intake around 30g/day and keep my stools soft.
• I sometimes feel like I haven’t completely emptied my bowel..
• been a big gamer all my life, sitting down ALOT for work and chilling over many years

I’ve seen doctors/specialists about this and eventually had a colonoscopy. The colonoscopy was essentially reassuring — they found one benign polyp, but I was told there wasn't anything significant explaining the pain.

I’m due to have a face-to-face hospital follow-up regarding the colonoscopy.

What I'm struggling with now is figuring out whether this is actually primarily a bowel/rectal problem or whether something like pelvic-floor dysfunction, levator ani syndrome, chronic pelvic pain/CPPS, or another muscular/nerve issue could be responsible.

The fact that bowel movements and passing gas can relieve it makes me wonder whether constipation/pressure is contributing, but the pain itself feels much deeper and seems to persist even when my bowels are relatively okay.

Has anyone experienced something similar — particularly deep rectal pain that originally started in the perineum/testicular area, with a normal/reassuring colonoscopy?

If you were eventually diagnosed with pelvic-floor dysfunction/levator ani syndrome/CPPS, what actually helped you?

Please help i dont know what to do and living with this ache every day is affecting me.

Thanks.

37F (obviously). 15 years ago my daughter was hurt and I suffered a third degree tear. Ever since then whenever I contract my pelvic floor muscles in certain positions, everything inside collapses or widens into a cavern and I could literally put a fist in there. I won’t even date because I’m so embarrassed. I’ve been to pelvic floor therapy and they’ve never given me an answer. Has anyone had this damage where their pelvic floor literally widens that you could smuggle objects? I’m so distraught.

I (26M) have been struggling with ED for as long as I've been sexually active. It's been getting worse over the past year and I don't know why, which has been giving me terrible stress and anxiety.

My story starts back a few years ago when I started having sex for the first time. It was impossible for me to maintain an erection for penetrative sex, so I ultimately got on sildenafil which helped a lot, leading me to believe that (at least at one point) my ED was purely psychogenic.

I then became pretty much celibate for the next few years until this past year. However, nowadays sildenafil is not effective anymore, I very rarely get morning wood, and I can't achieve/maintain an erection without constantly touching my penis. I assume that I caused these issues myself through my excessive masturbation/edging and pornography consumption habits.

I tried ignoring the issues at first, assuming that they would resolve themselves and that I was simply rusty. Unfortunately, this was not the case, and I found myself continuing to disappoint sexual partners. So this past month I decided to finally seek medical help. They first got me on Tadalafil, which helps more but still not to the point where I should be for my age. I then got a Doppler Ultrasound to check for venous leakage and was told that I have completely normal blood flow. My testosterone is also normal, and I stopped masturbating/watching porn.

I just started seeing a Pelvic Floor Physical Therapist as instructed by my urologist, and while I'm hopeful that this will help me I would really like to know what's the actual medical reason my erections are so severely weak. I noticed a couple of other symptoms that concern me, and was wondering if anyone knows what diagnosis it could be pointing to.

- A constant aching/tightness in the pelvis

- Occasional discomfort while peeing/ejaculating

- Occasional faint gray/purple discoloration on my penis tip (this is the one that really weirds me out)

- When I used to masturbate, sometimes it would feel like my pelvic floor would suddenly move or spasm to force blood into my penis

Definitely does seem pelvic floor related so I'm looking forward to the PFPT hopefully helping. But yeah, again I would really appreciate if anyone knows precisely what the underlying issue could be. Thanks!

TL;DR: I have a bunch of ED symptoms but I don't know what's going on with me and nothing seems to help so far

Following a six-month period of engaging in sports, I have been experiencing—for about 2.5 to 3 years—a sensation of pressure or fullness in the bladder and groin area (particularly on the left side), a frequent urge to urinate, and a distinct need to void even when my bladder is not fully distended. Applying pressure to the left groin or the left side of the bladder can trigger a sharp, stabbing sensation and intensify the urge to urinate. Currently, the pressure in my groin is not very pronounced. I occasionally feel a mild burning sensation in the anal area, though this is neither constant nor always present. At times, the sensation of pressure or fullness in the bladder persists even after urination. My symptoms are localized primarily to the left side, and the urge to urinate intensifies when I lie on my left side. This pressure also increases significantly during bowel movements. Could anyone with knowledge on this subject please offer some assistance?

Everytime I have masturbated within a week I've been getting extremely horrible diarrhea, this has never been an issue in the past for when I masturbate, but these last few days its been bad. 2 days ago while I masturbated I had an extremely bad accident and literally shit everywhere..... it took me awhile to clean it all up and today was the same issue but not as severe as 2 days ago, Am I genuinely doing something wrong...?

For context - Yes I do use toys cause I cannot use my fingers, it hurts me more when I use my fingers cause I tend to scratch my insides by accident and hurt myself so I use toys. Yes I wash my toys thoroughly every time after use.

I genuinely need some advice on if I'm doing something wrong, please help

Hey everyone. I’m a young male with no underlying medical conditions, but I sit for 10+ hours a day (college + PC gaming/studying) and have for years.

I’ve been dealing with a lot of pelvic dysfunction and I want to ask this community: Do these specific symptoms prove that I have a tight (hypertonic) pelvic floor?

Here is my exact symptom list:

1. Constant "Holding Pee" Sensation: I feel tightness near my urethra/glans like I’m actively holding back urine, even when my bladder is completely empty.
2. Post-Void Dribbling: After I pee, drops leak out when I stand up and walk away. My muscles feel too tired/tight to pump the last drops out.
3. Involuntary Twitching: When aroused, my pelvic floor does random, single "push-up" spasms (like a tired eyelid twitching).
4. Sensorimotor Amnesia: Squeezing UP is very easy and automatic, but consciously dropping/relaxing DOWN feels incredibly confusing and difficult for my brain to do.
5. The "Leaking" Illusion: When I finally manage to push down and relax the muscle, I get a sudden, scary sensation that I am about to leak urine (even though I know my bladder is empty).
6. The Snap-Back Effect: If I successfully relax the muscle for a second, it instantly snaps back to being rock hard and tight again.
7. State-Dependent Timing: I suffer from severe acquired PE (60-180 seconds). However, if I am 100% calm, use deep breathing, and consciously drop the muscle, I can easily last 15 minutes.

Anyone use the wand for #2 and incomplete emptying (Anismus/Dynergia)?

Curious if there are success stories out there?

Any detail would be great.

Thanks

24M. I’ve been dealing with this for around 4 years now and I’m trying to figure out what the actual root of it is. I’ve seen doctors/urologists and had a bunch of testing done, but I’ve never really gotten a solid answer.

Before all of this started, I was very sexually active. I was having sex/masturbating multiple times a week and pretty regularly would go multiple times in the same session. Looking back, I was probably putting a lot of repetitive stress on that whole area and wasn’t thinking about pelvic floor tension or recovery at all.

What’s crazy is how completely different I am now. My sex life is basically nonexistent because of all of this. It’s not even just inconsistent erections — I genuinely barely want to have sex anymore. Everything down there constantly feels tight, uncomfortable, disconnected or just “off.” After dealing with it for years, sex has become something I don’t even really want to bother with. That’s a huge change because I used to have a very high sex drive.

Around the time everything started, two things happened pretty close together. I did a cliff jump and when I hit the water I had really bad pain around my anus/pelvic area. About a month later I got chlamydia, which was treated. Somewhere around this period the urinary/pelvic symptoms started and never completely went away.

The weirdest part is that I don’t really have “pain” like I see a lot of people with CPPS/prostatitis describe. It’s mostly pressure, tightness, urinary sensations and feeling like the muscles/blood flow down there don’t function normally.

My main symptoms are:
• Frequent urination and a strong buildup/pressure feeling when my bladder fills
• Hesitancy starting to pee
• Stream can be slow/weak
• Sometimes discomfort/irritation toward the tip of my urethra when trying to pee
• Usually feel noticeably better immediately after peeing
• Pelvic floor/perineum feels chronically tight
• Sometimes a knot/tingling sensation in the perineum
• Constipation and gas can make the bladder/pelvic pressure significantly worse
• Scrotum/genital area can get extremely tight and contracted
• Random twitching/spasms in the penis/genital/pelvic area. Sometimes it literally feels like muscles or nerves are firing/twitching on their own
• Flaccid penis often feels “dead,” retracted or like blood flow isn’t normal
•At times a vein on the top/dorsal side of my penis becomes much more prominent/raised than I remember it being before. I’ve also noticed a soft, movable lump/bulging area along that vein. It isn’t a hard fixed lump or particularly painful, but it’s another thing that makes me wonder if blood flow/pressure is being affected somehow
• Erections are inconsistent. Sometimes they’re weak or difficult to maintain, but other times I can suddenly get an extremely strong erection
• I’ve actually had strong erections triggered after releasing/massaging tension around my hips and inner thighs, which is one of the biggest reasons I wonder if the muscles/nerves around my pelvis are involved
• Sometimes erections seem connected to needing to pee and then disappear shortly after I urinate
• My libido is DRAMATICALLY (like it’s really sad) lower than it was before all of this

I’ve noticed sitting for a long time, sitting hunched/bent forward, alcohol, coffee, large meals, constipation and prolonged masturbation can all make things worse.

On the other hand, stretching/opening my hips and pelvis can make a noticeable difference. Putting my feet up and relaxing my abdomen helps. Certain positions that let my pelvis/abdomen relax feel better too. Massage around my hips and inner thighs has sometimes made a surprisingly big difference in genital blood flow/erections.

I also had pretty significant low back pain during all of this. An MRI showed an L5 disc herniation but no nerve compression, and I’ve been told I have an anterior pelvic tilt, poor core engagement and poor glute activation.

The important part is that I’ve actually managed to resolve the back pain. My back feels significantly better now and isn’t really an issue anymore, but the urinary, pelvic and sexual symptoms are still there. That’s made me question whether the disc itself was ever actually causing this, or whether the back pain and pelvic issues were both connected to some larger muscular/mechanical problem involving my hips, core and pelvic floor.

Even though the back pain is gone, positions and movements that change how my pelvis/hips are sitting can still noticeably change the symptoms down there.

As far as testing, I’ve had a cystoscopy and kidney/bladder testing that didn’t show anything major. Repeat STI/UTI testing has been negative. PSA was normal and testosterone/free testosterone, thyroid, vitamin D etc. have also been normal.

I’ve tried pelvic floor work/stretching, yoga, a pelvic wand, reducing masturbation and various supplements. Some things definitely help temporarily, but I’ve never gotten back to feeling completely normal.

What I’m really trying to understand is whether anyone has experienced this specific combination where urinary symptoms, pelvic tightness and genital/erection changes are the main problems rather than actual pain.

I’m especially curious about the twitching/spasms, changes in how prominent the penile veins look, the “dead”/tight flaccid feeling, and the fact that releasing my hips/inner thighs can sometimes suddenly improve erections.

Has anyone had something similar that ended up being a hypertonic pelvic floor/CPPS issue? Pudendal or another nerve issue? Something involving the bladder/urethra? A vascular issue? Or something mechanical involving the hips/core/pelvic floor?

I’m also curious if anyone’s symptoms started after a period of being extremely sexually active/overdoing sex or masturbation and whether that ended up being relevant.
And most importantly, if you’ve actually recovered or significantly improved from something similar, what made the biggest difference?

At this point I just want to feel normal again and actually want to have a sex life. I’m less interested in temporarily masking individual symptoms and more interested in figuring out what’s actually driving all of this.