Thanks for sharing this! What would be the next step? Does this, with the trigger point therapy, seem to be a path to a goal or a life-long treatment?
I do not really know. I would not think so, especially considering how well me and JG have responded to just a few weeks worth of half-ass therapy.
Today my urologist noted that my prostate feel 100% normal. Guess this sort of cements that my āprostateā symptoms are def. pelvic floor related.
Still going ok Moonmam?
deleted; meant to send a PM, not make a post; sorry
Yup, still doing the exercises. I have actually completely weaned off of HydroCortisone over the past 2 weeks. Went from 25mg to 0mg. I notice that off of HC it is a ton harder to relax the pelvic floor. As soon as I dropped the HC many of the improvements began to immediately fade. With a lower level of cortisol, my body is producing more norepinephrine, which is causing the pelvic floor to become tense causing the issues. It is 100% harder to do pelvic drops now. When I take Prazosin though, the symptoms goes away.
-
Adrenal function in a big component of this. Unhealthy adrenals mean you body will produce more norepinephrine making it 5x harder to relax. Supplement with HC or Dexa if you have low saliva or urinary cortisol.
-
Taking daily alpha-1 blockers will likely speed the healing process. I really need to take this daily.
-
Multiple daily pelvic stretching and pelvic drops/opens is imperative.
Boston2009 reported while taking hc it was easier to do Squats, Iām assuming from looser hips.
Moon man how do you know the only thing causing your muscles to be tight is neoepinephrine? Not doubting, just wondering if there are other factors too.
Because hydrocortisone keeps norepinephrine blunted. 20-40mg of hydrocortisone is not a high enough dose to have any profound affect on inflammation, so I can def. rule that part out.
When I immediately weaned off HC, I could literally feel my norepinephrine rise. I was clenching my jaws more, I was a little bit more ātired and wiredā. The penile symptoms came back, but yet when I would take alpha1 blocker (blocks norepineprhine from the smooth muscles in the pelvic floor) the penile symptoms disappear.
More infoā¦
[i]"Pelvic Myoneuropathy, in its most simplified and broadest terms, describes a process in which people of a particular genetic type and often with tense, anxious, and frequently atopic (allergy-prone) dispositions, develop a chronic process in the pelvis that involves muscles, nerves and mast cells. Such individuals tend to tense the muscles of their pelvic floors subconsciously and continuously. This clenching of deep muscles can be provoked either by the individualās tense disposition, or it can be the result of a āguardingā response to a preceding trauma to the pelvic or spinal area, pelvic surgery, bicycling, childbirth, long periods of sitting and stress at work, and in some cases, urinary tract infections (prostatitis and cystitis). Other common events that lead to injury are:
[Size=4]chronic tense holding patterns that develop in childhood as a result of sexual abuse, traumatic toilet training, abnormal bowel patterns, guilt surrounding sexual feelings, dance training or stress
repetitive minor trauma or straining with constipation or urinary obstruction
other inflammations of pelvic organs such as urethritis, endometriosis, vaginitis, proctitis or anal fissures, or referred pain from other attaching muscle groups or viscera or nerves. [/size]
The subsequent muscle spasm and hypertonicity of the pelvic muscles leads to a hyperirritability of the muscle fibers. The hyperirritable bundles of fibers within the muscles of the pelvic floor become āknottedā, inelastic and unable to contract or relax. The overstimulated nerves innervating these muscles, through a complex process involving central sensitization, intermingling of afferent (sensory) fibers, neural wind-up, intercommunication among nerve plexuses, neural cross-talk, viscerosomatic convergence, the nature of visceral afferentes, and individual variations of anatomy and neurophysiology, eventually set up a process in the tissues of the genitourinary tract that leads to pathology. This pathology results when the nerve endings overproduce chemicals called neuropeptides. Neuropeptides stimulate powerful immune defence cells called mast cells. Once stimulated, these cells produce a wide range of chemicals (histamine, TNF-alpha, inflammatory prostaglandins, leukotreines) that cause pain, inflammation and all the symptoms of sterile prostatitis, urethritis, orchialgia, epididymitis, cystitis and vulvodynia. Therapy is multimodal, involving intrapelvic deep muscle ātrigger pointā massage and release, specific stretching exercises, stress control and special forms of pelvic muscle relaxation training, nerve therapy (Neurontin, Elavil, botox*), mast cell protectives and mast cell byproduct amelioratives (ProstaQā , Q-Urolā , antihistamines, alpha-blockers, etc). [/i]
chronicprostatitis.com/pelvicmyoneuropathy.html
In our case, the cause is likely the fact that allopregnanelone was blocked for so long. Our bodies natural valium.
[b][Size=4]Sexual dysfunction in men with chronic prostatitis/chronic pelvic pain syndrome: improvement after trigger point release and paradoxical relaxation training.
[/size][/b]Anderson RU, Wise D, Sawyer T, Chan CA.
Source
Department of Urology, Stanford University School of Medicine, Stanford, California, USA.
Abstract
PURPOSE:
The impact of chronic pelvic pain syndrome on sexual function in men is underestimated. We quantified sexual dysfunction (ejaculatory pain, decreased libido, erectile dysfunction and ejaculatory difficulties) in men with chronic pelvic pain syndrome and assessed the effects of pelvic muscle trigger point release concomitant with paradoxical relaxation training.
MATERIALS AND METHODS:
We treated 146 men with a mean age of 42 years who had had refractory chronic pelvic pain syndrome for at least 1 month with trigger point release/paradoxical relaxation training to release trigger points in the pelvic floor musculature. The Pelvic Pain Symptom Survey and National Institutes of Health-Chronic Prostatitis Symptom Index were used to document the severity/frequency of pain, urinary and sexual symptoms. A global response assessment was done to record patient perceptions of overall therapeutic effects at an average 5-month followup.
RESULTS:
At baseline 133 men (92%) had sexual dysfunction, including ejaculatory pain in 56%, decreased libido in 66%, and erectile and ejaculatory dysfunction in 31%. After trigger point release/paradoxical relaxation training specific Pelvic Pain Symptom Survey sexual symptoms improved an average of 77% to 87% in responders, that is greater than 50% improvement. Overall a global response assessment of markedly or moderately improved, indicating clinical success, was reported by 70% of patients who had a significant decrease of 9 (35%) and 7 points (26%) on the National Institutes of Health-Chronic Prostatitis Symptom Index (p < 0.001). Pelvic Pain Symptom Survey sexual scores improved 43% with a markedly improved global response assessment (p < 0.001) but only 10% with moderate improvement (p = 0.96).
CONCLUSIONS:
Sexual dysfunction is common in men with refractory chronic pelvic pain syndrome but it is unexpected in the mid fifth decade of life. [Size=4]Application of the trigger point release/paradoxical relaxation training protocol was associated with significant improvement in pelvic pain, urinary symptoms, libido, ejaculatory pain, and erectile and ejaculatory dysfunction.[/size]
what does this mean? the refractory part is not clear to me.
Oh my god this is so crazy that you brought this up. I have been researching norepinephrine for a little bit trying to learn more about it. I knew it played a role in my condition when in my worst crash about a week ago, I started having full body shocks. Like I had massive, MASSIVE adrenaline to the point where I could run for 10 minutes straight up and down stairs and not be breathing heavy at all, and completely rested. It blew my mindā¦ I basically labeled it as having massive adrenaline rush, which led me to think that norepinephrine played a large part in it.
Has anyone been prescribed Gabapentin? It has been shown to help with hypertonia, which we (presumably) have causing the penile issues. A leading urologist in NYC has looked at a PFS users penis and immediately stated that it was hypertonic penis (from tightened, contracted pelvic floor muscles).
[Size=4]GABA agonists and gabapentin for spastic hypertonia
[/size]
Spasticity is a result of an imbalance between the afferent excitatory and descending inhibitory pathways after central nervous system damage. Its pharmacologic control is believed to result from the antagonism of inhibitory mechanisms (gamma-aminobutyric acid GABA or glycine-mediated antagonism of excitatory mechanisms), or both. Because GABA receptor sites are widely present in the central nervous system, it is amenable to pharmacologic manipulation.
mendeley.com/research/gaba-agonists-gabapentin-spastic-hypertonia/
CHRONIC PELVIC PAIN SYNDROME TYPE 3 SUCCESFULLY TREATED WITH BIOFEEDBACK PHYSICAL THERAPY
Erik B Cornel*, Hengelo , Netherlands ; Ernst P van Haarst, Amsterdam , Netherlands
Physical therapy for the pelvic floor can help improve symptoms in some men with CPPS (nonbacterial or type III prostatitis). This group of researchers tested the effectiveness of pelvic floor therapy by looking at their NIH-CPSI scores, measurements of pelvic floor muscle tone, and urinary function before and after therapy. (Men with CPPS often have high tone. In other words, the muscles donāt relax.) The physical therapy technique involved biofeedback to teach the men to relax these muscles. Two of the 23 men enrolled couldnāt be trained well and didnāt show improvement. But for the other 21 men, the NIH-CPSI score fell significantly from a mean of 26 (range 11 to 33) down to 8 (range 1 to 19) after treatment. Muscle tone also improved (that is, the muscles became more relaxed). In healthy men, the measurement of muscle tone in the pelvic floor should be 1 mev, but the average before treatment in the men with CPPS was 5 (range 2.5-100), which decreased significantly to 1.4 (range 0.5-2.8) after treatment. These researchers believe that physical therapy for the pelvic floor should play a role in CPPS treatment.
Auto-Immune Theory
Elevated levels of proinflammatory cytokines in the semen of patients with chronic prostatitis/chronic pelvic pain syndrome.
Some men with chronic prostatitis/chronic pelvic pain syndrome have elevated levels of TNF-alpha and IL-1 beta in the semen. This suggests that inflammation of the genital tract is a feature of this disease, irrespective of the presence or absence of leukocytes in the expressed prostatic secretions. Seminal cytokine levels may provide an objective measure of disease in these patients and suggest specific therapeutic strategies to treat chronic prostatitis/chronic pelvic pain syndrome in such patients.
Cracking thread this
I also have/had the same problem that I could not f2lex my penis/stop urinary flow/push out urine harder". It could be related to my reduced āsquirting powerā when ejaculating.
i also had less squirt pow in my bad period and also difficult to escreting.
itās due to a lkind of lower belly tension
we are all going aroud this but nothing is clear
Does anyone know this āOkiā guy and whether he fully recovered? Seems to be an old member of the yahoo forum from what Iāve read
OK, donāt want to piss on the bomfire but looks like heās still fucked after 8 months of treatment. This is from Pelvicpain.org.uk
Also, iāve done alot of reading into this Wise-Anderson protocol today. Sounds like a load of BS if iām honest, yet another fake trying to profit from our suffering. Check out what some of these guys have to say on this link and the āclinicā conditions: pelvicpain.org.uk/forum/viewtopic.php?p=3191#3191
I really donāt know what to believe anymore. I have become such a big sceptic over this ordeal.
Good find on Oki. I would be interested to see which PT he went to. I have posted above that it is imperative to go to a PT who SPECIFICALLY deals with mens pelvic floor health on a daily basis. They need to understand both biofeedback and trigger point therapy. There are about 4 of them that I know of at the moment.
I still have a huge amount of interest in Gabapentin in treating this with PTā¦even moreso than alpha-1 blockers.
As far as the Wise-Anderson clinicā¦there are many sketchy reports out there, unfortunately I cannot edit my previous posts. I still stand by there are about 4-5 PTs in America that I know have helped men with CPPS (W-A not being one of them).
As far as doctors, I know of two urologists (one in US and one in Scotland) who have looked at a penis and immediately said āthis is hypertonic penis caused by tensed, contracted pelvic floor musclesā.
The PT is the first step over the stretching. Stretching comes second. There is a doctor in Boston who believes that this is an auto-immune reaction. He even holds a patent on how to treat it. I am trying to schedule a consult with himā¦