Hard flaccid syndrome: Symptoms, causes and treatment

If your flaccid penis stays semi-rigid when you’re not aroused (and you’re experiencing other symptoms like pain around your penis, changes in sensation and issues ejaculating and urinating) you might be dealing with something that is becoming known as hard-flaccid syndrome (HFS).

Hard-flaccid syndrome isn’t formally recognised as a health condition. The name was created by men who have experienced it and discussed it in depth on internet forums, subreddits and chat groups.  Awareness of HFS amongst health experts is low and there’s not a lot of research into its causes and effects

Here’s what you need to know about HFS and how to reverse it.

What is hard flaccid syndrome?

Hard-flaccid syndrome is when your flaccid penis stays firm and semi-rigid without sexual arousal. We don’t know how common HFS is, but an initial report on four cases found it mostly affects men in their 20s to 30s.

Symptoms of hard flaccid syndrome

The main symptoms of HFS are that your penis feels firm, semi-rigid and what many describe as “rubbery” while flaccid.

In addition to physical symptoms, emotional distress, depression, anxiety, decreased libido, sleep problems and relationship problems are common. The stress caused can make physical symptoms worse and continue a painful cycle.

Causes of hard flaccid syndrome

We don’t know the exact cause of HFS, but it’s likely linked to nerve damage. A person with HFS probably experienced an initial injury to their penis, damaging the nerve bundles that control blood flow to the penis and pelvic floor. Distress about the injury and noticing changes to your penis triggers a stress response that leads to extensive pelvic floor muscle spasms, which ultimately causes more damage to the nerves in the area. This creates more distress and the cycle continues.

Spinal and sacral issues problems can potentially contribute to or exacerbate hard flaccid syndrome (HFS), although they are not typically considered a primary cause. The connection between back issues and HFS is related to the complex interplay of nerves and muscles in the pelvic region.

Hard flaccid syndrome and masturbation

Masturbating too much, for too long or too aggressively, or using techniques like jelqing and edging, could cause trauma to your pelvic nerves leading to hard flaccid syndrome.

Hard flaccid syndrome treatment

There is no standard treatment for hard flaccid syndrome but for most people with hard flaccid, the first step in treatment is managing your mental health. Managing distress, stress, anxiety and depression through counselling can help start recovery.

Specialised pelvic floor physical therapy can address your overactive pelvic floor and impacted nerves in the area. This involves a range of pelvic floor exercises and it’s best to work with a qualified men’s health physiotherapist to ensure you’re doing them correctly. You can make the problem worse by doing pelvic floor exercises or Kegels incorrectly.

Shockwave therapy, which involves low-frequency sound waves applied to a target area to increase blood flow and nitric oxide release, has also been explored as a potential treatment option for hard flaccid.

Dr Jo Milios also recommends gentle abdominal muscle releases, massage, breath work and stretches. A break from masturbation and sexual activity can help things heal too.

“When you start treatment, you usually improve really quickly,” Milios says. “It’s reversible, it’s just like a cramp in the muscle.”

What to do if you think you have hard flaccid syndrome

Hard flaccid syndrome isn’t widely recognised or understood amongst health professionals so it’s not surprising that plenty of blokes report not getting the help they want. Always try talking to your doctor first, seek our a men’s health physiotherapist and sex therapist.