HARD FLACCID and Norepinephrine/epinphrine

[fendool Member Find all posts View Profile Close fendool]

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4837321/


"Stress and anxiety lead to increased epinephrine production, and heightened sympathetic tone leads to exaggerated cavernosal smooth muscle contraction, inability of smooth muscle to relax, and subsequent erectile dysfunction."

"On physical examination in a man with hypertonic cavernous smooth muscle, the penis may initially be contracted and tender to palpation. As the exam proceeds and the patient becomes less anxious, the penile tissue will often noticeably relax."

"For patients who have ED related to hypertonic cavernous smooth muscle and excessive sympathetic discharge, we recommend a trial of a low-dose alpha adrenergic blocker, such as terazosin 1 mg PO at bedtime nightly."


I am a sufferer. Why has nobody brought this up before? I'm not sure what the underlying cause is, but isn't it clear from the article that Hard Flaccid sufferers have too much epinephrine/Norepinephrine in their penis? Has anybody tried beta blockers?

Also, some further studies:

https://www.sciencedirect.com/science/article/pii/S0090429501015217

https://www.ncbi.nlm.nih.gov/pubmed/2342199

[Pegasus AdministratorPE Gym EditorPEGym Hero ☺ Admin of the Month Mar 2015 Find all posts View Profile Close Pegasus]

Actually hf suffers usually resist the idea that stress is a causal factor .

The mods myself included have repeatedly put the idea that dealing with stress/anxiety should be regarded as part of the treatment for hf and have been roundly criticised for it .

[HansTwilight Retired ModeratorPE Gym Editor Member of the Month Jan 2017PEGym Hero Find all posts View Profile Close HansTwilight]

Literally proves what we have been saying this whole time.

Yes, they have too much epinephrine because they are anxious. The medication simply relaxes the blood vessels but doesn’t treat the cause. Treat the anxiety.

[Big Al AdministratorPEGym EditorMale Enhancement Coach Rep.PEGym Hero Find all posts View Profile Close Big Al]

Correlations between stress and HF have been made on many occasions.

[CUSP82 Administrator Admin of the Month Dec 2014PEGym Hero Find all posts View Profile Close CUSP82]

No one wants to treat the real issue of stress and anxiety because they refuse to believe it. The injury heals but the brain won't let it. Does anyone really think that a hard flaccid is a new thing? No we just think it's a new thing because we have access to more information. Those that suffer, and they do suffer, simply refuse not only to believe it but to even consider it. They can't possibly think they are exacerbating things themselves.

[CUSP82 Administrator Admin of the Month Dec 2014PEGym Hero Find all posts View Profile Close CUSP82]

https://www.urologynews.uk.com/featu...accid-syndrome

[greg123 Senior Member Find all posts View Profile Close greg123]

Check my thread guys I've wrote everything about hf plus the link cusp posted. The muscles that remain tight get weak due to being contracted all the time. That means that re strengthening the right muscles includes the steps to heal this condition. Ofcourse stress plays a very important role and its ofter the cause.

[CelDub Senior Member Find all posts View Profile Close CelDub]

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4837321/


"Stress and anxiety lead to increased epinephrine production, and heightened sympathetic tone leads to exaggerated cavernosal smooth muscle contraction, inability of smooth muscle to relax, and subsequent erectile dysfunction."

"On physical examination in a man with hypertonic cavernous smooth muscle, the penis may initially be contracted and tender to palpation. As the exam proceeds and the patient becomes less anxious, the penile tissue will often noticeably relax."

"For patients who have ED related to hypertonic cavernous smooth muscle and excessive sympathetic discharge, we recommend a trial of a low-dose alpha adrenergic blocker, such as terazosin 1 mg PO at bedtime nightly."


I am a sufferer. Why has nobody brought this up before? I'm not sure what the underlying cause is, but isn't it clear from the article that Hard Flaccid sufferers have too much epinephrine/Norepinephrine in their penis? Has anybody tried beta blockers?

Also, some further studies:

https://www.sciencedirect.com/science/article/pii/S0090429501015217

https://www.ncbi.nlm.nih.gov/pubmed/2342199

Interesting stuff! HF sufferer here that believes he’s on the right - and maybe only - physical track towards kicking it however, has never disregarded the mental side.

[Big Al AdministratorPEGym EditorMale Enhancement Coach Rep.PEGym Hero Find all posts View Profile Close Big Al]

Check my thread guys I've wrote everything about hf plus the link cusp posted. The muscles that remain tight get weak due to being contracted all the time. That means that re strengthening the right muscles includes the steps to heal this condition. Ofcourse stress plays a very important role and its ofter the cause.

There are cases where the Ischiocavernosus muscles stay perpetually strained- which has been observed to contribute to HF.

[Big Al AdministratorPEGym EditorMale Enhancement Coach Rep.PEGym Hero Find all posts View Profile Close Big Al]

Interesting stuff! HF sufferer here that believes he’s on the right - and maybe only - physical track towards kicking it however, has never disregarded the mental side.

The frustration comes from attempting to find a singular answer for a symptom which can be caused by different factors. One has to determine the root cause to successfully treat the issue.

[fendool Member Find all posts View Profile Close fendool]

No one wants to treat the real issue of stress and anxiety because they refuse to believe it. The injury heals but the brain won't let it. Does anyone really think that a hard flaccid is a new thing? No we just think it's a new thing because we have access to more information. Those that suffer, and they do suffer, simply refuse not only to believe it but to even consider it. They can't possibly think they are exacerbating things themselves.

In my opinion, mental 'stress' plays a small part in HF. Physical 'stress' is the more likely culprit. Another good read:

https://www.researchgate.net/publica..._of_four_cases


"Psychological symptoms are usually present ranging from mild anxiety to severe depression. Moreover, laboratory and imaging tests are often unremarkable. Our cases included men between the ages of 22 and 34years of age and they all reported the onset of their symptoms after a trauma during sexual intercourse or tough masturbation."

"we know very little about whether it is a true medical disorder or a psychological issue"

"Although the exact mechanisms resulting in HF are not clear, traumatic events such as rough masturbation or jelq-ing may be responsible for the onset of the symptoms. The location and the extension of this traumatic injury may affect the pudendal nerve and artery, which may deteriorate pelvic floor muscle and erectile functions. In addition, HF patients commonly report symptoms similar to chronic pelvic pain syndrome [3] or pelvic floor tightness [2,4]."

"we hypothesize that these penile sensation changes and erection complaints maybe the result of a (minor) trauma to the nerves passing adjacent to the corpus spongiosum in radix penis, resulting in inflammation in these nerves"

"None of the HF patients in these forums report any experience with low-intensity shock-wave therapy,which may be administered to patients who failed previous therapies. Although we could not identify any reports about topical alprostadil creams, we believe that they may be offered to HF patients whose primary complaint is the softness in penile glans"

[Pegasus AdministratorPE Gym EditorPEGym Hero ☺ Admin of the Month Mar 2015 Find all posts View Profile Close Pegasus]

In my opinion, mental 'stress' plays a small part in HF. Physical 'stress' is the more likely culprit. Another good read:

https://www.researchgate.net/publica..._of_four_cases


"Psychological symptoms are usually present ranging from mild anxiety to severe depression. Moreover, laboratory and imaging tests are often unremarkable. Our cases included men between the ages of 22 and 34years of age and they all reported the onset of their symptoms after a trauma during sexual intercourse or tough masturbation."

"we know very little about whether it is a true medical disorder or a psychological issue"

"Although the exact mechanisms resulting in HF are not clear, traumatic events such as rough masturbation or jelq-ing may be responsible for the onset of the symptoms. The location and the extension of this traumatic injury may affect the pudendal nerve and artery, which may deteriorate pelvic floor muscle and erectile functions. In addition, HF patients commonly report symptoms similar to chronic pelvic pain syndrome [3] or pelvic floor tightness [2,4]."

"we hypothesize that these penile sensation changes and erection complaints maybe the result of a (minor) trauma to the nerves passing adjacent to the corpus spongiosum in radix penis, resulting in inflammation in these nerves"

"None of the HF patients in these forums report any experience with low-intensity shock-wave therapy,which may be administered to patients who failed previous therapies. Although we could not identify any reports about topical alprostadil creams, we believe that they may be offered to HF patients whose primary complaint is the softness in penile glans"

So at the physical level a pelvic issue most here believe that . Most of the mods also believe anxiety is heavily involved and causal. It seems typical though that hf guys want to deny the mental aspects.

[HFrecovering Senior Member Find all posts View Profile Close HFrecovering]

So at the physical level a pelvic issue most here believe that . Most of the mods also believe anxiety is heavily involved and causal. It seems typical though that hf guys want to deny the mental aspects.

we do not know how implicated the mental aspects are. the pelvic floor muscles are hard wired to your nervous system, when they are under pressure and tense from muscle dysfunction they are going to hyper react to any stress.

my theory is that some people have been able to resolve symptoms purely by working on there mental state however unbeknown to them the pelvic floor muscle dysfunction still remains.


lots of people are having massive success purely with DCT which completely flips the mental theory on its head. we will know more in a year or so once more people have been at dct for a while.

[Pegasus AdministratorPE Gym EditorPEGym Hero ☺ Admin of the Month Mar 2015 Find all posts View Profile Close Pegasus]

we do not know how implicated the mental aspects are. the pelvic floor muscles are hard wired to your nervous system, when they are under pressure and tense from muscle dysfunction they are going to hyper react to any stress.

my theory is that some people have been able to resolve symptoms purely by working on there mental state however unbeknown to them the pelvic floor muscle dysfunction still remains.


lots of people are having massive success purely with DCT which completely flips the mental theory on its head. we will know more in a year or so once more people have been at dct for a while.

Actually no .
The pf is not hard wired to tense with anxiety . Guys with pf issues often seem to tense this area in reaction to anxiety in the same way I do my shoulders . That is it is a habit. With hf the front of the pelvic floor specifically the ic muscle seems particularly involved .
In some cases hf has been resolved from purely mental work . So the guy stops holding tension in the ic muscle and/or resolves anxiety. Bang hf disappears . Now keep in mind there is also often some physical issue as well so I do not recommend a mental only approach but rather mental and physical.
There is a very large group of guys with hf and we have seen a handfull who have done dctso I don't know about "lots".
Some of the guys doing dct have not yet seen results .
No one that I know of has gone years with no recurrence and recurrence is typical with physical only training.
In short I am withholding judgement on dct particularly as it is a commercial enterprise .

[HFrecovering Senior Member Find all posts View Profile Close HFrecovering]

Actually no .
The pf is not hard wired to tense with anxiety . Guys with pf issues often seem to tense this area in reaction to anxiety in the same way I do my shoulders . That is it is a habit. With hf the front of the pelvic floor specifically the ic muscle seems particularly involved .
In some cases hf has been resolved from purely mental work . So the guy stops holding tension in the ic muscle and/or resolves anxiety. Bang hf disappears . Now keep in mind there is also often some physical issue as well so I do not recommend a mental only approach but rather mental and physical.
There is a very large group of guys with hf and we have seen a handfull who have done dctso I don't know about "lots".
Some of the guys doing dct have not yet seen results .
No one that I know of has gone years with no recurrence and recurrence is typical with physical only training.
In short I am withholding judgement on dct particularly as it is a commercial enterprise .

never said "hard wired to tense with anxiety" you are misquoting me.

I said when a muscle is dysfunctional, under pressure and tense it hyper reacts to stress and emotions, just like I do with my jaw and abdominals, this isn't debatable, it's fact.

you keep mentioning these so called people who have a "recurrency or relapse" yet I've been viewing this forum 10 years and I've yet to see one of these, I wonder if you can actually provide me some examples of this because if you can't I feel like it's just something you say to try and emphasise the mental aspects to hf people.

for the third time in a month I'll explain this again, there are people over the years on this forum who convince themselves they are getting better because they are trying a new treatment, they come on the forum and tell everyone that they are better or that they nearly are better, later down the line when you have a conversation with them and scratch below the surface you discover they never actually got rid of it, it is a mind game they play with themselves, I've seen it countless times and I have even been guilty of doing it myself several years ago.