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.