pudendal nerve injury, mind-body, or...?

[romotronco88]

Hi y’all! Eager to connect with others, and continue to find answers to this.

I’ve had lack of sensation and libido issues since an incident in March 2023. I was doing some prostate play, which was helping libido by relieving pain from a skin condition down there, when I felt discomfort upon entry, and my glowy sex sensations zapped out. My penis and the internal mechanisms that seemed to power it, have largely gone dark, sensation wise.

Since the injury I've had: cold glans, constipation, occasional hourglassing, pleasureless orgasm/sex/masturbation, some urinary weirdness, lack of erection overnight or morning, and too hard erections overnight sometimes. I have had HF during this and much of my life, although there are periods where I have HF on and off but sex stuff is still great. The lack of sensation spreads to my dick but feels most pronounced inside — inner testicle, perineum, groin — which I've always thought of as the engine room.

I was told by one doc who treats these things that he believes I caused a pudendal nerve torsion injury and to give myself two years to see if I can heal naturally.

Good news: Starting in July, after 1.5 years of this, I began to see significant improvement – more periods of sexual feeling again, better feelings of release after BMs, and just a general sense of health and well being. Since September, things have gotten MUCH better — using weed and even alcohol for some exciting sex encounters, getting my partner to do a lot of massages of that area, getting morning and overnight erections again. Critically, I’ve started to have drive and sensitivity. Had a few times having getting freaky with my partner recently that felt like the olden days almost. And a few times masturbating where I can feel horny again. Feeling 85 percent back, at times.

FOR me, the sensation is linked to a deep feeling of horniness / desire. I’ve noticed when things are feeling good, the pleasure starts even before physical contact — it is pleasureable just to think hot thoughts or look at pics of naked women online. MY million dollar question is what is the chicken or the egg: the horniness in my mind, or the sensation in my loin, IE physical connection.

The bad news is I still have what feel like crushing setbacks, over seemingly small things. In the last six weeks, two different times masturbating, when things were only feeling so-so to start off, resulted in me falling off Recovery Mountain. The lack of sensation is back, sometimes overnight boners go away for a bit, and constipation can rear its head again. Yesterday had HORRIBLE constipation when out with my guy friends in the city drinking and visiting a restaurant. Fun times.

It’s been so fuggin hard to figure out what is going on and how best to tackle this damn thing. My million dollar q is how much is mind/nervous system based, and how much is just some horrible nerve injury I really have no control over. I’m not at the point of considering surgery, but if I really can’t have sexual sensation on the regular, I would consider it. I LOVE YOU ALL, EVERYONE FIGHTING THIS THING. Feel free to connect via DM.

[Violet M]

MY million dollar question is what is the chicken or the egg: the horniness in my mind, or the sensation in my loin, IE physical connection.

My million dollar q is how much is mind/nervous system based, and how much is just some horrible nerve injury I really have no control over. I’m not at the point of considering surgery, but if I really can’t have sexual sensation on the regular, I would consider it.

I think the chicken and the egg question is one of the most difficult ones to deal with. Since you had a known incident/injury, it's kind of hard to believe that there is no physical connection. And even if things sort of heal, you can still be prone to what caused it in the first place -- like a possible genetic predisposition to developing a physical problem from things like a tight space between ligaments, or many other genetic components that we have no control over. So maybe your nerve starts to heal but then gets reinjured. I don't know, just brainstorming here. I'm not sure anyone can answer your question with 100% certainty. It is true there is a significant mindbody connection. So maybe your problems are partly physical but partly mind based. Sorry, that wasn't much of a definite answer was it? Wishing you the best.

Violet

[romotronco88]

Thanks Violet. Just really seeking guidance on how to move beyond this and haven’t found much. On a good day I feel ok! Bad weeks I start thinking I should consider more aggressive treatment, up to and including surgery

It’s hard to quantify how often it’s good v bad .. but in general experience anything close to the sensation and level of being turned on I used to have very rarely. So I’m just trying to understand where I am, so I can weigh my choices. Many days like today it really does seem like things are screwed. As a 39 year old I’d very much like to experience sexual pleasure again. But it could always be worse, my body still does and can perform basic functions even if it doesn’t feel the way it used to

[Violet M]

Some other guys have posted about similar issues on this forum. If you put the word "flaccid" into the search bar in the upper right, it will take you to a list of posts where this has been discussed. You might find some of it interesting. I know it's really hard to decide what to do but when it comes to surgery, my thoughts are that it is a last resort to consider only if you are willing to take the risk of possibly getting worse. If your quality of life is so bad that you are willing to take that risk, then you can put it on your list of options. Some people would argue that you are taking a risk of getting worse if you don't do anything, and I suppose that is true to some extent. So, there are no easy answers, unfortunately. When I was considering surgery, I made a list of pros and cons. It seemed easier to weigh them when you look at them written down side by side. Sometimes it becomes clear that one of the pros or cons is significantly more important that the rest of the stuff on the list. Anyway, I wish you the best as you figure this out.

Violet