For a large chunk of my life (as a 26M) I've had pelvic floor problems to overcome like frequent urination or pain from bowel movements, but for years I've been stuck with perineum pain after ejaculation from all the contractions an orgasm makes the pelvic floor do. Before I even heard of PT stuff it was thought to be chronic prostatitis but with a urologist that went nowhere. Years later the perineum pain got so bad it became a constant spasmy pain that wouldn't got away even without ejaculating. Then I saw a pelvic floor PT over 2 years ago to get a grasp of concepts like stretches, reverse kegels, diaphragmatic breathing, and a bit of internal work, which let me fairly quickly get rid of the constant pain over the course of a few weeks. Even after all that though, I'm still stuck with pain after ejaculating and my PT has provided hit or miss advice.

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My problem is the build up to an orgasm is fine, but as an orgasm happens it often gives off a slight feeling of pain as the muscles contract to pump stuff out. Immediately after the orgasm there might be several involuntary contractions for a couple seconds too that hurt a bit more. Then after a couple minutes an awful burning sore muscle kind of pain starts and it lasts wayyy too long. Years ago it used to be bad enough that it would be a very intense burn lasting over 3 days. Now it's like a mild burn lasting 1-3 days. It gradually heals and lowers in intensity overtime, but it takes forever to fully go away. After that period I can basically be symptom free until I decide to orgasm once again, or I abstain and a wet dream sets it off again regardless.

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The only thing that seems to reduce symptoms is orgasming when the pelvic floor muscles in the area feel extra relaxed. If it's really relaxed the build up will feel the pain after will only hurt mildly and for about 1 day to half a day. The frog pose or simply sitting down and "splitting" my legs out to the side (while deep breathing & reverse kegeling) are the two main stretches that seem to have helped me reach this relaxed state but it's fairly uncommon. I'm told out of all places I hold a lot of tension in my inner thighs, so it makes sense these particular stretches would help. Also when I'm in pain massaging the perineum helps a bit on top of doing stretches, but usually that results in temporary relief for only a few minutes.

I also should add I think I have slight ED as I rarely get natural erections when aroused. I almost always have to manually rub it to get an erection going. This also can improve somewhat when the pelvic floor area feels super relaxed.

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TLDR; I've gotten rid of other bad pelvic floor / cpps symptoms but long lasting pain after ejaculation hasn't gone away. It's been very incrementally improved over the years at best.

Was anyone here able to overcome and properly heal from post ejaculation pain similar to this? Or at the very least has anyone found ways to reliably reduce the pain once it begins?