His and Her Health

Alan:
I don't recall, did you ever have penile sensitivity issues? Thanks!

Also, thanks for still sticking around despite your success. You're a great contributor to this cause.

OT: I have been on Twin Lab Gabba for 3.5 months with no results with EA but it does help with other things. Good stuff! I think I will try and buy some bulk Gabba and increase the dose a bit along with my usual 500mg Twin Lab dosages to see if that helps. Keep you guys posted!

chromeo:
Please keep me posted on your visits to the psychologist. This is an avenue I want to explore and am curious how it works out for you. Thanks!

Needhelp:

Yes, the tension was found by manual manipulation (internal and external) , ultrasounds and also biofeedback tests.

To be perfectly honest, I was like you and had none of the symptoms of PN in the begining...just lack of sensitivty and EA. Over time I have developed a few common ones but never to the degree of some of the horror stories out there. There are a lot of symptoms and they vary on the severity of the nerve disruption and cause. Sounds like if you have it, it is minor but any disruption to this nerve slight or severe, shuts it down and it can sometimes take awhile to recover after it is fixed. I have seen less severe cases are recovered in an average of 6 - 8 weeks, usually within 3 months. More severe cases can take months or sometime years to recover.

As for treatment, a pelvic floor physical therapist who has training in PN is a great place to start. They really undersatnd it and have a lot of tricks up their sleeves and can point you in other areas based on what they find. Finding the cause is the most difficult and it can range from pelvic misalignment, muscle tension, joint or ligament dysfunction, scar tissue, adhesion etc. You just have to keep ruling things out. So far in my case, my sacrum was twisted where the nerve originates so an adjustment was done. As a result my joint was out of place too. Hoping that was it but still trying other things. Either the PT or a chiro can help for that. For the muscles, ligaments, and tendons, depending on the experience of the PT...they can usually do it or they will send you to a good clinical massgage therapist whose has training in trigger point therapy, myofasical release, and sometimes accupuncture. Not a relaxation type massage...this stuff hurts!

As far as doctors, there are very few and the main guy is in France. Dr. Filler in CA has a technology which is debatable but may be worth a try (MR Neurography). Relatively new so not covered by many insurances but supposedly can find pudendal nerve disruptions. You can also have an EMG or a pudendal nerve motor latency test (PNMLT). Dr Antolak in MN is supposedly a good place for this.

This is a very little researched area so not too many mainstream docs can help or even know about it. Hope this helps!

Nofun:

I am currently being treated for the pudendal nerve (pudendal neuralgia). Similar symptoms as you, numbness in perineum, penis etc. You are right that the symtoms can be caused without entrapment. As of now they feel my nerve was stretched due to a twisted sacrum (where the nerve originates from) from a bad slip i had (since readjusted). Along with the nerve being stretched, my muscles overcompensated for the displacement and may also be interfering with the nerve. I had biofeedback and my muscles were indeed in an abnormal state of tension. I'm praying this was the problem and hopefully will make some progress.

Shuttler:
Glad you are having some improvement! I think the fact your condition seemed to have started around October 07 and you are immediately seeing results is a good sign if it is indeed pudendal nerve related. From what I've been told, the longer the nerve is stressed/compressed the longer it takes for it to recover depending on severity. It seems likely your possible nerve dispruption was not too severe and I would think you're recovery would be sooner rather than later based on your results. Good luck and I'm pulling for ya!

Also, if possible, can you provide some details as to what the chiros are finding? i.e sacroiliac joint dysfunction, pubic bone displacement, etc. Thanks!

Shuttler:
When did you have your vasectomy? (MM/YYYY) Thanks!

shuttler:

I have experienced similar sensations when urinating. Just more feeling than i'm used to. At one time i felt a slight burning in my urethra (nothing major) but i saw it as a positive. I have had absolutely no feeling there for over a year, pain or pleasure, so it was interesting to feel something in the area again. From my research, i read alot of times it comes back out of nowhere for some sufferers. Praying something changes for the good some day...

Worth noting for those of us without sensitivty exploring the nerve issue to EA, I was instructed to load up on a B Complex to help aide nerve rejuvenation. I am taking Twin Labs B-100 as well as an extra B-12 Dot (also from Twin Labs). I will keep you posted on my results.

shuttler

Definitely keep us posted on your work. I am currently right behind you on the pelvic treatment. Quick recap of my story, ackward slip twisted my sacrum out of place in summer of 2008 and these symtoms followed shorty after. The sacrum issue wasn't discovered until 2 weeks ago (since readjusted) and as a result I am going for a pelvic xray and possible MRI tomorrow to make sure nothing else is out of wack causing nerve disruption. The nerve pathways of the pudendal are very vulrerable to disruption. If something turns up, my plan will be to follow your path and realign everything to eliminate the possibility of PNE. The important thing to note is the recovery time for this issue can be long so if you do not see results in the next few weeks don't be discouraged. There can be many causes for EA so hopefully our case can prove to be an effective solution like Alan has had.

jhuckison:

Yes, there are a lot of good sites out there as well as specific cases to research. I have been googling like crazy for the past year about it and there's plenty of info. The good news for you is if you do have it and it's from cycling the recovery time seems to be much quicker from what I read, average like 2-3 months.

Understandable with doctors not knowing, but many Pelvic Floor PT's are at the forefront of the PN field and go through extensive training for it. It is important to differntiate vs regular PT's and Pelvic FLoor PT's as their main focus is the pelvic area (muscles, nerves, blood flow etc). The profession began more so for child birth issues as you can imagine a lot can go wrong after delivery in that area. Eventually they began seeing more and more men as time progressed so they have seen our issues and different causes of it before. I'd say it's 50/50 in the office I go to (men to female patients). Their gripe has always been doctors neglecting the field or not knowing about it (very common). It was never suggested to me by any doctors, i found it on my own accord and had a urologist give me a prescription.

I included a few more sites that have better links to docs and PT's so you can find one close if you go down this road (first two have the lists). The PT's with stars next to their names have had PN training which is a big plus for our condition.

www.pudendalhelp.com/List_Of_PT'S.html
pudendal.info
pudendal.com

I agree with you that this may be the cause for some of us. Worth researching a bit...it is an interesting possibilty.

"The pudendal nerve is responsible for orgasm, urination, and defecation in both sexes. The pudendal nerve innervates the penis and clitoris, bulbospongiosus and ischiocavernosus muscles, and areas around the scrotum, perineum, and anus. At sexual climax, the spasms in the bulbospongiosus and ischiocavernous results in ejaculation in the male and most of the feelings of orgasm in both sexes. These muscles pulse at 0.8Hz at orgasm in both sexes. Difficult childbirth or cycling can compress or stretch the pudendal nerve but permanent injury is rare. Entrapment of the nerve is very rare but can happen. Pudendal Nerve Entrapment (PNE) is akin to Carpal Tunnel syndrome."

Nofun:

Yeah, crazy but it was. I had an ackward slip in summer of 2008 and EA/lack of sensitivty followed shortly after and eventaully ED set in. You are absolutley right about the sacrum/pelvis relationship which results in muscles in that area not functioning properly to compensate for the adjustment. This can lead to nerve compression/stretching as well as improper blood flow since it is such a complex region. I have some minor pains in this region which led me down the pelvic floor therapy route and would suggest anyone try this if they have any unusual feelings in this area, severe or not.

I have to say, there are not many of them but if you find a good pelvic floor PT it's quite remarkable how much they know and techniques used to help. I remember asking if they've seen anything like my condition before and fixed it and the reply was simply, "of course, it's what we do!". Unfortunately, if it is a pudendal nerve/artery injury it can take a long time to heal depending on the severity (anywhere from 2 weeks to years from my research). My fingers are crossed and will keep everyone posted on results.

Yes,for the full 30 days the mirapex/cialis combo gave me the functional aspect back but no help with sensitivty/EA. I had no side effects whatsoever from either . Unfortunately, when I stopped the positive results did as well.

Had my T levels checked twice in past year, normal range on the high side for me.

I have had wet dreams in recent years after about a month of abstinence of any sexual gratification (no sex or masterbation). With EA, I tried this last year to see if any mental issues are with my case. The thought was if the orgasm was normal during a wet dream (i usually wake up in the middle of an orgasm) then more than likely there is a mental cause for my condition. Unfortunately I did not have one during the trial period.

I have taken tetracycline in the past but it was when I was around 15. EA didn't start until I was 32 so it is unlikely the cause for me.

In other news....I tried mirapex for 30 days @ .125mg including cialis daily as suggested by a uroligist. Normal mechanics came back (strong morning erections and random ones throughout the day) but still no return of penile sensitivty or normal orgasms.

Upon Alan's advice, I quit the pharmaceticals and then tried GABA from Twin Labs. I am on week 3 @ 5 pills per day. Nothing noticiable has changed so far.

Also, in regards to the pelvic floor PT...it was discovered that my sacrum was twisted out of place (likely from an accident when my EA started). It has since been corrected and I feel better. It was suggested this may be contributuing to EA since the pudendal nerve (S2, S3, S4) originates from there. Hoping to see improvements so I will keep you guys posted if anything changes.

Low libido, erectile dysfunction, little to no penile feeling, ejaculatory anhedonia.

Thanks Alan

Just an update with where I am at. Still doing the pelvic floor therapy and have since regained erections. Also, visited a new urologist who has seen our issue before. He has me on cialis daily and mirapex. Seems to have helped regain a bit of sensitivity in my penis. I'll keep you guys updated with my results from the mirapex as I have seen it mentioned on the board before.

Alan: What particular brand Gaba supplement are you taking? Thought I'd give it a try but don't know which one to buy. Can you provide details as to which one you are buying? Thanks!

Makes sense to me...I've seen quite a bit written on the effects of testosterone and penile sensitivty.

Just curious Jaderr, were your T-levels normal when you had them tested? Thx!

Tarheelm:

Did you ever follow though with the pelvic floor/pudendal neuralgia possibility? I am on the same page as you with that being a possible cause. I have started therapy and it has had a noticeable effect so far. Just curious what your experience was if you did it. (sorry if it is covered already, I just briefly went over your posts).

I explored the histamine route and it may have had a positive effect on me. Used to take unisom (antihistimine) nightly for years. Stopped that and also smoking and as a result I have the before and after feeling back...still no luck on the middle but before that I felt absolutley nothing so it was worth it.

Thanks for the input lostmojo, I did read back a fews pages and saw you and Daniel's situation which seems similar to mine sans the back issue. Scares me to think this may continue for years. I may try the saw palmetto. Seems like I'm close and just need an extra kick to get there so it can't hurt.

If I were to pick one I would suspect the lack of use by cutting back. It makes sense to me since overuse caused it in the past on occassion so there was a direct correalation there. Part of me thinks I may have "blown a gasket" and may need to give it a rest to heal and let my body work itself out. Initially when the problem started I was still masterbating quite a bit, maybe even more, just to see what the hell was going on and if the orgasm came back yet. Hey, you don't know till you try right? It's kind of like a catch 22 in my case where I panic b/c it's gone and want to see if it's back but what if all my body wanted was to give it a rest so it could heal if something is indeed wrong or worn out? Maybe each time I did it, the healing process was reset or pushed back. One step forward, two steps back. Add to that the mental anxiety from the issue and that may make it worse meaning I'm thinking so much about it maybe that is effecting the results even more since the orgasm heavily involves the brain. Sort of like when time goes slow when you think about it too much or watch a clock.

One of the things I really plan to try is complete abstinence, no sex, no masturbation PERIOD. I have done this in the past for a different reason and as a result I began having wet dreams in the middle of the night and would wake up at ejaculation or just before with the orgasm usually more intense than normal. Bizarre I know but the body seems to take care of itself when it needs to. That said, since allegedly morning erections rule out the mental aspect because your body is acting naturally on it's own, maybe if I can have another wet dream things will be 100% since my mind is completely at ease and I will experience a good old 10/10. If that happens, it's game on b/c then I know it is mental and probably was due to overuse. Research seems to suggest anxiety, stress, depression, etc have a negative effect on sexual function and I am definitely going though that because of this problem. That said, if it works I know a 10/10 is obtainable and I am confident I should be able to overcome the issue. My spirits will be flying high, stress, depression, etc, will go away and I feel at that point there ain't nothing to it but to do it and I will hopefully be back to normal!

Of course, being a man that is easier said then done but I have pretty strong self discipline. It took a good month or two for the wet dreams to occur so it is a long process which is why I have put it off while I try other things in the short term.

Just checking in and thought I'd post a bit more about my situation in hopes maybe something may help.

I'm 33, 6' 2", about 185, I have had no surgeries, have never done drugs, no sleep apnea, had a physical and everthing checked out, blood pressure normal, T levels high which was my main concern, no diabtes etc (I have the data and can give specifics if helpful). One thing that sticks out is I had a herniated disc at the S1-L5. After research it seems these are not the right areas for orgams mechanisms. I had hoped they were because my solution may have been back surgery. The back injury was not recent and orgasms were fine years after the incident.

It's a bit foggy in my memory but mine was a gradual process as slowly the sex drive went down, impotence seemed to follow then orgasm slowly declined to the point we are all at. It started probably late last summer and became full blown probably by winter. Over the years once in awhile when I have either had sex or masturbated more than usual in one day with less time between I would experience this (SA) on the final one, kind of like exhaustion. Didn't think much of it because it would be an isolated case when it happened and to be honest made sense to me and things were back to normal the next day anyway. I seem to be able to trace my last 10/10 orgasm to a day I had masturbated twice within a small timespan (less than an hour maybe?). Again, I had experienced this before and didn't think much of it EXCEPT this time the normal orgasms did not return the next day and have not since. "Pleasurable" sensitivty on the bottom of the head of my penis to maybe 3 inches below has diminished, but I do have normal sensitivty there in regards to pain, touch etc. Basically that used to be my sweet spot but is no more. As a result i rarely have erections and cannot remember the last time I had a sexual thought which resulted in one. If I do get one unprovoked from touch it is always first thing in the morning which research suggests my problem may be a mental thing. SA and impotence are clearly related but I am not sure in which order...chicken or the egg I suppose. It seems that doctors were not very helpful with this based on the board therefor I have done most of the research on my own and I have not mentioned it to any of them yet.

So, things I have done to try and find a solution: Got a physical and MRI to check things out (info available if needed), I quit smoking in November after maybe 5 years of it (pack a day). I also would take unisom daily and read on here about antihistimens so i stopped that. I used that for maybe 4 years? I drastically stopped masturbation (used to be maybe 5 times a week or so, now rarely) and due to SA have purposely remained sexually inactive mostly becuase there is lack of motivation when I know that the pleasurable feeling is gone and there is no happy ending so to speak. I tried maca root which did seem to help morning erections return. Outside of the morning ones I can still get them but usually need to try and they seem smaller than before and sometimes not as solid as they should be and more difficult to maintain. In fact, overal both erect and not, size seems to have gone down...maybe I'm imagining it but it seems that way. I also began taking a multi and fish oils. Anyway, the good news is after the previously mentioned things over the past few months I now get the euphoric sensation or build up just before ejaculation again (was gone before) but still absolutley nothing during release. The tired sensation and drowsy head feeling afterwards have also returned. Just missing that one integral part of the release. I plan to try some of the things on here a bit more and maybe maca again to see if I can get that final part back. May see a urologist if I can work up the courage.

Well, that's all I can think of now. I am still chugging through this thread but felt I might as well give my details in the meantime to see if it helps us. Feel free to ask me any questions, I am more than willing to answer them to help our cause.

Hey everyone! So glad I found this thread! I have recently began experiencing this and am now relieved to know I'm not alone! I plan to read through the thread to get up to date so I can contribute better. Hopefully I can add some input!