What is Hardflaccid Syndrome?

What is hard flaccid syndrome?

Hardflaccid is a condition which is still unknown amongst most medical practitioners in the world. There's currently no published literature what so ever, the information about the syndrome can mainly be found in forums. 

Hard Flaccid syndrome is a type of CPPS. Chronic Pelvic region tension results in a decreased blood flow to the penis.

The decrease of bloodflow leads to the penis being stiff and hard even though it's in its flaccid state. Causing a loss in penile size and erection struggles.

It seems to always be accumulated after intense pelvic stress. Common causes are physical exercises that puts pressure on the pelvic region, kegels, excessive masturbation/sex, and PE- exercises like jelqing, stretching and hanging.

Common symptoms besides the hardflaccid are

Deflated glans during erection

Loss of penile size

Low Libido, problem with achieving an erection or sustaining it.

No morning Erections

A lot of physical stimulation is most often required in order to obtain and maintain a erection. Visuals or cognitive thought often seems to not be enough. 

Tension/cramps in pelvis and the muscles nearby. Hips, hamstrings, lower back and so on. 

Trembling muscles

Cold hands and feet


Mental health of sufferers:

Most people with this syndrome will experience a really intense depression. This genitals is the last thing you want chronic problems with and many feel like this will be a threat for their future ability to acquire a wife and family. 

A lot of psychological symptoms hits a sufferer simultaneously. Lots of people quits their jobs/schools because of the feeling of constant depression/anxiety. Many times insomnia is present as well, increasing the intensity of the other symptoms. Isolation seems to be common and unfortunately this many times leads to suicidal thoughts. The condition therefore needs to be taken with seriousness when presented. Unfortunately Doctors and Physical Therapists around the world many times diminish the condition because of lack of knowledge. 

I write more about anxiety and hard flaccid within this blogpost.

Lack of knowledge within doctors and urologists: 

Most men with hard flaccid has met with tons of doctors and urologists that doesn't have a clue. As of yet, it's not widely recognised as a condition by urologists or doctors. The problem is rare, and many sufferers don't seek help because they're embarrassed or they don't dare to be upfront about their problem with the genitals so they might present it as a pelvic floor problem. 

It's extremely hard for doctors to diagnose and give correct treatment as there is no research available. And when the patient go through all the available tests like: Doppler ultrasound of the penis, sexually transmitted infection screen, flexible cystoscopy, blood tests, prostate examination and so on - nothing will look like it's wrong. 

This leads to a lot of misdiagnoses. Some people might get diagnosed with Peyronie's disease while another one might get laughed at, getting told it's all in their head. 

Physical and Mental Therapy is not enough:

If physical therapy (Trigger point therapy, stretching, rehab exercises) and mental therapy (cognitive behavioural therapy and so on) would be enough, there would be no chronic hard flaccid sufferers.

Right now, pretty much no one with a chronic syndrome is being able to cure them self. Everyone is trying the same things over and over again. Doing all types of different stretches, trying to abstain for months, only to get back to square one after ejaculating. 

Urology news, UK recently published an article where they addressed the problem in order to spread recognition.

In the article they do describe stress as a key factor for the development of this problem. They also do talk about on of the biological theories about how stress can caus chronic pelvic tension. The following paragraph down below is from the article:

"Stress is a key risk factor for the development of this condition by way of causing prolonged contraction of the muscles of the pelvic floor. Stress can be triggered by an injury directly to the penis during sexual intercourse or masturbation, or stress secondary to psychosocial distress in the absence of injury.

Within the body, psychological stress triggers the release of adrenalin with a primitive fight or flight response. The body goes into high alert; blood is directed away from certain visceral organs like the stomach to the muscles of the limbs and pelvis, so danger can be avoided.

One of the biological theories proposed to explain the relationship between stress and the development of hard flaccid syndrome is as follows:

Initial stress, be it physical or psychological, triggers an abnormal fight or flight response resulting in increased sympathetic stimulation to the muscles of the pelvis via the perineal branch of the pudendal nerve.

A surge of adrenaline, noradrenaline and cortisol is released from the afferent nerve fibres promoting increased blood flow to the bulbospongiosus, ischiocavernous muscle and levator ani muscles as well as sustained muscle contraction.

Sustained contraction of the ischiocavernosus and bulbocavernosus muscle results in obstructed venous outflow from the penis via compression of the deep dorsal vein. This process is likely to be responsible for the semi-engorged penis in the flaccid state.

Prolonged contraction of the muscles results in pelvic myoneuropathy secondary to neurogenic inflammation. The muscles physically lose their ability to relax, remaining contracted. The severe cramping, clenching sensation men describe in their pelvis, penile shortening, erectile and urinary dysfunction is likely attributed to this.

Myofascial syndrome then occurs. Multiple painful trigger points develop in the muscles, resulting in the area becoming hypersensitive. Slight stimulation to the penis / pelvis results in a complex cascade of afferent and efferent nerve impulses, resulting in the secretion of neuropeptides which consequentially cause severe pain and inflammation disproportionate to the initial stimulus"

It is a great theory and it is true that anxiety severely can increase tension within the area and worsen things a lot. I do remember vividly, how my symptoms would be at its worst when my anxiety was intensely present.

The anxiety triggers further clenching how the pelvic floor, which in turn leads to trigger points around the area and tightness of muscles. 

It's a negative spiral that you need to take control of. Because of what's written above, I really do think one should direct a lot of tension to physical therapy and mental therapy.

It's however NOT the main reason behind hard flaccid. If it would have been, I would have been cured after the 8 years of mental and physical therapy I did and so would everyone else that have tried.

I went all the way, read tons of books, saw a physical therapist, got completely rid of my anxiety, had a daily physical routine I followed for years that I constantly improved and so on. It did help a lot, but it never got me cured.

 So, what is the actual cause of hard flaccid then?

No one before has ever made the connection of the problem being partly bacterial. The first 8 years I approached this affliction as purely physical. After some trial and error things got a lot better after physical therapy. I found out that the pelvic tension had caused other nearby muscles to attract tension and weakness as well. If you decrease that tension and make them stronger. The pelvic tension would get decreased as well.

However, I never got 100% and If I would perform certain exercises or ejaculate frequently things would quickly get worse.

I continued my research and found a forum with people who had attracted prostatitis. Even though their symptoms didn't exactly looked like mine, I found that they at least had some decently similar symptoms like pelvic pain, lower back pain and so on. Google "prostatitis hard flaccid" and you will also get a couple of results.

I could quickly sort out that I did not have a normal prostate infection that was causing the pelvic tension. But after some further research I found a study where people with chronic pelvic pain, that did not get well after the normal prostatitis therapy (antibiotics) was turned to a different program. Where you change your diet and eat another kind of medicine. During this study more than 80% of the people attending got a lot better or got completely cured of their pelvic paic. More about my bacterial theory in this blogpost.

After lots of trial and error, I got rid of my hardflaccid in a matter of 2-3 weeks. Completely. It was one of the best days in my life

I'm now looking to help as many other people as possible with this problem. I'm the only one I know of that has gotten rid of this problem after a long period of time. You can read more about my coaching here