Hard Flaccid Syndrome (HFS) is a mostly unknown but increasingly prevalent condition that affects men's sexual health. This guide will help you understand the causes, symptoms, and treatment options available.
The majority of patients who have this condition are in their 20s and 30s. In recent years, more research has been done on hard flaccid syndrome.
Quick FAQs
Hard flaccid syndrome is a condition where the penis remains semi-rigid in the absence of arousal.
Some potential causes of hard flaccid syndrome include trauma, pelvic floor dysfunction, and nerve compression.
Common symptoms of hard flaccid syndrome include pain when ejaculating, numbness or coldness, and less frequent morning erections.
Medical authorities are beginning to investigate possible treatments that may help with curing the condition. Here’s some of the latest information to know about hard flaccid syndrome.
The National Library of Medicine describes hard flaccid syndrome as a condition in which the penis remains semi-rigid, or "hard," even when it's not aroused or erect. This persistent state of tension can lead to constant pain, discomfort, and sexual dysfunction.
The condition is said to be so new, most information on the condition comes from online forums like Reddit. As recently as 2020, it was not recognized by medical authorities as a legitimate condition.
Causes
The exact causes of hard flaccid syndrome remain unknown, but various factors may contribute to its development. Some potential causes include:
Trauma
Trauma to the penis during masturbation or sexual intercourse was what patients primarily reported as what led to the onset of their symptoms.
Pelvic Floor Dysfunction
Pelvic floor muscles play a vital role in supporting the bladder, bowel, and sexual organs. Dysfunction in these muscles can lead to erectile dysfunction, and may also contribute to hard flaccid syndrome.
Nerve Compression
Compression of the pudendal nerve, which provides sensation to the penis, can potentially be a factor when experiencing hard flaccid syndrome.
Anxiety and Stress
High levels of stress and anxiety can trigger muscle tension, which may lead to hard flaccid syndrome.
Symptoms of Hard Flaccid Syndrome
Men with hard flaccid syndrome may experience a range of symptoms, including:
A semi-rigid, non-erect penis
Pain or discomfort when ejaculating or urinating
Erectile dysfunction or difficulty maintaining an erection
Numb or cold feeling
Less frequent morning erections
Urinary symptoms
Psychological distress such as anxiety or depression
Symptoms are said to be worse in the standing position.
Diagnosis and Testing
There is no specific way to diagnose HFS. Laboratory and imaging tests are generally inconclusive.
Diagnosis typically involves a thorough physical examination, medical history, and the exclusion of other potential causes. Additional tests may include:
Pelvic Floor Muscle Assessment: To identify any dysfunction in the pelvic floor muscles, which can contribute to poor erectile function.
Neurological Examination: To assess the function of the pudendal nerve.Pudendal neuralgia is a known cause of certain sexual dysfunctions, such as ED and PE.
Given how new the condition is, doctors are still figuring out how to cure hard flaccid syndrome. Treatment for HFS varies depending on the underlying cause and severity of symptoms. Some options include:
Pelvic Floor Physical Therapy
A specialized physical therapist can help men with HFS strengthen their pelvic floor muscles, reduce muscle tension, and improve overall function. In at least one case study, it has proven to be a potentially effective treatment for hard flaccid syndrome.
Pain medications
Medications for pain management may be prescribed to alleviate symptoms. PDE5 inhibitors may also be prescribed to help improve blood flow to the penis.
Cognitive Behavioral Therapy (CBT)
CBT can help individuals reduce anxiety and stress. While anxiety has not been examined for whether it increases the risk of hard flaccid syndrome, anxiety has been proven to increase the risk of similar sexual dysfunctions like ED.
Trigger Point Injections
Trigger point injections is known to be effective at relaxing muscles, and may help relax the muscles of patients with hard flaccid syndrome.
Erectile dysfunction is a common issue for those experiencing hard flaccid syndrome. While one study didn’t find ED medications were effective, it still may be worth trying. Here are the top ED meds available:
Sildenafil - Sildenafil is the generic version of Viagra, which can work within 30 to 60 minutes and last for up to four hours.
Tadalafil - Tadalafil is the generic version of Cialis. It can work within 30 to 60 minutes and last for up to 36 hours.
Avanafil - Avanafil is sold under the brand name Stendra. The medication typically starts working within 15 to 30 minutes and lasts for up to 6 hours.
Vardenafil - Vardenafil is the generic version of Levitra. It begins to work within 60 minutes and can last up to five hours.
Learn more about how ED meds work and consult with a doctor to determine if it’s a good treatment option.
Psychological effects of living with HFS
In an article in the Journal of Sexual Medicine, it was noted that sufferers of hard flaccid syndrome experienced psychological issues such as mild anxiety and severe depression. These issues have also been reported by users on online forums as well.
In addition to medical treatments, certain lifestyle changes might help manage hard flaccid syndrome symptoms:
Stress Management: Techniques such as meditation, deep breathing exercises, and mindfulness can help reduce stress and anxiety, which may contribute to hard flaccid syndrome.
Regular Exercise: Engaging in regular exercise, particularly activities that promote pelvic floor health, could potentially manage HFS.
Proper Ergonomics: Ensuring proper posture and support during prolonged sitting can help reduce pressure on the pelvic floor muscles and pudendal nerve.
Diet and Nutrition: A balanced diet rich in anti-inflammatory foods may help alleviate HFS symptoms.
Takeaways
Hard Flaccid Syndrome is a complex and often misunderstood condition that can have a significant impact on men's sexual health and overall well-being. Studies suggest it may mainly affect men in their 20s and 30s.
Current treatment options that may help treat HFS include pelvic floor therapy and pain medication. Researchers continue to investigate the condition more, more information will become available to help those who have it.
By understanding the potential causes, symptoms, and treatment options, individuals with HFS can work with healthcare professionals to develop an effective treatment plan and improve their quality of life.
Our team has over a decade of experience in the sexual wellness field and are experts in sexual dysfunctions, like premature ejaculation. We help couples and individuals better understand treatment options available for different types of sexual needs and educate the public on all things related to intimacy. All of our authored content is medically reviewed for accuracy and reliability.
Sources:
Absorption Pharmaceuticals LLC (Promescent) has strict informational citing guidelines and relies on peer-reviewed studies, academic or research institutions, medical associations, and medical experts. We attempt to use primary sources and refrain from using tertiary references and only citing trustworthy sources. Each article is reviewed, written, and updated by Medical Professionals or authoritative Experts in a specific, related field of practice. You can find out more about how we ensure our content is accurate and current by reading our editorial policy.
Abdessater M, Kanbar A, Akakpo W, Beley S. Hard flaccid syndrome: state of current knowledge. Basic Clin Androl. 2020 Jun 4;30:7. doi: 10.1186/s12610-020-00105-5. PMID: 32518654; PMCID: PMC7271516. Accessed on Apr, 10, 2023.
Gul M, Towe M, Yafi FA, Serefoglu EC. Hard flaccid syndrome: initial report of four cases. Int J Impot Res. 2020 Mar;32(2):176-179. doi: 10.1038/s41443-019-0133-z. Epub 2019 Mar 19. PMID: 30890780. Accessed on Apr, 10, 2023.
"A prospectively collected observational study of pelvic floor muscle strength and erectile function using a novel personalized extracorporeal perineometer - Nature." Nature.com, 2021, www.nature.com/articles/s41598-021-97230-6. Accessed on Apr, 10, 2023.
Aoun F, Alkassis M, Tayeh GA, Chebel JA, Semaan A, Sarkis J, Mansour R, Mjaess G, Albisinni S, Absil F, Bollens R, Roumeguère T. Sexual dysfunction due to pudendal neuralgia: a systematic review. Transl Androl Urol. 2021 Jun;10(6):2500-2511. doi: 10.21037/tau-21-13. PMID: 34295736; PMCID: PMC8261452. Accessed on Apr, 10, 2023.
"Successful Treatment of Hard Flaccid Syndrome: A case report - The Journal of Sexual Medicine." Sciencedirect.com, 2022, www.sciencedirect.com/science/article/abs/pii/S174360952200251X. Accessed on Apr, 10, 2023.
Velurajah R, Brunckhorst O, Waqar M, McMullen I, Ahmed K. Erectile dysfunction in patients with anxiety disorders: a systematic review. Int J Impot Res. 2022 Mar;34(2):177-186. doi: 10.1038/s41443-020-00405-4. Epub 2021 Feb 18. PMID: 33603242; PMCID: PMC8964411. Accessed on Apr, 10, 2023.
Hammi C, Schroeder JD, Yeung B. Trigger Point Injection. [Updated 2022 Nov 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK542196/. Accessed on Apr, 10, 2023.
Maggi M, Pirola GM, Absil F, De Plaen E, Mosca A, Salciccia S, Sciarra A, Bollens R. Erectile function recovery after laparoscopic decompression of pudendal artery and nerve: a documented case report. Cent European J Urol. 2020;73(4):569-571. doi: 10.5173/ceju.2020.0088.R1. Epub 2020 Dec 3. PMID: 33552586; PMCID: PMC7848823. Accessed on Apr, 10, 2023.
M. Gül, E.C. Serefoglu, PO-01-037 Hard Flaccid: Is It a New Syndrome?, The Journal of Sexual Medicine, Volume 16, Issue Supplement_2, May 2019, Page S58, https://doi.org/10.1016/j.jsxm.2019.03.194. Accessed on Apr, 10, 2023.
"Hard Flaccid and Depressed - Reddit." Reddit.com, 2020, www.reddit.com/r/Hard_Flaccid/comments/hxpxe8/hard_flaccid_and_depressed/. Accessed on Apr, 10, 2023.
The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
