Hard Flaccid Syndrome: Symptoms, Causes, and Treatment

Experiencing any abnormality during sex can be an extremely frustrating experience for men — especially when it comes to getting it up.

Hard flaccid syndrome is a common yet incredibly underrepresented sexual disorder that numerous men have experienced in their lifetime.

Although it has not yet been formally recognized or defined by the sexual medicine community, it won’t keep us from talking about it!

Read on as we uncover the common symptoms, causes, and best treatments for hard flaccid syndrome.

What is Hard Flaccid Syndrome?

Hard flaccid syndrome symptoms include: Penile numbness, pain, or discomfort...

Hard flaccid syndrome (HF) is a type of sexual dysfunction characterized by chronic pain in the penis and perineum, also known as the area between the penis and anus.

A recent study published by Basic and Clinical Andrology states that the syndrome is "poorly recognized". Although HF lacks an evidence-based definition from the medical community, experts describe it as a type of chronic pelvic pain syndrome (CPPS) involving a collection of symptoms.

Hard flaccid syndrome symptoms include:

• Firmness or rigidity in the penis while in a flaccid state
• Contraction or muscle tension in the pelvic floor muscles
• Penile numbness, pain, or discomfort
• Difficulties achieving or maintaining an erection (similar to symptoms experienced with erectile dysfunction)
• Painful ejaculation
• Painful or weak urination
• Underlying symptoms of anxiety or depression

What Causes Hard Flaccid Syndrome?

Most men have reported that their symptoms began after a traumatic penile incident, such as during aggressive sexual intercourse or masturbation.

Unfortunately, the actual cause of hard flaccid syndrome is not completely clear.

However, based on reports from different men, there may be two common subtypes of HF. The first is related to pelvic floor muscle function (due to trauma or injury) and the second is related to blood flow and anxiety.

The Role of the Pelvic Floor Muscles

Most men have reported that their symptoms began after a traumatic penile incident, such as during aggressive sexual intercourse or masturbation. When the penile tissue is injured, there is likely more underlying trauma within the superficial pelvic floor muscles.

The pelvic floor muscles are integral to normal erectile functioning. These muscles may become compromised or injured when the penis is overly lengthened. It can happen due to excessive or rough masturbation, using a penis pump, or during a traumatic sex incident.

As a result, the injured muscles become tighter, compressing the associated nerves and venous structures that help with normal erectile and urinary function.

The Role of the Nervous System

The Sexual Medicine Society of North America describes hard flaccid syndrome as “an imbalance or dysregulation of the penile nervous system”.

The sympathetic nervous system, associated with the “fight or flight” response, will inhibit an erection by slowing blood flow. In contrast, the parasympathetic nervous system or “rest and digest” system will promote an erection by increasing blood flow.

However, someone struggling with HF may experience a heightened sympathetic tone causing a weaker or less erect penis when aroused.

The Role of Stress and Anxiety

Though physical trauma to the penile tissues is likely to cause hard flaccid syndrome, some research suggests that stress and anxiety can worsen symptoms. When men begin to feel anxiety about their sexual performance, they’re more likely to experience sexual dysfunction such as HF.

Stress and anxiety also regulate the nervous system, which can further imbalance sympathetic/parasympathetic responses.

The Effects of Hard Flaccid Syndrome on Intimacy, Relationships, and Mental Health

Intimacy plays an essential part in our romantic relationships. Like erectile dysfunction or premature ejaculation, hard flaccid syndrome can draw a wedge between couples, making sex and intimacy nearly impossible.

Over time, HF can cause a lot of tension within a relationship, often making a man feel frustrated, angry, depressed, and even less masculine. Without having a solid understanding of the condition, HF may also affect our partner’s mental health, making them feel less attractive or desired and more anxious or confused.

Shame or embarrassment surrounding these symptoms may prevent couples from discussing this condition.

How to Treat Hard Flaccid Syndrome

The idea behind this method is less about strengthening the muscles and more about reducing their tension or overstimulation.

Though diagnosing hard flaccid syndrome can be tricky, there are some beneficial strategies physicians and physical therapists use that are shown to improve or resolve symptoms.

No standard treatment protocol exists since the medical community has not yet defined this condition. However, men report experiencing beneficial results with certain medications for pain management, pelvic floor exercises to relieve muscle tension, and other stress reduction techniques to limit mental disturbances.

Pelvic Floor Physical Therapy

Above all else, pelvic floor physical therapy is one of the top treatment methods for addressing hard flaccid symptoms.

As mentioned earlier, pelvic floor muscle tension is commonly associated with this condition. For this reason, healthcare providers recommend various pelvic floor exercises that help ease muscle tension and improve overall pelvic health and functioning.

The idea behind this method is less about strengthening the muscles and more about reducing their tension or overstimulation.

For example, pelvic yoga is an effective relaxation exercise that helps down-regulate muscle activation and improves erectile function.

Focused Shockwave Therapy

Focused shockwave (FSW) therapy is another beneficial treatment for hard flaccid patients. Using a device known as a wand, FSW emits gentle pulses of shockwaves that targets penile tissue to stimulate blood flow in the penis. The purpose of this is to encourage tissue remodeling in the hopes of promoting healthy erections.

Stress Relieving Techniques

Stress is strongly related to reducing erectile function and creating muscle tension. So, handling stress can play a large part in resolving symptoms of hard flaccid syndrome.

Pelvic pain specialists suggest activities such as mindfulness, meditation, journaling, yoga, and reading to help support HF patients in their journey to resolve pelvic pain now and in the future.

Suppose you’re struggling to manage your stress. In that case, speaking to a mental health professional about your symptoms may also be helpful.

FAQs

What is hard flaccid syndrome?

Hard flaccid syndrome is a chronic painful condition characterized by a semi-rigid penis while in its resting or flaccid state.

How is hard flaccid syndrome diagnosed?

Diagnoses of this male sexual dysfunction may be based on specific symptoms, including extreme penile pain or discomfort, inability to achieve a full erection while aroused, erectile dysfunction, pain during or after ejaculation, a reduced force of ejaculation, and so on.

Can hard flaccid syndrome be cured?

Though this condition is challenging to treat, there are many ways to manage symptoms using pelvic floor physical therapy.

Another helpful way to restore erectile function is by managing stress and anxiety levels. Some practical stress-relieving techniques include yoga, journaling, meditation, and reading.