Vaginal thrush vitamin a

This is gonna be a long one, but I need to vent and am “happy” I finally know what’s wrong. If you don’t wanna see my vent, please scroll down and look at my questions
PLEASE, IF YOU’RE READING THIS, GIVE ME ANY ADVICE THAT HELPED YOU WITH SIBO/SIFO
DISCLAIMER: I don’t wanna repeat how useless doctors were during all of my injuries/diseases, so I’m just gonna put it here. I visited the ER and hospital probably 40 times, ended up with either „psychosomatic, making it up, it’s your fault, stop wasting out time, you’re irrational” every single time.
I started anorexia recovery in October 2023 (am normal weight now) and had many letdowns. In December I had a back injury and was in bed for a month, couldn’t move a limb. Took many NSAIDs and after finding a good physiotherapeut I got better.
Right after that m stomach started burning and I got H pylori. Two months of no luck with doctors, I found a single gastro out of 14 I visited who trusted me, gave me abx and I was cured in 2 weeks. I took PPIs the whole 2-3 months, which caused my SIBO.
No doctor helped me again, and I also got an insatiable hunger and carbs cravings. I got a blood test and found out I had insulin resistance. - how is that possible? I’ve only been eating for ~5 months, this can’t be right. I felt defeated and accepted that I’ll never eat “normally” again and will have to do low carb/keto forever. But then…
It dawned on me. SIFO. Candida. Candida causes high blood sugar… carb cravings… insatiable hunger. I read some of the posts here and I felt happy. I know it’s bad - as bad as SIBO, but I finally know I actually “don’t” have insulin resistance from food, only from Candida! And once I cure it, it’ll go away.
So now I’m here, ready to kill SIBO and SIFO. And get my life back. In 5 months I’m starting uni and I will be cured by then. I do not accept any other outcomes. I am determined. If I have to starve for a month to kill those bastards, I will. I kept messing around until today, now I have hope for being 100% healthy because once I kill SIBO and SIFO, insulin resistance WILL go away and I will be happy again. No more crying. No more defeat. I will win.
SYMPTOMS (idk which one is caused by SIBO/SIFO)

• mild oral thrush
• extreme 24/7 bloating
• extremely extreme hunger and cravings (wake up at night)
• depression (no more, I’ll kick its ass)
• mild brain fog
• mild constipation

I need your help

1. What antifungals work on every strain? My country doesn’t do yeast test so I can’t do a resistance test. I can get my hands on fluconazole, nystatin and maybe other options if you have a good recommendation.
   
2. Antifungals or herbs? Which is more effective? If herbs, what combo do you recommend?
   
3. Biofilm - would NAC and Kirkman be enough?
   
4. Diet - MEVY, do ammounts matter? Vegetables in ulimited ammounts or restricted to grams like SIBO low FODMAP?
   
5. Fasting - would a prolonged fast (7-14 days) kill Candida if I took some herbs while on it, like ADP oregano, ginger, allicin, and tumeric?
   
6. Probiotics safe for SIBO and SIFO both? S Boulardii is one of them, is L reuteri and Rhamnosus as well? How about Colostrum?
   
7. What Vitamins/Supplements will help fight SIBO/SIFO and boost immunity? And what dosage? I read about large dosage of vit C - how large?
   
8. Should I take Metformin to adress IR for now and stop when I’m cured? Will it help anyhow with SIBO/SIFO?
   

9. Wish me luck!
Please know I’m from EU so supplements from the USA are unreachable for me. If you’re from the EU, please share the doctor who helped you!!

My daughter is 1 month old now and feeding is generally going well, she's packing on weight.
For at least a week I've had a sore nipple on one side, tender enough that my breast pads are a bit uncomfortable against the nipple. And then I have intermittent shooting pain in the nipple and breast. I had antibiotics after my c section, then vaginal thrush so I'm pretty paranoid it's thrush on my breast.
I've seen an LC who is happy with my latch. Dr sort of fobbed me off so I'm not sure whether to push back.
Baby has no symptoms really and my other breast is currently fine. Has anyone else had this experience - what was the cause?

Cross posting from askdocs.
22F. Seeing a general neurologist (already saw MS specialist) and getting an EMG in three weeks but would like to get other people’s opinions - my PCP has no idea what’s going on with me. What should I look into next? Sorry for the long post but I thought I should include all info in case it’s relevant.
Current symptoms: - perceived weakness and neuropathy in left hand/wrist (feels like a weird burning/tingling sensation, sometimes triggered by the cold but present a majority of the time) - this is by far my worst symptom - occasional tingling sensations in other extremities, but never as frequent as left hand - bad upper back pain (comes and goes, gets worse with certain positions and never in one specific area) - derealization/brain fog (feels like I’m out of it/in a different universe, also hard to describe) - occasional chills/shivering - fatigue (sort of comes and goes in waves)
Timeline of my symptoms:
Feb 2023: fell twice while drunk (don’t have balance issues), woke up a two days later with terrible back spasms. A few days after that I noticed weird tingling sensations in my hands and feet and freaked out, also generally not feeling well/having a lot of fatigue. Freaked out about having MS - doctor did brain MRI and told me to chill out, symptoms went away.
Sept 2023: started experiencing chronic fatigue, brain fog, and derealization, chalked it up to weed withdrawals (I was cutting back at the time).
Oct 2023: got Covid - brain fog and fatigue got a lot worse.
Late Oct 2023: started having weird stomach issues - constant bloating and random sharp pains in lower abdomen. Got some tests done, this went away in around a month.
Early Nov 2023: started getting vaginal pain/constant burning sensation. Got more tests done, also went away in around a month.
Dec 2023: started feeling a bit better, then had a terrifying experience on THC (fully disassociated and thought I was dying multiple times), quit again.
Mid Dec 2023: started talking combination birth control for PCOS as per gyno’s recommendation.
Late Dec 2023: started getting weird muscle weakness in both left hand and foot, went away in around three weeks. Also felt chest pain a few times and ended up in the ER for it, where I got my heart tested. Fatigue was pretty bad this whole time.
Jan-Feb 2024: muscle weakness mostly gone, fatigue slowly improving throughout these months, still dealing with some brain fog. Resumed weed use which was probably a bad idea.
March-May 2024: Quit weed for good. Switched to new progestin-only birth control because the combination one was giving me high BP. Started getting all this weird neuropathy and joint pain all over the place, for a few days it was super bad in my left/hand wrist and since then it’s been mostly in that area. Makes me wonder whether I have carpal tunnel or some nerve compression problem - it’s pretty painful. Sometimes shows up in left foot but not that bad there. Still have some derealization and brain fog that shows up for a few hours a day - it’s weird. Fatigue and back pain still present. Symptoms come and go in ways though - I have both good and bad days. I’d like to think I’m improving overall, but days like today make me not so sure of that.
Medical history: - had spinal fusion surgery for scoliosis in thoracic spine when I was 15 - have PCOS - no family history of any autoimmune or neurological conditions except for grandmother with MS. Got genetic testing for 150 ish conditions and every single one was negative
Medications/drugs: - take 2,000 IU of vitamin D3 every day - started birth control in December (right before the neuropathy started - wonder if they might be related?) - chronic daily THC abuse for ~14 months right before all this started, been sober for several months now (possibly related?)
Tests I’ve already had: - brain MRI in Feb 2023 and March 2024 - both showed one/possibly two unchanged nonspecific T2 hyperintensities that the MS specialist said were benign - cervical spine MRI - 100% clear - neurological exams (multiple) - 100% normal - full abdominal and pelvic ultrasound - clear except for benign liver finding that doctor is not concerned about - chest x-ray - 100% clear - two EKGs - normal - thoracic spine x-ray - clear, showed that screws from surgery are in proper place - stool test - normal - urine test - normal - pap smear - atypical cells of undetermined significance, HPV negative - doctor said not to worry about it/continue screening every three years - lyme disease test - initial screening came back positive but confirmation tests were negative so doctors concluded it wasn’t lyme - B12 test - 526 (normal) - A1C - 4.8 (normal) - Rheumatoid factor - normal - C-reactive protein - normal/on lower side - ESR - normal/on lower side - SPEP panel with immunofixation - all normal - Jo-1 antibody - negative - CBC and complete metabolic panel - all normal - hepatic panel - normal - Methylmalonic acid - normal - TSH with reflex - normal - troponin - normal - PT-INR - normal - magnesium - normal - lipase - normal - serum protein electrophoresis - normal - mono (multiple times) - negative - reproductive hormones - elevated androgens (hence the PCOS diagnosis)

26F Diagnosed with IBS, GERD, and POTS. I currently take Lansoprazole, Metoprolol, Hailey 24Fe (birth control), and Vyvanse.
Ever since I was around 19-20 years old, my weight would change pretty drastically from year to year. I did swim and track in high school and I worked out consistently throughout college (aerial silks, weights, and yoga). I started college at around 115lbs (for reference I’m 5’3). By sophomore year, I was almost 130lbs. I thought, freshman 15, it happens to a lot of people, and I adjusted my eating habits to be less junk / fast food. By junior year, I was about 112lbs. Senior year, I was 120lbs give or take. I never really TRIED to gain or lose weight.
Surprisingly, I stayed at 120lbs throughout covid/lockdown despite no longer working out. Around mid-2021, I started to not be able to keep down food, throwing up most of my meals, feeling full all the time, and I lost weight very quickly, I was down to 100lbs in three months. Obviously, I was concerned and went to the doctor and they first did a pregnancy test (negative), then bloodwork. Everything came back normal except my T3/T4 (can’t remember exactly) showed a slight hyperthyroidism. I was sent to an endocrinologist who ran another pregnancy test (negative) and more bloodwork, she said everything was fine and normal. My primary doctor was having me drink protein smoothies instead of eating meals and taking prenatal vitamins to make sure I was getting enough nutrients in the mean time, and that kept me stable at 100lbs. Still, most of the time I felt full no matter if I had eaten or not and I would throw up most solid food.
Since I had just started a new bipolar medication (Latuda) right before the vomiting started, my psych took me off that (didn’t help) and put me on Abilify instead (which I ended up switching from a few months later to Lamotrigine because it gave me tardive dyskinesia). I also took a break from my birth control for most of 2022 to see if that effecting my hormones was causing it (no, it wasn’t).
It was around SeptembeOctober of 2021 that I experienced my first POTS fainting episode. We didn’t know what was happening so my boyfriend brought me to the ER, but by the time I got there I was already recovering from it so the doctors there didn’t take me seriously, especially since COVID was still big. I would have a few more fainting spells and then an abnormal EKG from an urgent care in October 2022 before I was diagnosed with POTS by a cardiologist.
During that time in mid to late 2022, I also had a vaginal ultrasound done (check for ovarian or uterine cancer / cysts; none, ovaries multi-follicular); a regular ultrasound to check my pancreas, kidneys, liver, etc. (family history of pancreatic cancer; all clear and normal); and an endoscopy/colonoscopy (signs of slight inflammation; diagnosed with IBS and GERD). After the IBS/GERD diagnosis, I was put on the lansoprazole, which did help a lot and got me back up to 120lbs by 2023. Once I had the IBS/GERD and POTS diagnoses, my primary doctor basically said, “We don’t know what’s causing them, so we’re just going to treat those symptoms for now.”
Now it’s 2024 and in the past 4 months I’ve now GAINED almost 20 lbs despite still eating less than I did before I started not being able to eat in 2021 and with almost no change to my diet otherwise beyond adding extra salt to help with the POTS symptoms, and I’ve actually been MORE active lately by trying to take my dogs on walks around our neighborhood (dependent on how bad POTS is that day).
Other symptoms I experience are migraines, fatigue, joint pain (particularly in my neck, back, and fingers), and brain fog. Also have family history of hypothyroidism and hydrocephalus.
Whenever I try to search about drastic fluctuations in weight, the results are all about the normal daily fluctuations people have, which makes me think that drastically losing 20lbs in 3 months without trying, slowly gaining it back over a year, and then suddenly gaining 20lbs in 3 months without trying over the span of a couple years isn’t something that typically happens to people. So doctors of Reddit, what do you think could cause it?

22F. Seeing another neurologist and getting an EMG in three weeks but would like to get other people’s opinions - my PCP has no idea what’s going on with me. What am I missing/where do I go from here?
Current symptoms: - perceived weakness and neuropathy in left hand/wrist (feels like a weird burning/tingling sensation, sometimes triggered by the cold but present a majority of the time) - this is by far my worst symptom - occasional tingling sensations in other extremities, but never as frequent as left hand - bad upper back pain (comes and goes, gets worse with certain positions and never in one specific area) - derealization/brain fog (feels like I’m out of it/in a different universe, also hard to describe) - occasional chills/shivering - fatigue (sort of comes and goes in waves)
Timeline of my symptoms:
Feb 2023: fell twice while drunk (don’t have balance issues), woke up a two days later with terrible back spasms. A few days after that I noticed weird tingling sensations in my hands and feet and freaked out, also generally not feeling well/having a lot of fatigue. Freaked out about having MS - doctor did brain MRI and told me to chill out, symptoms went away.
Sept 2023: started experiencing chronic fatigue and derealization, chalked it up to weed withdrawals (I was cutting back at the time).
Oct 2023: got Covid - brain fog and fatigue got a lot worse.
Late Oct 2023: started having weird stomach issues - constant bloating and random sharp pains in lower abdomen. Got some tests done, this went away in around a month.
Early Nov 2023: started getting vaginal pain/constant burning sensation. Got more tests done, also went away in around a month.
Dec 2023: started feeling a bit better, then had a terrifying experience on THC (fully disassociated and thought I was dying multiple times), quit for good.
Mid Dec 2023: started talking birth control for PCOS as per gyno’s recommendation.
Late Dec 2023: started getting weird muscle weakness in both left hand and foot, went away in around three weeks. Also felt chest pain a few times and ended up in the ER for it, where I got my heart tested. Fatigue was pretty bad this whole time.
Jan-Feb 2024: muscle weakness mostly gone, fatigue slowly improving throughout these months, still dealing with some brain fog. Resumed weed use which was probably a bad idea.
March-May 2024: Quit weed for good. Switched to new progestin-only birth control because the combination one was giving me high BP. Started getting all this weird neuropathy and joint pain all over the place, for a few days it was super bad in my left/hand wrist and since then it’s been mostly in that area. Makes me wonder whether I have carpal tunnel or some nerve compression problem - it’s pretty painful. Sometimes shows up in left foot but not that bad there. Still have some derealization and brain fog that shows up for a few hours a day - it’s weird. Fatigue and back pain still present. Symptoms come and go in ways though - I have both good and bad days. I’d like to think I’m improving overall, but days like today make me not so sure of that.
Medical history: - had spinal fusion surgery for scoliosis in thoracic spine when I was 15 - PCOS - no family history of any autoimmune or neurological conditions except for grandmother with MS
Medications/drugs: - take 2,000 IU of vitamin D3 every day - started birth control in December (right before the neuropathy started - wonder if they might be related?) - chronic daily THC abuse for ~14 months right before all this started, been sober for several months now (possibly related?)
Tests I’ve already had: - brain MRI in Feb 2023 and March 2024 - both showed unchanged one/possibly two nonspecific T2 hyperintensities that the MS specialist said were benign - cervical spine MRI - 100% clear - neurological exams (multiple) - 100% normal - full abdominal and pelvic ultrasound - clear except for benign liver finding that doctor is not concerned about - chest x-ray - 100% clear - two EKGs - normal - thoracic spine x-ray - clear, showed that screws from surgery are in proper place - stool test - normal - urine test - normal - pap smear - atypical cells of undetermined significance, HPV negative - doctor said not to worry about it/continue screening every three years - lyme disease test - initial screening came back positive but confirmation tests were negative so doctors concluded it wasn’t lyme - B12 test - 526 (normal) - A1C - 4.8 (normal) - Rheumatoid factor - normal - C-reactive protein - normal/on lower side - ESR - normal/on lower side - SPEP panel with immunofixation - all normal - Jo-1 antibody - normal - CBC and complete metabolic panel - all normal - hepatic panel - normal - Methylmalonic acid - normal - TSH with reflex - normal - troponin - normal - PT-INR - normal - magnesium - normal - lipase - normal - serum protein electrophoresis - normal - mono (multiple times) - negative - reproductive hormones - elevated androgens (hence the PCOS diagnosis)

I am so confused about ACV. I started taking ACV pills about 2 weeks ago, I felt amazing the first week but now I feel awful. I see mixed signals about if it’s good or bad for Candida. It’s a natural anti fungal and have heard many success stories with it. I don’t have Candida confirmed. Symptoms are oral thrush, vaginal thrush, dandruff and fatigue. Should I keep taking it or stop.

hey guys. i had an encounter march the 18th. it was protected vaginal and oral and i’ve been stressing ever since :(. she told me that she was clean and when i asked her for records of that she got annoyed at me and told me not to text her again. like i said, it was protected so i shouldn’t be too worried right? i have a white tongue rn and i’m afraid it could be oral thrush, i had some headaches and muscle pains but this was ab a month ago and hasn’t happened since. it was all very mild. the thing scaring me now is this white tongue. my throat isn’t sore and i haven’t had a sore throat since the encounter. i’m scared i have something like HIV and i feel like my life is just spiralling out of control. i need some advice thank u guys

Oral candidiasis, called thrush, involves white spots on the mouth and tongue, sore throat, and difficulty swallowing.
Candidiasis in the female genitals is called a yeast infection (Also known as vaginal candidiasis).

There are over 20 species of Candida yeasts that can cause infection in humans. The most common type is Candida albicans. 90% of people with HIV/AIDS develop Candida infections.

Read more about this Fungal infection: Symptoms What Can You Do? Seeking Medical Care Treatment

I (F26) am trying to figure out the reasons why I have candida glabrata (vagina) and can’t seem to fight it off. I read lots of scary things online, so here’s my background: - 2.5 years of being albicans positive, with recurrent yeast infections. Albicans negative since August. - glabrata positive since January. - negative for HIV or STDs. - positive for ureaplasma in August, but went under treatment and now it’s negative. - blood tests alright, no weird results. - drastically reduced sugar in the past 6 months, especially the past 2, as I’ve started to follow the diet even more strictly & no alcohol. - I’ve been on daily probiotics for the past year almost; - No unprotected sex with my partner, and no sex at all when I have a thrush. - I’ve done significant lifestyle changes. - did 2 rounds of vaginal Econazole treatments, no luck. - Fluconazole-resistant.
Given all this, WHY? Why am I still at the starting point? Why is there no progress?

I'm a 38 y/o female.
I was diagnosed with asthma as a kid.
Current meds Soprobec 200 two puffs AM, two puffs PM, ventolin as needed.
I moved into this flat in 2022, was fine before I moved and to begin with, then I developed worsening asthma symptoms as the months went on. I spent ages trying to fathom out the possible cause. I found no sign of mold or anything like that. then found out tobacco smoke from the man downstairs was coming into mine, it's been so bad on a couple of occasions my bathroom has 'fogged up' with smoke. I have tried everything, including having the council works department out to see if we could seal up any gaps etc, nope, no way of stopping it. He seems to vanish for long periods of time, leaving his flat empty. During these periods, my asthma symptoms vanish completely.
In response to my worsening asthma symptoms, in Jan 2024 the asthma nurses at my surgery decided to increase my ICS dose of Beclomethasone from 400mg a day to 800mg a day. Now I have high functioning Autism on top of all this, I am far from dumb or stupid, but anything to do with numbers seems to go over my head a lot of the time, even though I am better at maths now, amounts of things can still flummox me.
NOBODY told me this was considered a moderate to high dose and I should be carrying a steroid warning card, nobody, not once. I wrongly guessed it was only a few mg more than the soprobec 100 I was on. The Soprobec 100 was two puffs am, two puffs pm.
Now, since I have been on the Soprobec 200 at 800mg a day, I have developed some extreme and very disruptive possible side effects.
All possible other causes of these symptoms just got ruled out in a complete bloodwork which included diabetes, hypercalcemia, thyroid and iron deficiency, which are all possible causes of the things I have listed below, all tests have come back requiring no further action.
These are:
EXTREME, unquenchable thirst. I am drinking easily over four liters of water per day. I am also waking up several times a night for a drink, and if I go out I must carry water with me otherwise the thirst is VERY distressing. I feel dehydrated on a 'cellular level', like it doesn't matter how much I drink, I feel thirsty WHILE drinking water!.
Fatigue so bad I can hardly get up out of my chair most days and I am asleep by 9pm, where before I would like to chill with my dog watching a film or something till about 12pm. I have gone from waking literal miles through local fields and woodland with my dog, to barely being able to take her on the local park which is only across the road. I hardly ever go out, and if I do, I suffer immensely as my muscles start aching. I live upstairs and I am struggling getting up the stairs.
It feels as if I have lost all muscle tone all over my body. I no longer feel safe walking my dog as she is med size mastiff cross who is quite strong, she has almost pulled me over at times and I cannot even lift my kitchen bin bag or the laundry basket, I have NEVER had this problem before.
I have lost my appetite and have to force myself to eat every meal, often taking hours rather than minutes.
Episodes of vaginal thrush, something I have NOT had for YEARS, started when I went on this high dose of ICS.
My once 'perfect' periods are now very heavy and irregular.
I feel more angry than before. I had to seriously check my anger levels in my adult years, and developed a much more patient and stoical outlook to life, which brought my stress levels down massively. Since I went on this inhaler I have been snapping at people again, including my own family :(
Tingling hands. This can come on anytime, never had it before the inhaler.
A terrible hoarse voice and it feels like my voice is getting deeper and I am starting to sound 'male' other people have noticed this too.
Profuse sweating on my hands and feet. My hands DRIP with sweat, to the point I hide them from people. Never happened before this inhaler.
Salt and red meat cravings. I am not a big fan of either, and due to heart problems in the family I keep my salt intake low. Other day I just felt compelled to walk into the local coop and buy pork loins and a pack of beef biltong, things I haven't eaten in many moons. I recall saying to myself 'this is SO out of character for you'.
Episodes of nausea, two episodes of vomiting in the morning over two months (not preggers before anyone asks lol) which were not related to anything I had eaten.
Dizzy spells and almost fainting, usually happens if I push myself to do even basic stuff like household chores, which I usually enjoy doing.
I know these are listed as 'rare' side effects, but unusual thirst, tiredness and weakness is mentioned both in the patient info leaflet with the inhaler, and in various other information regarding side effects, such as this article: https://www.mayoclinic.org/drugs-supplements/corticosteroid-inhalation-route/side-effects/drg-20070533?p=1
I take the inhaler via a spacer, my technique is good, I've been doing this whole asthma game all my life, so I am pretty ofay with it all now lol.
I have had a battle over this inhaler with my GP and other asthma services as well. They just do NOT believe ICS can have systemic side effects, in contradiction to what the drug manufacturers say on the leaflet. I think I am going to have to go back to the GP and stand up for myself, which is not something I am good at at all, and present them with this information leaflet, which actually tells you to consult your doctor if you develop any of them!.
Would it be worth asking to try the same dose, as I do not want to risk withdrawal, I have experienced this before from ICS, but on a different steroid with a different inhaler?.
Is there any more bloodwork I could ask for, perhaps adrenal function or cortisol levels?.
I am at a loss, I need to control my asthma, but I also need to be able to live!.
Thank you for taking time to read this, I hope everyone is well and your asthma leaves you alone to enjoy the summer!. :)

I’m on year 7 of my IC journey that started at 15 years old. I’ve had pretty much everything under the sun with multiple specialists, so I thought I would share for people in the same positions I was in during the beggining.
Regular gyno or urologists are oftentimes clueless about IC. Please see a urogyno asap.
Hydroxozine and Benadryl can help with the bladder sensitivity and burning a bit as well as help you sleep.
If you’re looking for something non drowsy Zyrtec may work for you and one of my friends has really good luck with Xyzal (both are otc).
There are some studies about the long term effects of too much Benadryl so I’d be cautious about that.
Some supplements that many people with IC take consistently are D-mannose, aloe tablets, magnesium (for the muscles and sleep), and marshmallow root. I’ve noticed improvement from D-mannose and aloe for the burning but not as much marshmallow root.
The aloe tablets are also great for those with vaginal dryness from their inflammation.
Desert harvest also has an AMAZING cream called relevium you can order over the counter with 4% lidocaine in it as well as aloe and vitamin e that helps repair skin and reduce inflammation. It’s so good for the burning. Do not use it inside (but a little won’t hurt if it gets in there). It’s mainly for urethra irritation and burning.
IC is not simply a bladder disorder originating from inside your bladder. It HEAVILY affects your muscles. Feel inside your vagina and if it’s very tight, banding, or causing painful intercourse you likely have hypertonic pelvic floor issues either causing or exacerbating your IC. There are many stretches you can do to help this as well as pelvic floor therapy. It’s a godsend for many, but don’t get discouraged if it gets a little worse before it gets better with that. It’s part of the process with the lactic acid build up in your muscles.
There are two common kinds of PFT one of which you should be very wary of. The first time I went through this process I saw a team who focused on electrostimulation therapy. This is where a probe is inserted vaginallty and anally and contracts the muscles more and more with each visit. That method also focuses on kegals. Not only does it make most people much worse while they’re in treatment, it’s proven to not be very effective at all and make some people worse. The goal of this method is to essentially wear out your muscles to the point they finally give up and relax. It’s effective for very few people and I would suggest only doing it as a last resort.
I would recommend pelvic floor therapy involving muscle relaxers, stretches, and vaginal massage before that. The way that works is that they essentially cut off blood flow to those tense muscles through massage, hoping that the fresh oxygenated blood flowing in helps the muscles to heal and relax. Once again this may feel worse before it feels better due to the lactic acid buildup.
Do not give up on Pelvic Floor Therapy until you’ve given it 6-12 weeks.
If those muscles are stubborn there are options for pelvic floor Botox injections as well as bladder injections. These can also be done under anasthesia during other procedures like cystoscopy and hydro hydrodistention. I honestly recommend doing that because it is very painful without it and may stress the fuck out of your muscles if you’re awake.
hydrodistention is when they fill your bladder to max capacity. This is done routinely to stretch your bladder and to measure bladder capacity.
There is also the bacterial side of things. Some people with IC have overgrowths of bacteria in their urine. There is a 24 hour urine test you can do to look at how your urine is comprised and how much you’re peeing. There is also a culture where they culture all the bacteria’s in your bladder in one inviroment as they would grow inside you. This is to replicate the environment of your bladder to see if you have any antibiotic resistances, overgrowths, or other things.
Ureaplasma and mycoplasma are another theory that’s kinda controversial and expensive to test for. But some consider it an std. it’s a type of bacteria that can overgrow in your bladder, but also it’s kinda a part of the natural microbiome so I don’t know how much credit I give that.
You may notice that you have other conditions such as PCOS, endometriosis, adenomyosis, and or IBS. These conditions are also inflaming your pelvis and can make your bladder more angry if not under check. However, I DONT suggest going crazy trying to cure other pelvic conditions in order to fix your bladder. That’s what I did and it didn’t work as I’d have hoped. I’d try to find multiple doctors or people recommended by ur urogynocologist to help you manage everything together if that sounds like you.
Hope this helps!

What do I need to say to have my doctor listen to me. I am not knowledgeable enough to cure myself, I have a sensitive body and am way too scared to try all these things. I’ve tried Fluconazole many times, my endoscopy was clear. The GI doctor recommended infectious disease due to persistent oral thrush BUT my primary care needs to send the referral and she won’t. She doesn’t seem to think I have overgrowth since my vaginal and oral cultures show minimal yeast. I’m genuinely so angry. I’m a 22 year old female and I have not been pushed aside so much of my life. I’m a first year teacher and have lived every day this entire year with a burning vagina and throat. Last time I went in she put me on Lexapro, I feel GASLIT. I want my life back please.

I am posting this in hope some of you can find yourself in this post and know what i can do, since doctors don’t seem to know/care.
Just received my blood test results from the gynecologist And it turned out that there were no abnormalities :)
My insulin was 'good' My cholesterol was slightly high but she told me not to worry about that because i am young (even though high cholesterol is also part of pcos symptoms) Testosterone was 'good' My vitamin D was low (I take vitamin D tablets every day)
Even though I am told after every examination and bloodwork that everything looks fine I do not feel well, I am always tired, I suffer from intestinal complaints, bloating and difficult bowel movements, I suffer from vaginal dryness and low libido, I suffer from mood swings and actually feel stressed and on edge 90% of the time (i am on anti depressants but i had the same complaints before i started taking them), sometimes I can literally feel the hormones rushing through my body which feels very unpleasant, my periods can be missed for months and are always late 2/4 weeks, I am very lucky when my periods are 'regular'(month or 2/3 in a row) at times, I always suffered from very heavy periods and blood loss even as a teenager thats what made me go on birth control (i stopped 5/6 years ago) I actually just don't know what I can do for myself anymore because they don't know the 'cause', thyroid, diabetes and endometriosis problems occur in my family I have been suffering from these complaints since 2019/2020 and it has not gotten any better and no reason can be found why not since i should be ‘fine’ right? there are several types of PCOS and you can also have several/mixed symptoms, and I have some symptoms of the Insulin resistance type and Inflammation type, always bloated, intestinal problems, always tired, always craving sweets and sugar, even after eating (I am also always tired after eating) i just don’t know what to do anymore i been trying to sort this all out for years and im tired.

ive been on the candida subreddit and a lot of members are saying that chronic vaginal thrush is caused by overgrowth candida in the gut. has anyone else found this to be true? as i am trust wondering if i need to go on a super strict candida diet. my thrush symptoms are mainly gone but i still get the discharge and a little funny feeling not as bad as it was but a little.

I have really bad health anxiety. I am a 32+ yo mom of 2 married for 10 years, monogamous for 12 years. I developed a sore throat almost 2 weeks ago that just kept getting worse so a week into it, I went to get it checked out at urgent care telling them I either had strep or thrush, no other symptoms. I thought it could have been thrush because I have had recurring fungal skin infections near my underarm and vaginal yeast infections since having my youngest child almost 2 years ago who I just recently weaned. The strep test was negative so my NP looked at my throat, asked a few questions about how I feel, and said she would be right back. She came back to the room and said she had to look at some photos but it looks like Herpes 1 to her. I looked visibly panicked because after 12 years of monogamy, my STI knowledge has been replaced with feeding schedules, breastfeeding knowledge, and everything else motherhood. So then she goes “Just 1! Not 2” she says she just finished nurse practitioner school and she had to stay on antivirals almost the whole time in school because she kept ulcers and cold sores from the stress and asked me if I’m stressed. I cried AT HER FACE on cue because I am so stressed working full time in insurance with 2 kids and a home and just life. I told her I also feel like I have a vaginal yeast infection coming on too. She said she would call me in antiviral for the throat because my throat looked horrible, red and white patches, as well as an anti fungal for vaginal yeast infection. The NP said that since I recently weaned my almost 2 year old baby that my hormones balancing out could for sure be contributing to these flare ups. No STI testing was done at this visit but I’m sure I’ve had STI testing done throughout both of my pregnancies and at all annual of my gynecology visits.
I get home and start googling and panicking and wondering if I could actually have HSV2 and not a vaginal yeast infection??? I did have unprotected sex with others before I met my husband 12 years ago but have been monogamous since we met. I talked to my husband about this and he says he has been 100% monogamous since we met too and I believe him. Our marriage is great and we shared each others locations and he truly wouldn’t even have time to do anything because we’re so busy and are always together if he’s not working.
I started the antiviral and anti fungal Wednesday night and it’s currently Saturday night and I do still have vaginal burning. My throat feels better.
I also performed oral sex on my husband a few days after my throat had started hurting when I assumed it was just a cold so now I’m freaking out that even if I don’t have HSV2 that I could give my husband genital herpes from giving him head while I had cold sores in my mouth/throat? Or if we have both been monogamous, could one of us have given us HSV2 from HSV1 because we do have frequent oral sex.
I have health anxiety and this all has just made me more anxious and stressed. I have cried and cried and had my husband google every possible thing. I have just felt like my life is over.

Hi everyone, I'm here to give an update on my 15 day Post operation, fibroid removing hysterectomy and first off, I want to say it was the best decision ever in regards to my fibroid journey. I'm two weeks post-op and feeling great. Like many of you, I was very anxious in the weeks leading up to my surgery to remove two fibroids that had been assessed at about grapefruit and orange sized 6 months previously. I was on Lupron to stop my periods, which only exacerbated my anxiety. My doctor prescribed add-back hormones, which helped tremendously with the volatile emotions, and Zopiclone to help me sleep, as that was also disturbed by the Lupron.
On the day of the surgery, I was at the peak of my nervousness. The nurse helped ease my fears by giving me a low dose of Ativan, which definitely helped as I went through the motions of talking to the anesthesiologist, my doctogynecologist, and the attending surgeons and nurses. I made it very clear to my doctor that I don’t do well with pain and I didn’t want to endure any unnecessary discomfort. I was brought to the surgical table and got through the anesthesiology needle poke pretty easily with the aid of the Ativan (I hate needles!) and before I knew it, I was slumping into that glorious sedation daze and within what felt like seconds wheeled to my room for my overnight stay. During surgery, I was administered generous amounts of nerve blockers and Fentanyl, so I woke up literally feeling nothing in my body and feeling quite euphoric.
I live in a wonderful small community in Canada and received the most exceptional care on the women and children’s floor. A few notable aspects of that overnight stay: the pain from the gas they used to expand your chest to get into your abdomen is no joke. I could feel it across my shoulder blades each time I breathed. The apparatus they provided me to test blowing air out of my lungs was uncomfortable but manageable and really helped to get movement within my internal torso, which is super important as you need to get the gas flowing so that it exits out your butt. I happily took the Hydromorphone made available to me every three hours, as well as the Tylenol and Advil, which they cycled every three hours as well. I certainly felt some discomfort, and again, the gas passing was painful but everything was manageable and the addition of the opioids during my stay made everything quite happy and pleasant.
I had a catheter attached to me, which was a new experience, as you go pee without any effort. I had four bandages on my abdomen indicating where my doctor had gone in laparoscopically. There was some overall tenderness and achiness which I attribute more to the positions I'm sure I was manipulated into while under , so the surgeons could get in via different angles. I was admitted into the recovery unit in the evening because my surgery was over four hours (about eight hours altogether end to end from my 11am admission)and there was no meal service available. Thankfully the wonderful nurses procured a sandwich from the cafeteria. I was absolutely famished and ate it quite voraciously. I was quite high at this point, so I thought it was the best thing I’d ever tasted in my life (it was a pedestrian tuna sandwich on plain bread).
Sleeping was more difficult, between the opioids and just general discomfort in my body. Oh, and the gas—the gas exiting your body does hurt as it makes its way through your tender digestive system, but it's very satisfying when it leaves. I know I kept the poor woman recovering in the adjoining section up all night with my flatulence, but the nurses assured me that it was encouraged to get it all out. I did wake up a number of times with some sharper pain and took advantage of the drugs on offer. My sleep was not deep nor necessarily restful, but it was enjoyable because I was pretty hopped up and happy. The hospital had affixed circulating airbags onto my legs to help prevent blood clots, and I found them to be quite relaxing.
I managed to sleep a few hours. When breakfast was served, I was happy to eat it. My doctor came to give me my surgical report and advised me that she had removed TWO grapefruit-sized fibroids along with my uterus and a dozen or so more little fibroids in the mix. One of the fibroids had necrotized. She showed me pictures of all the pieces and tissue. I don't do well with anything medical-related, but it was actually quite satisfying to see what had amounted to about the size of a bowling ball removed from my body. I had my uterus, fallopian tubes, and of course fibroids removed but my ovaries left intact. She said the total mass of the removed organ and bits was about 4 to 5 lbs. I'm very happy she was able to do it mostly vaginally with some assistance through the four small incisions on my belly. After receiving the all-clear from my doctor, the nurses removed my IV, which had been hooked up to dispense electrolytes and vitamins. Then they removed my catheter. I was really nervous about having my catheter removed because I didn't understand the mechanics of how it was attached, but it was just a quick little pinch and then it was gone. Another thing I had to demonstrate before being discharged was that I could pee on my own. It felt odd because I was activating muscles that were still tender, and I was uncertain about what was going on down there, but after being filled with various intravenous fluids as well as the juice and water I had been drinking, it was pretty easy to just sit back, relax, and let it flow. My partner came, wheeled me out in a wheelchair, and took me home where she had configured the bed with a variety of adjustable wedge pillows to ensure I was comfortable.
I was also sent home with a prescription for 15 additional Hydromorphone tablets, and I diligently took those every three hours because I had no desire to be a hero and endure any pain. The doctor prescribed one to two every three hours; I took one every three hours and that was sufficient, cycled with one Tylenol and one Advil every three hours. Getting out of bed was pretty easy; it just felt like I had had a rigorous ab workout and was a bit tender.
The worst part was trying to compel a bowel movement. The opioids are a bit of a double-edged sword in that they really enhance the healing experience, but they also cause constipation at a crucial time when your bowels are already quite shocked and don't need any more discouragement. I started on doctor recommended Colace pills and Restoralax on day one. By day four, I still hadn't had a BM and was starting to feel quite bloated and heavily constipated. What worked for me was a combination of warm milk of magnesia and prune juice. I downed a large glass of that and within about three to four hours, I had explosive diarrhea, which wasn't as bad as it sounds as it was a relief to finally get things moving. I had to endure about a day or two of just expelling liquid but still feeling like I was constipated. I continued to take the Colace and then added in Senokot (which I wouldn't recommend until you've had that first explosive movement) and have been taking that combination now for about a week, and finally, two weeks post-op, I had my first normal bowel movement today.
I ended up refilling my prescription for another 20 Hydromorphone pills about four days after the first. Near the end of that prescription, I started tapering down my dose, which I think helped significantly with the discomfort of weaning off. I've struggled with substance abuse issues in the past (five years sober this month!), so of course, the prospect of using potent drugs for the surgery and recovery was concerning to me and my family, but I can tell you that I was able to ease off without relapsing. I got through the whole experience with minimal pain and suffering. If you can get access to the drugs, do yourself a favor and don’t try to be a hero—take them! You’ve already been a hero dealing with these alien tumors disrupting your body for so long. Honestly, I think the fact that I don’t drink alcohol has probably helped my recovery significantly.
Yesterday, my partner helped remove the steri- strips. They did not fall off on their own as I had read, but they came off easily with just a little bit of pinching. I now see the faintest scars you’d expect from a super minor cat scratch.
My body definitely looks different, and everything just feels better. I always felt that I had an unsightly paunch, but the reality was I had a massive collection of fibroids the size of a bowling ball, and having them removed has made me look quite svelte, and there's still some swelling reduction to happen.
I feel like I could run a marathon, but my partner keeps reminding me to take it easy and to stick to walking only for exercise for the full six weeks. It’s a small investment to make for lifelong health. All in all, my experience was as good as it could be, and to top it off, I got the call from my doctor that my biopsy came back all clear from cancer. Let me know if you have any questions , happy to help you with your journey!

Approximately 2 months ago, I had severe back pain. My pcp immediately prescribed me with steroid pills without even seeing me or talking to me. I advised my pcp that I could barely walk or drive, which is a problem since I have to commute over a hour to work. Eventually, I finally get an MRI for the spine and have 20mm disc protrusion with multiple tears in my back. During the MRI, I have incidental finding of lesions on my ovaries.
I get a vaginal ultrasound and the find: RIGHT ADNEXA: The right ovary measures 10.3 × 5.7 x 9.4 cm. Note is made of a 9.4 x 5.7 x 10.3 cm cystic and solid mass, with overall size >/= 10cm. This lesion is category Х. LEFT ADNEXA: The left ovary measures 7.7 x 6.9 x 5.5 cm. Note is made of a 6 x 5 x 5.5 x 6.7 cm mass containing homogeneous ground glass low level echoes. This mass probably represents an endometrioma and is category 1.
I make an appointment with the OBGYN who said that I did not need CA 125 blood test cause it would come back elevated due to my age and my left ovary possibly having endometrioma. The OBGYN confirmed my right ovary had a tumor.
I meet with an OBGYN oncologist who does a pelvis test and feels my tumor. He said it didn’t matter what side the tumor was on he did not believe it was cancer because of my age and not having symptoms. He recommended just watching over my tumor with ultra sounds because he believes it may be endometrioma. Obviously he could not confirm that the tumor was not cancer and he referred me back to a regular OBGYN.
I have no obvious symptoms of ovarian cancer or endometrioma, but I do have severe back pain, cough with phlegm off and on since November, and thrush.
Should I be worried and what should be my next steps be?

**i have not completed this plan, i am just starting it. i wanted to give a picture of what my experience with evvy was like, but i will absolutely update after the 3 months to share if it worked completely.
Hii. F(28) here longtime sufferer of BV. In the past, I would be able to make it go away just with a few days of boric acid. But for the last 2 years, my period would bring back the symptoms every month. somehow the change to my pH from the boric acid + probiotic suppositories became only temporary, until the products wore off or every time my period re-set my pH to alkaline.
I hesitated forever on an evvy test because it is $100. But finally I was so desperate it felt worth it. it was SO helpful. I learned the majority of the bacteria I had was Gardnerella, and then other bv-typical strains. I had NO good bacteria. After the test you have about 10 days(don't quote me) to book a free 1:1 with a coach(? dont quote me on the name) but not a doctor, yet. (the doc costs $ if you choose to proceed). That initial free call helps make a plan on what steps to take to move forward based on your results. That call was SO illuminating. I found out that Gardnerella will form a biofilm around it so in order for any difference to be made, you have to first break down that biofilm for the bacteria to even be accessible. Normally, antibiotics are not recommended or helpful because it kills the good bacteria. But! Nothing could kill my Gardnerella on its own (boric acid doesn't *kill* anything. what it does is: changes ur pH to acidic /helps with smell/ and breaks down the biofilm). Plus, I didnt even have good bacteria to kill in the first place!
So here was the plan. Now of course, this is based on my specific strains I had. But if you want to at least get an idea of what helps, or if you already know you have Gardnerella, here is some advice.

1. boric acid for 7 days to break down biofilm
2. Day 8: Clindamycin antibiotic vaginal CREAM (follow instructions, usually 7 days). The coach *specifically* recommended Clindamycin for gardnerella and said it helps kill a variety of strains. So it seems to be a preferrable antibiotic, and she said cream is much better because it attacks at the source!
3. could potentially take Diflucan after the course of antibiotics just to prevent/cure a yeast infection if that comes about after the treatment
4. after treatment, take probiotics for 2-3 months. I always thought probiotics were good to take just ongoing/forever bc it helps with other health as well, but this woman said if you take probiotics for too long (esp. vaginal targeted ones) it can cause an overgrowth of good bacteria, and I forget what the name of that condition is, but it's not good. So I will probably continue eating probiotic-rich foods (yogurt, fermented stuff) but I will follow her instruction to stop taking daily probiotics after 3 months (if it did its job).
5. two other supplements she specifically recommended to take alongside the probiotic: Lactoferrin (she recommended Jarrow brand) and vitamin D. Again, do your own research/ talk to your doctor if these supplements might not be good for you but personally they seem to be pretty generally beneficial/ can't hurt ESP. vitamin D!!
6. she said to re-test with evvy after those 2-3 months to see if the bacteria is now balanced and everything did its job. she said it's okay to take preventative boric acid at times when you could be at risk (after period/ after sex) but the goal is for this now balanced/good bacteria flora to LAST.

use discretion for your own treatment BUT a lot of these things imo are beneficial in general /just good to know an example of what treatment can look like. good luck and lmk if you have questions!

Hi everyone,
This sub has taught me more than any other doctor of mine. Unfortunately I haven't been able to find any solution to my issues. I have a case of chronic uti, I'm in my early twenties and it has wrecked my life. I have had uti 4-5 times from 2023-24 I was on a harsh course of antibiotics for another treatment before and after that, the symptoms got worse. I got a High vaginal swab done at the clinic, and it came back positive with e.coli. I was put on antibiotics. My gynecologist said post treatment she can't see any signs of infection inside my vaginal canal. However I'm still seeing the symptoms. I FEEL LIKE TEARING MY LABIA OFF. My vulva is super inflamed. It's also red. But there's no lesions. No bad odor. And normal discharge. It's just inflamed as if it's angry. It feels like I have cuts sometimes and it burns when I have to pee sometimes. But mostly it's the itching. My skin folds feel like they have lost its elasticity. If I poke them, they remain squished. My fasting glucose was normal. And I have been cleared for all stds which were tested for. No past history of any stds. The only thing left is mycoplasma and ureaplasma which my doctors refuse to test me for since the inflammation is only on the folds of the skin not inside the vagina.
I also suspect oral thrush ( and gut imbalance not sure if this could cause me inflammation on the labia but I have yet to be tested for Sibo, Sifo and h.pylori ), I'm working with a holistic nutritionist and we might scope it further since the allopathic doctors refused to even check me ( I have white buildup on tongue ) I haven't had sex in months. My sex life is on a complete hold i feel like I won't get better. I crave it so much yet the pain and irritation is so much. I'm afraid this will strain my relationship if I don't find solutions. It's strained my relationship w my self already. I had a nervous breakdown today because of my issues. It's been going on for months now. Ever since I was sick. I'm not sure if this could be a case but I also have inflammation in my intestine. I don't know what to do anymore. I feel like giving up. I'm so tired of dosing with antibiotics over antibiotics and hard drugs. I'm so sorry for the rant. I just feel only women here feel my pain. If you listened to me, thank you.

I’m experiencing vaginal dryness now since Christmas and I had a dose of BV around that time that I treated and since then can’t seem to get wet during sex or mastrabation, I then got thrush which I treated with just external cream but I’m wondering now if it’s not fully gone and that’s what’s causing the dryness? Would doing an internal tablet do any harm if there is no thrush present? I’m at my wits end with it now as lube is inconvenient and this is just a new problem. TIA

The link between Post-SSRI Sexual Dysfunction, Hard Flaccid Syndrome, Post Finasteride Syndrome, Pelvic Floor Dysfunction, Chronic Pelvic Pain Syndrome and advice on how to start your healing journey based on 8 years of research and personal experiences : pssdhealing (reddit.com)
Here are all my thoughts and advice based on my personal experiences, other people’s insight and helpful experiences, and research I have done on and off about pelvic floor issues from the past eight years or so. I am not claiming that any of this is revolutionary, but I hope it can help some of you out there to give you a head start on healing and advance our understanding of these conditions. As I am a 27 year old male with previous major problems with pelvic floor issues and hard flaccid, some of my advice may be biased towards my condition. However, I believe everyone can benefit from a lot of this because I really do think that all of these conditions that I mentioned are linked in at least some way, especially by pelvic floor dysfunction and sex hormone desensitization. I try not to come to these forums because it increases anxiety and negative emotions which leads to worse pelvic floor symptoms, so my apologies if I do not respond to your questions. For hard flaccid and pelvic floor affected people, follow my advice and I am confident you can heal and reach a place where your symptoms barely affect your life, if at all, which is where I am at now. The mentality of trying to find a 100% “magic cure” solution just leads to anxiety and catastrophic thinking if you have a set back which will only worsen your symptoms. You can and will heal. I know this is a lot of information, but try to implement just one or two things at a time. Focus on the present, and take it one day at a time. Don’t get overwhelmed. All of this is my opinion and not professional medical advice. Talk with your doctor before starting anything.
Post Finasteride Syndrome (PFS), Post-SSRI Sexual Dysfunction (PSSD), Hard Flaccid Syndrome (HFS), Pelvic Floor Dysfunction, and Chronic Pelvic Pain Syndrome all can have some similar symptoms. I believe that they are all either caused or can be exacerbated by androgen and estrogen receptor insensitivity and are triggered by medication, genital injury, and pelvic floor inflammation and dysfunction. The pelvic floor is rich in androgen receptors and estrogen receptors. However, without proper androgen receptor activation and sensitivity, the pelvic floor muscles don’t have enough DHT which line the tissues of the pelvic floor, genitalia, and lower urinary tract. DHT is vital for healthy sexual functioning in both sexes - it provides an anabolic effect to tissues to provide strength, stability, healing, and relaxation to tissues. As a result of androgen receptor insensitivity and lack of DHT, the pelvic floor can become chronically weakened, tight, and inflamed which reduces blood flow to the region leading to even more androgen receptor insensitivity and thus less DHT. These symptoms can cause psychological stress to the individual which tightens the pelvic floor further leading to more symptoms and less blood flow. One study found that androgen sensitivity has raised the possibility that androgens can be used to rebuild the weakened and/or damaged muscles comprising the pelvic floor - source. Some people may also have normal hormone levels in the blood when tested, but these hormones cannot reach or be effective in the pelvic floor tissues or brain due to sex hormone insensitivity and the lack of the blood flow in the region caused by pelvic floor tightness and dysfunction. It is also likely that there is a problem with desensitized estrogen receptors causing a similar mechanism of dysfunction because they are also found in the pelvic floor, genitals, and brain and are important for pelvic floor health, sexual functioning, cognition, and emotions in both sexes. The most important element to remember to help start the healing process for these disorders is to boost blood flow through supplements, stretches, and exercises which will increase both androgen and estrogen receptor sensitivity over time.
Many males with PFS, PSSD, and Pelvic Floor dysfunction are affected by the hard flaccid condition.
Post Finasteride Syndrome (PFS) caused by Finasteride, a 5-alpha-reductase inhibitor (5-ARI), plummets DHT levels in the body to try to help hair loss causing sexual dysfunction and pelvic floor issues. Androgen receptors that surround the pelvic floor, genitals, and brain become desensitized due to the Finasteride leading to less DHT binding to these receptors causing dysfunction and a tight, weak pelvic floor. The tight, dysfunctional pelvic floor now restricts blood flow which impacts healing and the delivery of testosterone to this area that further exacerbates androgen insensitivity leading to less DHT in these tissues. Since androgen receptors are found in the brain and androgens have neuroprotective effects, this could be one reason why some PFS and PSSD sufferers are also impacted cognitively. An herbal supplement called Saw Palmetto has also been reported to cause a disorder similar to PFS because it is also a 5-ARI that blocks the conversion of testosterone into DHT. Another disorder called Post Accutane Syndrome (PAS) is also similar to PFS and it reduces DHT as well through being a 5-ARI: “Isotretinoin, used to treat severe acne, has been shown to induce hormonal changes, especially to reduce 5 alpha-reductase in the production of the tissue-derived dihydrotestosterone (DHT) metabolite 3 alpha-Adiol G.”. PFS, PAS, and PSSD are thought to cause not only androgen receptor desensitization, but likely estrogen receptor desensitization as well.
For Post-SSRI Sexual Dysfunction (PSSD), SSRIs are also known to decrease androgens and down regulate androgen receptors. This study shows that SSRIs can have an anti-estrogenic effect as well and can even reduce the expression of estrogen receptors (ER), including in the hypothalamus.. As sex hormones get desensitized in the pelvic floor, genital region, and brain, it causes localized DHT and estrogen levels in these tissues to decrease causing emotional blunting, sexual dysfunction, pelvic floor issues, hard flaccid syndrome, and more. The pelvic floor dysfunction can then prevent the sex hormone receptors from being reactivated and sensitized due to restricting oxygen and sex hormone rich blood flow to the tissues. SSRIs can cause androgen receptor insensitivity and estrogen receptor insensitivity by severely inhibiting the serotonin transporter (SERT) leading to increased serotonin levels which desensitizes those receptors throughout the body. One key to help heal from PSSD is increasing androgen production, androgen receptor sensitivity, and blood flow to boost BDNF, SERT, and DHT levels to hopefully allow any estrogen receptor desensitization recover on its own over time after everything else is normalized. Once androgen levels in local tissues (pelvic floor, brain, genitals) are normalized again through androgen receptor activation and sensitivity, it will encourage the conversion of androgens into estrogens in these tissues via aromatase. It is also worth to mention that some community members are trying to restore estrogen receptor sensitivity via boosting estrogen in various ways including by taking hops extract which is a potent phytoestrogen. This is also interesting: Estradiol represents another important natural ligand for androgen receptors that may play an essential role for the androgen receptor function and the development of the male reproductive system.
As mentioned earlier, people with PSSD and other disorders might have normal looking hormone blood tests (testosterone, DHT, estrogen, etc), but the issue is that these hormones are not functioning in the brain, pelvic floor, and genitals properly due to androgen and estrogen receptor insensitivity. An important thing to also recognize is that the medical community still has no official explanation how exactly SSRIs cause all of these debilitating side effects, but they are still being readily prescribed without informed consent about the risks of PSSD. It is unfortunate that it is people like us on the internet leading the charge to investigate and inform. We all need to continue to do our part to spread awareness of these iatrogenic disorders to warn people about the risks of taking these medications because their medical providers aren’t likely going to. Thank you to the PSSD Network for helping to give a voice to the unheard.
Post-SSRI Sexual Dysfunction (PSSD): Biological Plausibility, Symptoms, Diagnosis, and Presumed Risk Factors
Androgen receptor (AR) inactivation in mice led to reduction in hypothalamic neural nitric oxide synthase (nNOS), indicating the regulatory sexual function of this neurotransmitter. Furthermore, activation of the pre and post-synaptic 5HT1A receptors was found to be correlated with inhibitory effect on erectile function. All of these factors are speculated to be involved in this symptom and might be related to epigenetic alteration of androgen receptor (AR) and estrogen receptor (ER) densities due to influence of SSRIs on the epigenome.
In male PSSD sufferers, the penile shaft can be rigid during erection, yet the glans of the penis remains flaccid.This symptom may arise from hypo-activation of the dopaminergic and oxytocinergic pathways. The glans of the penis, in particular, receives its blood supply from the deep dorsal artery. Perhaps this points to a selective arterial malfunction relative to pelvic floor dysfunction which usually accompanies PSSD.
Here is another interesting study that gives support to the importance of increasing blood flow to help heal:
If SSRIs produce sexual side effects by impairing vasocongestion to the genital region, it would be expected that pharmacologic agents that increase blood flow to the genital region would improve sexual functioning. Indeed, several anecdotal reports and studies have found that sildenafil (a drug designed to treat erectile failure by increasing blood flow into the penile tissue) was successful in reversing SSRI-induced sexual dysfunction in both men and women [8,9,87,88,109]. Sildenafil acts to increase blood flow into the genital tissue by facilitating c-GMP activity that is initiated by nitric oxide [19] and preliminary evidence suggests that the SSRIs may cause sexual difficulties by inhibiting nitric oxide synthase [39,118].
Here is a paper from a community member that hypothesizes that the main issue is lasting estrogen receptor insensitivity just to give another interesting perspective on Post-SSRI Sexual Dysfunction, Post-Finasteride Syndrome, and Post-Retinoid Sexual Dysfunction
As the body is starved of DHT, ARs upregulate in response. At the same time, ER activation is significantly increased as a result of the increased production of Estradiol during treatment (due to higher Testosterone availability by reduced 5a reduction to DHT) - eventually leading to ER downregulation.
Hard Flaccid Syndrome (HFS) - There are many men suffering from HFS and pelvic floor issues due to PSSD, PFS, heavy weight lifting, excess kegeling, or in the case I’m presenting here, physical damage to the genitals from excessive, vigorous sexual activity (my case) or penis enlargement exercises. When the genitals get damaged, an inflammatory process starts and the pelvic floor contracts to protect itself. Since the pelvic floor is now in a chronic, contracted state, it limits oxygen and sex hormone rich blood flow to the genitals and pelvic floor which leads to sex hormone insensitivity and negatively impacts healing, muscle relaxation, and DHT production in these tissues. Finasteride, Accutane, and SSRIs also desensitize sex hormone receptors in the genitals and pelvic floor tissues leading to hard flaccid and pelvic floor dysfunction. Since the pelvic floor tightness restricts blood flow, it is difficult for hard flaccid sufferers to reactivate and sensitize their pelvic floor muscle androgen receptors again to regain relaxation and strength in their pelvic floor muscles, including the ischiocavernosus (IC), bulbocavernosus (BC), and pubococcygeus (PC) which are in a contracted state; the IC muscle in particular is thought to be the most implicated in the cause of hard flaccid. We first need to promote relaxation in the pelvic floor by boosting blood flow through supplements and stretches because tight muscles are weak muscles. Once the pelvic floor is in a chronic state of tension, it is hard to heal from pelvic floor issues because you likely already had bad habits such as poor posture, unhealthy sexual practices, stiff muscles, sedentary lifestyle, unchecked anxiety, and other negative lifestyle factors. Along with supplements, exercises, and stretches, correcting these bad habits is necessary to heal to have an even healthier pelvic floor than you ever had before because it likely was already tight and dysfunctional to begin with before developing obvious issues, but it was more subtle and you had no awareness of your pelvic floor muscles until now. You have the potential to now become a much healthier person overall than you ever would have been without being affected by pelvic floor dysfunction and hard flaccid.
32% of women will develop a pelvic floor disorder in their lifetime which is double that of men. While childbirth and pregnancy plays a role in this discrepancy, women also have far less testosterone and DHT levels than men which I believe plays a major factor. Since women have less testosterone, their androgen receptors that line the pelvic floor don’t make enough DHT to adequately support these tissues compared to men. This makes them more prone to pelvic floor dysfunction that causes them a disparate amount of pain, tightness, and inflammation. Androgen receptors and their ability to convert testosterone into DHT play such a vital role in pelvic floor health and sexual functioning. This is mentioned in a research study: Prevailing scientific literature has indicated the presence of androgen receptors in the levator ani muscle and pelvic fascia. The existence of androgen receptors in the vaginal wall can play an essential role in the development of pelvic floor disorders in women.Thus, androgen-related disorders may interfere with the function of pelvic floor muscles. [Many people mistakenly believe that androgens are only important for male sexual health:](https://www.bumc.bu.edu/sexualmedicine/patientinformation-physicians/androgen-insuffiency-in-women/#:~:text=Androgen%20insufficiency%20syndrome%2C%20characterized%20by,of%20sexual%20dysfunction%20in%20women.] Androgens have a three-fold action on female sexual function. They (1) increase libido by providing the fuel for a woman’s psychosexual stimulation, (2) increase sensitivity and blood flow to the external genitalia, and (3) increase the intensity of sexual gratification.
What I see in all these conditions is that sex hormone receptors become desensitized in the pelvic floor and genital tissues either from a drug, pelvic tightness, or inflammation from injury leading to less hormones being produced causing sexual and pelvic floor dysfunction. The pelvic floor now goes into a chronic tightened state as a response, leading to less oxygen and testosterone rich blood flow to the genital and pelvic region which leads to more androgen insensitivity and subsequently less DHT. This all explains why many people who have these conditions are helped by supplements that improve androgen receptor sensitivity and blood flow, and why pelvic floor therapy and exercises are so helpful to many of them. Estrogen receptor insensitivity in the pelvic floor also appears to have a similar mechanical negative effect by leading to less estrogen levels in the pelvic floor and genital tissues. It is also possible that some people with PSSD/PFS may have subtle or no pelvic floor symptoms, but the medication still desensitizes sex hormone sensitivity in their genitals and pelvic floor tissues that is leading to sexual dysfunction.
Another study linking androgens and the pelvic floor: Levator ani and other muscles of the pelvic floor and lower urinary tract are sensitive to the anabolic effects of testosterone. Androgen receptors are also expressed in the pelvic floor and lower urinary tract of both animals and humans. Anabolic effects of androgens may play an important role in the female pelvic-floor and lower-urinary-tract disorders. Furthermore, the interactions between androgen and nitric oxide synthase and arginase have been demonstrated, suggesting that androgens may also participate in modulating the physiological functions of the lower urinary tract through nitric oxide. The action of androgens in the lower urinary tract and pelvic floor is complex and may depend on their anabolic effects, hormonal modulation, receptor expression, interaction with nitric oxide synthase, or a combination of these effects.
My solution to help heal and improve the well-being of people with these issues is to try to improve sex hormone receptor sensitivity and pelvic floor function through supplements, stretches, exercises, and boosting blood flow which will hopefully restore normal levels of estrogens and androgens in pelvic, genital, and brain tissues. The body has a tremendous capability of self-healing, but we need to support it through active recovery methods.
We will first start with supplements (this is not professional medical advice - talk with your doctor before taking):
L-citrulline - This is the precursor to l-arginine, and it will improve blood flow and levels of nitric oxide to help get oxygen and testosterone rich blood to the pelvic floor and genital tissues to increase androgen sensitivity. Nitric oxide can also induce smooth muscle relaxation which is important for relaxing the pelvic floor. Herein we report on a young man affected by PSSD who regained sexual functioning after 3-month treatment with EDOVIS, a dietary supplement containing L-citrulline and other commonly used aphrodisiacs.. I recommend taking at least 6000 mg daily by taking 2000mg three times throughout the day. The max dose is 10,000mg. Even potentially better, people report great results using Cialis to improve blood flow and healing rather than L-citrulline and some doctors will even prescribe it to women if you show them the evidence - talk with your doctor. “Tadalafil (Cialis) reversal of sexual dysfunction caused by serotonin enhancing medications in women”. L-Citrulline and Cialis are not recommended to be taken together.
L-Carnitine - This will improve the number of androgen receptors and their sensitivity to testosterone to increase levels of DHT in the pelvic floor, genital tissues, and brain. I recommend taking 2000mg daily. Acetyl-L-Carnitine can pass through the blood-brain barrier, while Propionyl-L-carnitine has a high degree of interaction with testosterone. Propionyl may be better for sexual and pelvic floor dysfunction, while Acetyl might help people suffering from the mental effects of PSSD. This study used each at 2000mg daily to improve erectile dysfunction along with Viagra.. I would work up to 2000mg each of Acetyl and Propionyl L-Carnitine along with Cialis instead of Viagra as it lasts in the body for much longer (36 hours) for increased blood flow healing purposes. You can also use L-Citrulline instead of Cialis as mentioned earlier. Discuss with your doctor before taking them.
Vitamin D - This vitamin, which acts more like a hormone, works directly with the endocrine system. It has its own receptors throughout the body and they are often in close proximity to androgen receptors. Deficiency in vitamin D is associated with a stunting of testosterone's effects on androgen receptors and a decline in testosterone levels. Vitamin D will encourage androgen receptor resensitization. One study found that higher vitamin D levels are associated with a decreased risk of pelvic floor disorders in women, and The levator ani and coccygeus muscles are skeletal muscles that are critical components of the pelvic floor and may be affected by vitamin D nutritional status. I recommend 4000IU of vitamin D daily or whatever gets your levels to 60 - 80 ng/ml.
If you have inflammatory issues or pain due to pelvic floor dysfunction, I recommend a fish oil supplement daily. I take fish oil, and I find that it helps limit pelvic inflammation. I also take Magnesium Glycinate to relax the smooth muscle that lines the pelvic floor and genital tissue. I recommend it for people with clear pelvic floor dysfunction, but others should be careful as research says magnesium is a 5-alpha-reductase inhibitor. Take quercetin and bromelain as needed if you experience pelvic inflammatory flare ups and pain, but just be careful as quercetin can also inhibit the production of DHT from testosterone as well. Some say fish oil blocks DHT too, but experiencing chronic pelvic floor pain and inflammation will do more harm to you than minimal DHT blocking. I recommend staying away from all DHT inhibiting foods and supplements for people with PSSD, PFS, and PAS unless you are experiencing pelvic pain and inflammation.
As always, discuss these supplements with your doctor to see if they are okay for you. Lower your supplement intake based on side effects. These aren’t a magic cure, but a tool to help you on your journey to recovery. Don’t do anything without doctor supervision, but this thread gives more evidence for the “cure” for PSSD/PFS being resensitizing androgen receptors and estrogen receptors along with enhancing blood flow as it details how some men recovered through taking high doses of androgens, post cycle therapy, and Cialis. This at least gives hope that a hormonal cure can be created one day by medical professionals. I would of course recommend trying to heal yourself naturally for a long time before doing any hormone treatments under the supervision of a doctor.
I also recommend doing some form of yoga or pelvic floor stretches daily to improve blood flow for pelvic floor relaxation and sex hormone receptor sensitivity. You also need to request to see a pelvic floor therapist for an evaluation and treatment. Learn how to do reverse kegels. Doing reverse kegels will be difficult at first because your pelvic floor is tight and you have little to no awareness of these muscles, so just focus on lengthening and relaxing the pelvic floor through stretches for now. Do not do regular kegels for pelvic floor issues. Learn how to diaphragmatically breathe in 360 degrees to create expansion in your rib cage and abdomen to encourage pelvic floor relaxation. Do not breathe through your chest, and “belly breathing” isn’t the right term because the ribs need to expand as well. You can learn how to diaphragmatically breathe through an exercise such as 4-7-8 breathing. Here is a great video on diaphragmatic breathing and another video. I cannot overstate it enough: retraining yourself to properly breathe diaphragmatically is the single most important thing that you can do to heal from pelvic floor issues. Be a student of breathing: study and take notes on how to breathe better.
Stretches/Yoga poses I recommend:
Hold the Malasana/hindi/yoga squat pose for at least 5-10 minutes at least twice a day, but doing it morning, mid-day, and at night would be the best. Some get great results holding it for 15-20 minutes.This is one of the most important things for your pelvic floor because it will help lengthen and release it. Doing them barefoot is also very beneficial to strengthen your ankles and feet which are connected to your pelvic floor. Again, remember to breathe deeply down into your belly and pelvic floor for all these stretches.
Begin your stretching routine with an Exercise ball ab stretch and Upward-facing dog/cobra pose. This will help stretch your lower abs and psoas muscles so that you can get more breath deeper down into your pelvic floor for the rest of your stretches. Some people say that these types of stretches aren’t great for people who have Anterior Pelvic Tilt, which we should fix, but I still do them as it is important to stretch the lower abs that are hard to get to. You can experiment with doing them sporadically instead of every time you stretch.
This is my current personal complete stretch routine I do in order 3+ days a week:
Myofascial release on my glutes with an orb massage ball but you can use any small hard ball (don’t do this if glutes are currently sore) > Calf stretch against a wall or a yoga block which is what I use > exercise ball ab stretch > upward facing dog > (optional) Do a handful of cat cows > Supine hamstring stretch with yoga strap or an IdealStretch tool which is what I use > Kneeling hip flexor stretch > flat on back supine single knee to chest stretch > then bring knee to opposite shoulder stretch > supine figure four > I do this stretch next right after figure four > Reclined bound angle pose > (optional) butterfly stretch > (optional) A little bit of downward facing dog to stretch the calves > (optional) Lizard Pose) > (optional) Half split stretch/Half monkey pose with yoga blocks > Half-pigeon pose > Child’s pose > Wall quad hip flexor stretch > Wall figure four stretch > Wall straddle pose > Wall happy baby pose > Flat on back while pulling knees apart > kneeling with one leg, other leg out to side for adductors > (optional) Frog pose with feet together > regular Frog pose with feet separated in line with the knees > Yoga squat/malasana > Corpse pose
All these stretches are the ones I found most useful in a routine. See what works for you and develop your own routine. Consistency is the most important. This long stretching routine may not be possible for you to complete regularly so make adjustments, but doing this routine at least 3 days a week is ideal. Stretches such as the yoga squat, supine hamstring stretch, hip flexor stretches, and wall stretches are vital and should be done most days to help relax the pelvic floor. For how long you should hold each stretch, just go by how you and your body feels. Really let go, breathe, and sink into every stretch. On rest days, doing some deep breathing in child’s pose, reclined bound angle pose, flat on back while pulling knees apart, and the happy baby wall pose is really great while trying to do gentle reverse kegels.
You can also work on more individualized stretches for posture to correct anterior pelvic tilt, muscle imbalances, and to release other tight muscles, such as the upper body. Listen to your body if you need to give yourself a rest day from stretching. Adding in a 30-60 minute walk/swim on rest days is incredibly beneficial as well. Eventually, you can also try to learn isometric PNF stretching to incorporate it into some of the stretches such as the kneeling hip flexor stretch and hamstring stretch.
After working to relax and lengthen your pelvic floor through yoga and stretches, I would begin gentle body strengthening exercises that are pelvic floor safe. The pelvic floor is a master compensator. So, if the glutes, adductors, deep hip rotators, transversus abdominis, and other supportive muscles are weak, then the pelvic floor is in the prime position to pick up the slack which leads to a lot of strain on the pelvic floor which results in tightness and dysfunction. You need to strengthen the surrounding muscles to relieve tightness in the pelvic floor. This is where working with a pelvic floor therapist would be helpful to point out safe individualized exercises for you. Yoga will help strengthen your muscles in a safe way too.
The glutes and transversus abdominis in particular are very important to strengthen. Glute bridge, single glute bridge, side lying leg raises, lateral band walks can help build up glute strength. Deadbugs, Bird Dog, 8- point planks, or planks with pelvic floor-friendly modifications, can help to strengthen the transversus abdominis (TVA). Abdominal work may be triggering to your pelvic floor symptoms, especially the 8 point plank, so you can instead look into hypopressive exercises to work the TVA without overworking the pelvic floor. These exercises will help you bring more awareness to your breathing, diaphragm, TVA, and pelvic floor which are all important for recovery. Here is how to find and become aware of the TVA. Do side planks for your oblique ab muscles.
For hip/abductors do the side lying hip abduction exercise, fire hydrants, and the shinbox lunge. For the adductors, do Copenhagen adductor exercise, cossack squats, and an exercise where you squeeze a soft ball between the knees just don’t do any crunch movements with pelvic floor issues. For hamstrings, Nordic hamstring curl/glute ham raises, and single leg bridge. For the back, do supine pelvic tilt. One person even reported that dorsiflexion exercises and stretches were one important element to solve his pelvic floor issues; this is most likely because the ankle bone, like everything else including even our jaw, is connected to the pelvic floor.
Like with anything, do all these exercises in moderation and stop if you sense your pelvic floor is not responding well to them - do them one at a time to see which ones your pelvic floor can handle for now. Here is an exercise routine from another poster that has helped many people. Just be careful of the ab exercises such as the ab wheel and 5 minute planks with your pelvic floor issues - don’t over do it or avoid it if they cause too many symptoms.
Myofascial release and foam rolling to release trigger points also helps a lot of people to relax their pelvic floor muscles and improve blood flow. The glutes are the most important area to target for pelvic floor issues when foam rolling in my experience if you only had limited time. Using a soft ball to lay on and breathe deeply can help release trigger points in the abdominal muscles and psoas which can help you breathe better and relax the pelvic floor. I haven’t done it, but you can also try out a massage gun for myofascial release; just be careful and don’t use it in sensitive pelvic areas. Some men and women also report success using a therawand to release internal trigger points that are causing them pelvic floor dysfunction symptoms.
Walking and swimming for 30-60 minutes are some of the best exercises to lengthen, relax, stretch, and release your pelvic floor, boost blood flow, and help to retain and build strength in muscles that give support to the pelvic floor. Walk or swim for 5+ days a week for the best results. The breaststroke and freestyle are very helpful for pelvic floor sufferers. Along with swimming, people also use an elliptical at a low resistance to help provide a cardio workout that is safer for your pelvic floor.
Fix your posture. Pelvic floor issues and hard flaccid syndrome are closely associated with Anterior Pelvic Tilt and other postural issues. Get evaluated by a physical therapist so that they can give you exercises and stretches to fix it. You could also look into the Postural Restoration institute and see one of their providers and try to implement some of their exercises. In the meantime, here is one video playlist on how to fix APT. Another video to fix APT says to stretch the hip flexors, lower back, while focusing on strengthening the abs, glutes, and hamstrings. Make sure that you sit and walk with good posture - watch this to learn how to walk correctly - activate your glutes during each step and push off with your back foot!. I also recommend getting a standing desk to try to avoid sitting for long periods of time.
Weight training can be effective for boosting active androgen receptors in the body to increase testosterone and DHT levels. However, you need to make sure that it isn’t making your pelvic floor symptoms worse which defeats the purpose. If you are going to lift weights with pelvic floor issues, don’t lift heavy, do any intensive ab workouts, or any other exercises that can put extra strain on your pelvic floor. Do lifts where you can sit down instead of standing up. Start with yoga, stretching, and gentle body exercises to relax your pelvic floor and strengthen surrounding muscles before incorporating consistent weight training. I highly recommend, however, just sticking with yoga and pelvic floor safe body weight exercises to build strength instead. Those with PSSD without pelvic floor dysfunction may benefit a lot from lifting weights, high-intensity interval training, and doing bodyweight exercises such as squats regularly to boost androgen receptors and DHT. Remember to see a pelvic floor therapist to get evaluated first before starting any weight lifting because many people have pelvic floor issues without even realizing it.
Work on your mental health. Anxiety can worsen pelvic floor issues. Just as dogs tuck and tense their tails when stressed, we tense our pelvic floors which are directly connected to our tailbone where we used to have tails ourselves in our evolutionary history. As we are impacted by sexual dysfunction and pelvic floor dysfunction symptoms, we become anxious along with other negative emotions which leads to more pelvic floor tension symptoms due to the fight or flight mode response causing even more anxiety leading to more symptoms. It is a vicious cycle that needs to break by not becoming anxious and negative when we experience pelvic floor symptoms or hard flaccid and instead let go, accept, and realize that it is a normal process when trying to heal because sometimes our muscles that are used to that tightness don't want to let go of the tension we hold in our pelvic floors. Daily yoga, meditation, stretching, and walking will help with anxiety. I would also see a mental health therapist because all of these issues are deeply traumatic and we cannot go through this alone. We often hold tension in the form of emotions and trauma in our bodies, especially our pelvic floor and genital areas. By openly talking about these issues with a therapist, it will help us process and release our emotions and trauma that we are holding inside our bodies to improve our anxiety, relax our pelvic floor, and to let go of all of our tension. Many people who healed their hard flaccid and pelvic floor issues said that solving their anxiety and negative thoughts by talking to a mental health counselor was vital in recovery. The mind-body connection is so powerful, and it directly impacts our pelvic floor. Those who are stuck in the cycle of experiencing pelvic floor symptoms leading to anxiety and negative thoughts will also benefit from Cognitive Behavioral Therapy you can do by yourself like in this video or preferably with a trained therapist. Here is an informative mini lecture on how stress impacts the pelvic floor.
I would also definitely go on a healthy anti-inflammatory diet. Avoid caffeine, alcohol, marijuana, and other substances. Avoid foods and liquids that can trigger pelvic floor inflammation such as highly acidic fruits and veggies, carbonated beverages, very spicy foods, and artificial sugars. To maintain a healthy gut to reduce inflammation in your body I recommend trying a low-histamine probiotic supplement along with eating healthy. You should also work on preventing or fixing constipation; eat a lot of soluble fiber to not get constipated - take a supplement such as metamucil if you have to. Check the Bristol stool shape chart to identify if you are constipated because even mild constipation can contribute to pelvic floor tension. This is because the constipation leads to a lot of pressure being put on your rectum and pelvic floor leading to the muscles becoming weak and dysfunctional. I am willing to bet many of you are constipated and don’t know it because it isn’t just whether you go regularly, it is also how your stool is shaped. People with pelvic floor disorders are at a high risk of constipation which makes their tension and dysfunction worse which then worsens the constipation, another cycle to fix. I recommend getting a Squatty Potty to reduce strain on the pelvic floor during elimination.
To help heal hard flaccid and pelvic floor issues, never watch pornography again (this is vital). Go on NoFap for 90+ days to help heal your brain and body from any unhealthy pornography and sexual habits you have partaken in. Pornography leads to involuntary kegels, a tight pelvic floor, desensitizes you, and messes up the dopamine and arousal circuitry in your brain. Don’t climax too often. Learn how to reverse kegel by yourself and during sexual activities. Never edge or regular kegel - it leads to pelvic floor tightness and dysfunction - just relax your arousal through a reverse kegel. Keep your pelvic floor relaxed during sexual activities.
Stay strong and never give up. You will heal. Thank you for reading.

Posted with my partners consent and enthusiasm for potential answers. Also created a new account to post this for privacy concerns. So my 32m girl friend 27f and I have been together for almost a year now. She has been struggling the last 10 months with repeating bladder pain, interstitial cystitis, yeast infections, and overall discomfort with her intimate areas. I Feel this is at this time we became intimate, but she denies it is because of me. So much so that she has made multiple emergency room visits (she’s a tough little lady) and countless appointments with urologists and main practitioner from pain. Her health is a major issue for herself, but it also pains me physically and emotionally to see her in so much discomfort, pain, and exhaustion from endless disappointing results. I am just a regular working guy so I really have no clue what to do other than to turn to others who are helpful, knowledgeable, and caring. Once again I’m listing these conditions and medications with consent and help from my partner. Per my partner after asking for complete symptoms. “The bladder problems started after I got the second UTI where I ended up in the hospital in August. This was also when I started getting yeast infections. The bladder problems became severe after they put me on Flagyl for Bacterial Vaginosis at the end of January. I stopped taking the birth control around the 12th of last month. I’m having pelvic discomfort, nausea, headaches, bladder spasms, recurring yeast infections, vaginal dermatitis (I think from the yeast infections), and bladder discomfort. I’m taking Wellbutrin, Buspar, and I started taking Urogesic Blue to help with the bladder pain, but I think it might be causing the nausea and headaches. I’m also on nitrofurantoin for the next five days for the UTI. I take quite a few supplements: fish oil, cranberry, Vitamin D, Folic acid, and probiotics” We have both noticed that each time she has an issue the determined prescription is antibiotics, but the antibiotics always cause yeast infections and bladder pain. We have both been checked for std and Sti near the beginning of our relationship when we both knew we were forever, and wanted to become intimate. So that is out of the question. We switched to wearing condoms when her discomforts started to arise and become consistent. I began to genuinely believe it was me causing the issues, and I still do. We have resorted to wearing sterile gloves when we want to become intimate with my hands during foreplay. I used to really love doing oral on her and have restrained myself for fear of injuring her long term with mouth bacteria(I don’t know, just trying here). She also cleans after each time we are passionate with each other. I love this woman with my entire heart and soul. I will marry this woman. I will care for her always. I want her to be healthy, happy, and not stressing over if she is going to have another episode. Please help with anything you can. She will take all things to her doctor for testing or insight. If you have made it this far, from the both of us, thank you.