Painful ejaculation is the biggest quandary in the world. How could something that should be so pleasurable cause SO much pain!? What foul temptress created this horrible affliction and why was a hot poker being repeatedly rammed down my urethra for what could turn out to be hours on end?! Did I still have a bacterial infection (my original infection was nonSTD, but your mind boggles when you are in excruciating pain)? Did I get this from one of those causal relationships? Could I pass this on to someone else? Clearly, sex was off the cards; even masturbation was now debatable! Is this how my life is going to be from now on? How could I face having to explain to any potential partner about my pain (after ejaculation and urination and the deep ache where my ball used to be), about the absence of a significant part of my male anatomy and my possible infertility (I couldn’t stomach having the tests done at the time)?



My pain is very much under control. Am I cured? Good question, what does that even mean? Do I still get aches and pains in my pelvis? The answer is yes. Do I get aches and pains elsewhere in my body? The answer is also yes! Is this ‘normal’? It is not ‘abnormal’ (just consider that for a second...) Can I rationalize this pelvic pain now? Yes, very much so. My pelvic pain is an indicator of my health, an early warning signal if you like. My last major flare was a precursor for a bout of shingles and round of 7 styes across both of my eyes over the following nine months! The flare up (burning on urination and ejaculation alongside a general heaviness in my groin) came off the back of an intense period of high stress and anxiety. My awareness, my ability to reflect and my studies have taught me not to catastrophize (not easy in the early days at all!) my situation. Pain is a warning system that is key to our survival as human beings. Without pain, we would not be here as a species!



There is hope out there; you are not alone (this is not an ad for the X-files). Current research indicates that a multidisciplinary approach is by far the most successful strategy for managing and reducing pelvic pain.



It had taken the best part of 9 months before my pain subsided and I felt confident enough even to consider a sexual relationship. Moving out of the flat, quitting my job and remodeling my lifestyle were all key to my recovery. Central to this and a message I preach to all of my patients is going back to basics. Doing things in moderation, gradually building things up until I felt strong or robust enough to take on more. It is rehab, plain and simple. Instead of juggling three jobs, working seven days a week, partying too hard and eating crap I looked after myself and did things that were kind to myself. I practiced mindfulness and meditation daily (I still do!), I got regular massages specific to my legs, back, and abdomen (there were no treatments available at the time for pelvic pain). I started gentle exercise including yoga (I quit a demanding tennis coaching role). I ate a variety of good food at the right times of a day. I balanced my work, learning to give myself a time out, taking breaks and holidays. In essence, I learned to switch off and pay attention to what my body was telling me (this is so central to recovery). I spent time EVERYDAY doing something that was just for me, something that benefited my health.

I have now been married to my beautiful wife for four years and have a little one coming this Christmas. Every couple of years I get some pelvic pain to remind me to calm down, switch off and look at my lifestyle (I am a human after all). It has taught me a lot about myself and my limitations. It reminds me of what I lost and will never get back again, but it reminds me of what I have gained and all that I am grateful for in life.



What is male pelvic pain? The National Institute of Health (NIH) classifies male pelvic pain into four primary categories:

Acute bacterial prostatitis

Chronic bacterial prostatitis

Chronic prostatitis (CP)/Chronic Pelvic Pain Syndrome (CPPS)

Inflammatory

Noninflammatory

Asymptomatic inflammatory prostatitis

With international findings indicating that only 5-10% of all cases are bacterium related (2) the majority of male pelvic pain cases fall into the type III Chronic Prostatitis (CP)/Chronic Pelvic Pain Syndrome (CPPS) category. Symptoms are widespread and unique to the individual, often making it a poorly understood condition to treat. They include but are not exclusive to the following.

Some patients have a plethora of the below, others just one or two: