Hard Flaccid

• This condition may arise following a traumatic event, which could include using a penile vacuum or pump, engaging in rough masturbation or intercourse, manually over-stretching the penis (a practice known as jelqing), or performing excessive squatting.
• An injury to the base of the penis can disrupt the nerves and blood vessels that supply both the penis and the pelvic floor muscles.
• The initial injury can cause significant emotional distress, which may overstimulate certain areas of the nervous system and lead to involuntary contractions of the pelvic floor muscles.
• Ongoing contractions of the pelvic floor muscles can compress nearby nerves and blood vessels, leading to sensory changes such as numbness or a cold sensation. This can also cause increased pelvic floor muscle tension and pain.
• Persistent contraction of the muscles involved in achieving and maintaining an erection can damage the venous structures of the penis. This damage may result in the penis remaining semi-erect even when flaccid.

While Hard-Flaccid Syndrome is not an officially recognized medical diagnosis, it has emerged as a term used to describe a collection of symptoms, largely through online discussions. The medical literature provides limited information on this condition, resulting in a lack of clear understanding and definition.

Many symptoms associated with Hard-Flaccid Syndrome overlap with those of Chronic Pelvic Pain Syndrome (CPPS), Male Pelvic Pain Syndrome, and Chronic Nonbacterial Prostatitis. Although these conditions are more formally recognized, they present their own challenges in achieving accurate diagnosis and effective treatment. Additionally, a significant number of pelvic floor physical therapists are trained primarily to treat women, which can be a limitation in addressing these issues. At PHRC, however, we provide care for both men and women, and often treat more men than women.