A Doctor with Hard Flaccid - Updates and Advice

[Romero MD Senior Member Find all posts View Profile Close Romero MD]

Hey doc, I believe we have the exact same symptoms from the start. I just wanted to ask, do we both have a front pelvic issue on the left?

From your story, I also believe so... And yes.

How do we go about doing trigger point massages as apposed to someone who has pelvic floor Hf issues?

I don't know if I understood the question...
The muscles are the same... Just massage the entire pelvic floor. Easy

Did you feel your testicle and blood flow on your left not as good as your right?

Again?...
No, I didn't feel that. The only thing I felt was colder skin, on the back of the scrotum. During perhaps the first 3 weeks. This is because the Perineal Artery (branch of the Pudendal Artery), which irrigates this portion of the skin, is slightly pinched, due to the muscular contracture, in the pelvic floor. And due to the heat caused by the contracture, which causes the testicles to hang lower and, therefore, become colder.

You are too much worried, Mi3an...
I already explained that your balls will not die because of Hard Flaccid/pelvic floor problems.

Ok, let's do it like this:
1 - Make an appointment for an Urologist
2 - Explain to the Urologist what Hard Flaccid is.
3 - Let the Urologist palpate your testicles and do an ultrasound.
Done. All your worries about blood flow will end.

Also what does it mean if I sill have diarrhea like bowel movements. I’ve never had IBS and only have had stool like this when food poisoned, antibiotics and really spicy food

Ok. This deserves more attention... How long have you had diarrhea? You have to make an appointment for your General Practitioner or Gastroenterologist.
You have to do blood tests, stool tests and possibly an image exam (colonoscopy).

[Ginsin Junior Member Find all posts View Profile Close Ginsin]

Hi doc

I've been following your protocol
I've realised after streches of pelvic floor I'll get hard flaccid.. Most of the day my penis is fine bit elongated though.. But after exercisces I'll get hard flaccid and when I'll do Rk it would go away .
Second hindi sqauts i think does help with hard flaccid but it's giving me more pain in penis.. I think it is the nerve issue.. So squatting can make things worse u reckon.
Third I went to a pelvic floor physio he did an live ultra sound of my pelvic floor to check how my pelvic floor was going on and off.. He said it looked normal it is not tight.
I think it's not only pelvic floor it's other muscles also causing pressure or dysfunction in pelvic floor. ( but apparently it's going on and of properly)

Doc can I ask you.. With hard flaccid being there does it mean u mean to have a tight pelvic floor or u can just have a messed up pelvic floor and have hard flaccid?

Thank you dear

[Romero MD Senior Member Find all posts View Profile Close Romero MD]

Hi Ginsin

Hi doc. I've been following your protocol
I've realised after streches of pelvic floor I'll get hard flaccid.. Most of the day my penis is fine bit elongated though.. But after exercisces I'll get hard flaccid and when I'll do Rk it would go away.

This is normal. I had that too. I also got slightly worse with certain stretches.

For example:
- I felt relief of Hard Flaccid, while training adductor flexibility, in the butterfly position. (I do Weighted Butterfly)
- I felt worsening of Hard Flaccid, while training hamstring flexibility, in the standing position. (I do Jefferson Curls)

Whenever I did Jefferson Curls, I got a little more Hard Flaccid. However, it is not the stretches themselves that are harmful. The training positions are the ones that cause the tension on the pelvic floor. The standing position inevitably creates more tension on the pelvic floor. Your Hard Flaccid will momentarily get worse, regardless of whether you are gaining flexibility in your hamstrings. This is not a problem. You will end up feeling more relief over the weeks.

If that momentary Hard Flaccid bothers you a lot, I have three more solutions for you:
1 - Do a Light Reverse Kegel, continuously, during all stretches. I do Reverse Kegels during all stretches.
2 - Decrease the intensity of the stretch. Don't go so hard.
3 - Try to do most of the training, in sitting positions, on a mat. The sitting position creates less tension on the pelvic floor (less Hard Flaccid). For example, you can also stretch your hamstrings while sitting on the floor. Right? You will feel more comfortable by avoiding stretching in the standing position.

Second hindi sqauts i think does help with hard flaccid but it's giving me more pain in penis.. I think it is the nerve issue.. So squatting can make things worse u reckon.

As you told me, in the other thread, you have:
1 - All common symptoms of Hard Flaccid.
2 - Nerve pain radiating to the glans.
3 - Tingling, pain and vibration sensation, on your pelvic floor, mainly when you are sitting.
You have Hard Flaccid and CPPS. Your Pudendal Nerve is being compressed by muscle contracture, in the pelvic floor. Which radiates pain up to the glans, through the Dorsal Nerve of the Penis.

Hindi Squats can be slightly painful at first, because before you gain flexibility, you are creating more pressure on your nerves, with your muscles, which are hard and tense.
You have three solutions:
1 - Decrease the intensity. Don't do the Hindi Squats too low.
2 - Do Reverse Kegels (more or less intense), during Hindi Squats. You have to find out what is the intensity of the Reverse Kegels that works for you and gives you less pain.
3 - Bet A LOT on Trigger Point massages, lying on the bed. Massage several times a day. Mostly, before Hindi Squats and flexibility training. Use the massages (and the Heat) as Warm-Up.

Third I went to a pelvic floor physio he did an live ultra sound of my pelvic floor to check how my pelvic floor was going on and off.. He said it looked normal it is not tight.

I advise you not to rely 100% on ultrasounds to diagnose tense muscles. I have had many friends and patients with muscle injuries, whose ultrasound was normal.
If you have Hard Flaccid, you have to have a muscular contracture in your pelvic floor. However...

I think it's not only pelvic floor it's other muscles also causing pressure or dysfunction in pelvic floor. ( but apparently it's going on and of properly)

...yes, I also agree with you. It is likely that other muscles are also contributing to the lack of flexibility. That's why I recommend everyone to train global flexibility as well. Not just flexibility in the pelvic floor.

Doc can I ask you.. With hard flaccid being there does it mean u mean to have a tight pelvic floor or u can just have a messed up pelvic floor and have hard flaccid?
Thank you dear

You must have a muscular contracture in the IC (and BC) muscle. It's these muscles that are going to create tension in the smooth muscle that is inside the Corpora Cavernosa of the penis - Hard Flaccid.
That's why you feel instant relief with Reverse Kegels. The only structure that justifies this instantaneous behavior is the muscle. And, from the photo you showed me, on the other thread, the base of your penis shaft is all contracted. That is muscle contracture.

You're welcome, Ginsin

[BenSu Junior Member Find all posts View Profile Close BenSu]

Hey everybody!

I'm Ben from france, but actually living in Oz.
I was reading this topic with a lot of interest!
i have Hf since 2 month now with spasm in the perineum, butt, legs
with pain in the left leg
the HF goes more on the left...

so i had sex with my GF and i heard/feel a pop on the left side and the next day whole the things happened...
The hard flaccid was so bad and painful, i had some suicidal thought to finish with that...
so low back pain as well, hips pain and left leg pain (more pain on the left side..)
and i dont know if its because of that but sometime i have some pain as well in the arms/shoulders (more on the left side as well)

the thing i noticed after that it's since many years i should have a hypetonicity of the PF because i do a lot of uncontrolled kegel everytime for years... so i think i injured myself because of that... but i dont understand why other pain came in the same time then...

SO after 2weeks of depression and hard pain i decided to take my healing by myselft! because after std, blood, urine test and ultrasound nothing ive been found...

So i started i course (overcome for pelvic pain)
i could see some improvement because of the stretching/relaxation poses
i started to do meditation as well because i was very stressed and it was just getting everything worst...
after 2 weeks of this course the HF changed... i mean before it was very contracted and small and so painfull, now it looks bigger (almost same size of flaccid than before) but still mild hard, i dont have anymore HF when i lay down and lets say almost gone when i sit as well... but when i stand i can feel my penis go back to be mild hard, sometime worst if im stressed...

So i'm only in the 8 weeks of the course and actually almost 10 weeks after everything starts.

M. Romero, do you thing it's still worth to ask my doc for some alpha bloc and muscle relaxant ?
i still have unconscious kegel al day long because of bad habits but i'm more aware of it and i try to do RK as much as i can, but sometime when i do too many i feel like its getting worst...

following the course help me as well as the first 4 weeks was just stretching, now the 4 others weeks are stretching and strengthening the surrounded muscle of the PF, and the last 4 weeks gonna be stretch and strengthening of the PF muscles
i started to do meditation for the stress and mindset as well which helps a lot, i started to take some supplement (cordyceps for strengh, reishi for stress and sleep and ginseng for energy)
i had insomnia as well for a month(4-5hoursof sleep)... but its getting much better now as i can sleep around 7hours per night =)

if you have any advises for me i will take it!

thanks to everybody and be brave to all the guys who are going through this!

[Romero MD Senior Member Find all posts View Profile Close Romero MD]

Hi Ben! Welcome to PEGym

First of all and most important...

I had some suicidal thought to finish with that... So after 2 weeks of depression...

...Who knows that this happened to you?
If you haven't already, I would like you to talk about this with your family, your girlfriend and your 3 closest friends. Don't deal with that weight alone.

If you ever have that kind of thoughts again:
1 - Talk to your family immediately
2 - Call your country's emergency number immediately. And go to the hospital if the phone health professional tells you to go.

Neither PEGym, NOR THE INTERNET, have the competence and ability to deal with depression or suicidal ideation. The first thing you all have to do is talk to someone (in person or over the phone).

Guys, I know you all like your penis a lot. But your penis is not your life. The value of the first is miserable, compared to the second. Your life is your most valuable gift. Furthermore, medicine has already found a way to give you a new penis. But we still haven't found a way to give you a new life. And don't wait for God to give you another life, because, most likely, this is the only one.
So, if you ever think about putting your life in checkmate, because of your penis or because of something else, talk to your family, friends and health professionals.

Ben, I'm glad you took the initiative to deal with your problem and sought help. And I hope that the medication you are taking has been prescribed by a Psychiatrist (or General Practitioner).

Now, your Hard Flaccid

I think it is also a typical and linear case. Frequent mechanism. Frequent symptoms.
And I think your pains are very much related to the same cause as Ginsin: global muscle tension, incorrect posture and nerve compression.

So i started i course (overcome for pelvic pain)
I could see some improvement because of the stretching/relaxation poses. following the course help me as well as the first 4 weeks was just stretching, now the 4 others weeks are stretching and strengthening the surrounded muscle of the PF, and the last 4 weeks gonna be stretch and strengthening of the PF muscles

I was watching the Overcome Course and it seemed interesting. Good stretches
In fact, Dr. Brianne Grogan's videos have been circulating on PEGym for some years.

Just pay attention to the Kegels in the last phase of the program. If you think you still have a lot of pain and symptoms, my advice is not to add them.
If you think you are already much better, add them, but always with a much larger proportion of Reverse Kegels.

I’m already adding some Kegels/Front Kegels. Mostly erect Front Kegels, in mini Edging sessions. Just to give the IC muscle a physiotherapeutic stimulus. Just as we do in any other muscle injury, to help the muscle heal.
But the amount of Reverse Kegels I do is much, much greater.
You have a muscular contracture. Your flexibility training has to be much more extended than your strength training.

after 2 weeks of this course the HF changed... i mean before it was very contracted and small and so painfull, now it looks bigger (almost same size of flaccid than before) but still mild hard, i dont have anymore HF when i lay down and lets say almost gone when i sit as well... but when i stand i can feel my penis go back to be mild hard, sometime worst if im stressed...
So i'm only in the 8 weeks of the course and actually almost 10 weeks after everything starts.

Good! Good! You are healing This takes time, Ben... But you are having a great evolution of improvements.

M. Romero, do you thing it's still worth to ask my doc for some alpha bloc and muscle relaxant ?

It's your decision.
If you had no improvements over the past 10 weeks, my answer would be totally yes.
If you are seeing improvements, you decide.

i still have unconscious kegel al day long because of bad habits but i'm more aware of it and i try to do RK as much as i can, but sometime when i do too many i feel like its getting worst...

Overtraining. The muscle gets too sore and has the opposite effect. Because too much training = small micro-injuries.
So, decrease intensity and frequency a little.

I started to do meditation as well because I was very stressed and it was just getting everything worst...I started to do meditation for the stress and mindset as well which helps a lot,

Very good. Great

i started to take some supplement (cordyceps for strengh, reishi for stress and sleep and ginseng for energy)

Ok. All right.

i had insomnia as well for a month(4-5hoursof sleep)... but its getting much better now as i can sleep around 7hours per night =)

Great!

if you have any advises for me i will take it!

1 - Talk to someone immediately, whenever you are depressed.
2 - Do not add Kegels too soon.

thanks to everybody and be brave to all the guys who are going through this!

A patient who motivates other patients... I have always loved this kind of strength...
A bow to you, Ben

I wish you a quick recovery

[TKL_ Junior Member Find all posts View Profile Close TKL_]

Okay Romero I've got some interesting developments.

The hard flaccid disappeared five days ago, completely by itself, so it took three weeks for the hard contraction to come to an end. After that, my penis has been hanging larger than before the injury pretty much constantly. It doesn't turtle at all, which is weird since I was a definite grower before the injury. I've also been getting A LOT of erections during the past 4 days, the libido came back with vengeance. The weird thing is that it takes a LONG time for the corpus cavernosum's to empty themselves from blood. I'm also quite sure that my spongiosum/glans don't partake in these erections, and I feel an annoying pressure in my perineum when I have an erection. I still haven't really touched my penis, but I know that my glans has quite good sensations, and that my shaft is pretty much numb. I can't really tell if I have an erection when I don't have anything that constricts them.

Other developments: 'ball' sensation in perineum has gone, random pains/fluttering in lower abdomen have reduced/stopped, reduced tingling/pulsing in perineum, it seems to be closer to the base of the penis now when present, penis twitches again after urination, but I also feel a pressure near my anus when peeing, easier to flatulate but still feels a bit different.

I think I'm going to go another two weeks on the conservative line since my condition hasn't really stagnated but seems to be developing.

[Romero MD Senior Member Find all posts View Profile Close Romero MD]

Okay Romero I've got some interesting developments. The hard flaccid disappeared five days ago, completely by itself, so it took three weeks for the hard contraction to come to an end.

Kabooom

After that, my penis has been hanging larger than before the injury pretty much constantly. It doesn't turtle at all, which is weird since I was a definite grower before the injury.

This is most likely happening because you already had a lot of muscle tension in the IC and BC BEFORE you got Hard Flaccid. You were a grower, because you had muscle tension on the pelvic floor. Now it's getting a lot more relaxed, you get a bigger flaccid.

Guys, let's all feel this evolution...

3 weeks ago:

Okay last night my flaccid turned rock hard, and it's basically been like that since. Even a warm shower doesn't really do much. It's rock hard stiff inside. No erections, absolutely impossible to even get a 10% erection right now, or pull it out. Yeah definitely need an urologist, I'm probably fucked for life.

Today:

I've also been getting A LOT of erections during the past 4 days, the libido came back with vengeance. The weird thing is that it takes a LONG time for the corpus cavernosum's to empty themselves from blood.

What do you think?...
This is what happens when you give your penis REST. And allow your healing machine to do its job.

I'm also quite sure that my spongiosum/glans don't partake in these erections, and I feel an annoying pressure in my perineum when I have an erection.

That pressure is the feeling of relaxation of the contracture. I had that too.
Begin to implement more flexibility exercises (more frequent and a little more intense). That pressure will pass over time.

I still haven't really touched my penis, but I know that my glans has quite good sensations, and that my shaft is pretty much numb. I can't really tell if I have an erection when I don't have anything that constricts them.

Do not worry. If your glans has quite good sensations, so will the shaft. Give it more rest.

Other developments: 'ball' sensation in perineum has gone, random pains/fluttering in lower abdomen have reduced/stopped, reduced tingling/pulsing in perineum, it seems to be closer to the base of the penis now when present, penis twitches again after urination, but I also feel a pressure near my anus when peeing, easier to flatulate but still feels a bit different.

Everything good Everything is evolving well. Do more flexibility exercises.

I think I'm going to go another two weeks on the conservative line since my condition hasn't really stagnated but seems to be developing.

4 more weeks. Are you a warrior? 4 weeks
Begin to implement more flexibility exercises, but only touch the penis in a month.

Be careful the first time you ejaculate. Read my past posts to see how was my experience. Always with Reverse Kegel before (during stimulation), during orgasm (between each orgasmic contraction) and after orgasm. And it's supposed to be a very light masturbation/sex. And no more than 10-15 minutes.

It is normal to feel a little pain on the pelvic floor for a few hours after ejaculation. The muscles had not been used abruptly (orgasmic contractions) for some time.

And do a lot of Hindi Squats and Heat therapy (blankets, hot rice sock) right after orgasm, too.

Thanks for the Update TKL
4 weeks
Keep going!

[TKL_ Junior Member Find all posts View Profile Close TKL_]

Man I'll go for half a year of abstinence if that's what it takes to have a functional penis. It would help avoiding porn too. 4 weeks is just fine with me, although I have to say it's quite inconvenient when you're horny as hell and have to go in public. I just had to walk back to my car from a food store because I saw a girl with a nice ass in tights, and got an obvious semi-boner. There's really no reason to wear tights except to flaunt your ass if you're not excercising, some of us are trying to heal our dicks lol. Haven't been this horny in ages.

Thanks for the support.

[BenSu Junior Member Find all posts View Profile Close BenSu]

thanks romero!

i do not have suicidal though anymore, it was just at the begining when the pain was so intense...
mediation hels for that, i did talk of that to my family and GF =).

now i'm more worried about some strange pain who goes in leg, back and arm, almost everytime in the right side... but it look like connected to stress...or muscular tension... i dont really know it's like i dont have a good blood flow... or the pain you have after you did too much sport...

the thing is, i can see some improvement in my condition but everytime i do unconscious kegels in my daily day, i try to stay aware of that but its hard, i guess it just gonna takes time...

thanks for your support!

[Romero MD Senior Member Find all posts View Profile Close Romero MD]

Man I'll go for half a year of abstinence if that's what it takes to have a functional penis. It would help avoiding porn too. 4 weeks is just fine with me, although I have to say it's quite inconvenient when you're horny as hell and have to go in public. I just had to walk back to my car from a food store because I saw a girl with a nice ass in tights, and got an obvious semi-boner. There's really no reason to wear tights except to flaunt your ass if you're not excercising, some of us are trying to heal our dicks lol. Haven't been this horny in ages.

Thanks for the support.

Hahahahahaha
Guys, are you reading?... Stop watching porn! What you need is to go to food stores more often

You're welcome, TKL

[Romero MD Senior Member Find all posts View Profile Close Romero MD]

thanks romero!
I do not have suicidal though anymore, it was just at the begining when the pain was so intense...
mediation hels for that, i did talk of that to my family and GF =).

now i'm more worried about some strange pain who goes in leg, back and arm, almost everytime in the right side... but it look like connected to stress...or muscular tension... i dont really know it's like i dont have a good blood flow... or the pain you have after you did too much sport...

Sleep 8 hours and eat healthy.
Are you doing the stretches of the Overcome Course for too long?...
Hang yourself from a pull-up bar, several times a day. It's one of my favorite posture exercises.

I have some lower back pain if I do too many intense Reverse Kegels, while I'm sitting. This happens because you are creating a Valsalva maneuver. The increase in abdominal pressure slightly compresses your spine. I hang from the bar, several times a day, to counteract that.

the thing is, i can see some improvement in my condition but everytime i do unconscious kegels in my daily day, i try to stay aware of that but its hard, i guess it just gonna takes time...

It's a little hard, yes... Sometimes it still happens to me. I just need to be more distracted, very focused on something or enthusiastic, talking to someone, and when I notice the pelvic floor has already contracted a little. It takes time...

That's why I don't want you to add Kegels too soon...

thanks for your support!

You're welcome, Ben

[Jay1983 Senior MemberMember of the Month Apr 2014, Sept 2016 Find all posts View Profile Close Jay1983]

Stop watching porn! What you need is to go to food stores more often

[Mi3an Junior Member Find all posts View Profile Close Mi3an]

Hey doc, after reading every advice you’ve given me and advice from a hard flaccid discord, I now understand HF as a symptom of multiple different factors. I know that it’ll take mental and physical ( stretching, resistance stretching, fixing tight and weak muscles surrounding the pelvic floor and globally). I’ll be going to a pelvic floor physio who understands hard flaccid soon. Is there anything that I should ask him to massage or trigger point massage? Also should I read obitoos book? Does he talk about getting rid of his varicocele on it?

[Romero MD Senior Member Find all posts View Profile Close Romero MD]

Hey doc, after reading every advice you’ve given me and advice from a hard flaccid discord, I now understand HF as a symptom of multiple different factors. I know that it’ll take mental and physical ( stretching, resistance stretching, fixing tight and weak muscles surrounding the pelvic floor and globally). I’ll be going to a pelvic floor physio who understands hard flaccid soon.

Very good, Mi3an! Great!

Is there anything that I should ask him to massage or trigger point massage?

The physiotherapist will surely understand more about specific massage techniques than I do... But make sure that he fully understands the mechanism and pathophysiology of Hard Flaccid. Explain to him everything you know about Hard Flaccid. And then let him do his job

Also should I read obitoos book?

I think it is a great book, despite the weakness I mentioned earlier. You decide

Does he talk about getting rid of his varicocele on it?

No. He talks about it on this thread:
- The Official Hard Flaccid Recovery Thread

[Mi3an Junior Member Find all posts View Profile Close Mi3an]

Do you believe his theory that a lot of HF people with varicocele completely reverse it when they start to reverse their HF?