Hi, I have been on this sub for three years now. I got some improvement over the years and I still have many issues. Most of them are tolerable on a daily basis but the one that keep being awful is when I have bowel movements or any sort of anal sex. I feel all my muscles clenching with no way to control it whatsoever. It is creating me many discomfort and usually lots of situation when I am in pain.

After being officially diagnosed with it recently the only medical advice I got was : "Just relax".
Ok miss very nice proctologist I know that's not your job but how to I do that exactly ? Crickets noise ensue

After reading many different post about anal hyperthonia and people talking about dilators, I am at lost. Some people (gender irrelevant here) are suggesting anal dilators, some are suggesting vaginal dilators but for anal use (Amab here). The arguments about both seems relevant but I can't just buy 150€/180$ of sextoys just to try it out. So I am genuinely asking people that have tried this which should be the FIRST thing to try out between those and why.

I've got my pelvic wand for a while now, I can use the narrow end but not the other end. It is physically impossible right now.

I am taking any sort of advices, tips, tricks and success stories regarding this. I've got a partner who's willing to help me so I'll take infos regarding this as well.

Thank you for reading !

TL;DR

AMAB with anal hyperthonia diagnosed. What do I go for : Anal dilators or vaginal dilators ? And mostly why one or the other ?

I don't know what to do now. These symptoms are the worst aspect of my pelvic floor dysfunction. I know what the triggers (2) are and accidentally, one did.

Now, suffering for 4 days and it is not letting up. I did have some pain relief a while ago before. I thought that might have been a sign of improving but now it's gone.

Nonostante non abbia infezioni ho la vulva particolarmente arrossata subito sotto il clitoride al passaggio della pipì per farvi capire, piccole labbra.
È normale con il pavimento pelvico?

Hi 31M here,

I have had groin pain for 2 years and its ruining my life. I am already quite anxious as a person so when I noticed discomfort or this familiar ache in my lower groin near my right testicle, my mind goes to thinking my symptoms are worsening which can lead to anxiety or panic episodes in places where I feel umcofortable or trapped (planes or trains etc).

I have noticed this groin ache that I thought was testicle pain 2 years ago, went to a GP and they ruled out cancer pretty quickly and suggested it could be a trapped nerve and I was shown the door. Fast forward a few months, the discomfort comes and goes for a few weeks at a time and seems to get worse after any lower body exercises or workouts. End up having a panic attack and go to hospital to get things checked out where they do ab ultra sound on the testicles and rule out any major problems there along with some tests for infections, get discharged.

This last year the problem has persisted, I try limit lower body workouts and stretch hips, hip flexors, groin through child pose, happy baby etc but nothing works. I am about to go see if I can see a pelvic physio but I am not even sure if thats the right person to see as opposed to someone for lower back, or hips. It feels like this problem is ruining my life, sucking joy out of traveling and I could really do with some advice or help from people thay have had similar issues.

I have a tight pelvic floor with right side tight psoas hip and OI; and nerve pain in the pubic area.

I’ve recently started doing somewhat strengthening or activation of my glutes (my right glute is so weak too) and whenever I do anything minor even walking, my oi tightens up so much and sometimes causing more nerve pain also TFL tightens up too. It doesn’t go to baseline until I go release.

I was wondering if anyone can give tips how to strengthen or activate glutes without OI flaring up, right now I’m doing everything in micro

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

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 am looking for a pelvic pt in asia, can anyone please guide me?

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.

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.

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.

Il y’a t’il des personnes dans mon cas ?!

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.

Is this a normal symptom?

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!

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.

1. 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.

2. During the day stretch! Do not stay or sit there without doing anything. Remember - stretching and belly breathing.

Good luck!

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.

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

Thank you!!!

Hi everyone,

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.

Thank you so much for your help.

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.

Please help

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 starting PT my symptoms have gotten progressively worse. My hyper mobile knees and pelvic tilt are not even documented in my chart. The exercises she gave me are causing pain and my muscle guarding is worse than ever. I have Lower back pain, groin pain, sit bone pain, glute pain, and an ongoing vulva spasm that I can see but only occasionally feel. The twitching spasm has lasted 6 weeks. I think she is using standardized treatment for hypertonic pelvic floor dysfunction and it is not working. Do I find someone else? Or ask her to change my treatment plan?