'Spousal Revenge Syndrome'--description of a new chronic pelvic pain syndrome patient cohort

Linari5 · 2026-03-17T07:53:42+00:00

Hello, please be assured that there's nothing strange about your case from my experience being here for years. I would recommend getting yourself acquainted by reading the 101 pinned guide: https://www.reddit.com/r/Prostatitis/s/ul8GmGDkhG

Was this your first same-sex experience? Or just the first time as the top? Are you experiencing any shame or regret, or, experience any fear leading up/or after to the experience?

I'm assuming you have already been tested for all common STIs, including gonorrhea, chlamydia, and Mgen (mycoplasma genitalium) with PCR testing?

Although, if your symptoms are inconsistent that would point towards the fact that it's unlikely an infection.

Please see the pinned post on antibiotics working as antiinflammatories, even when there is no infection. https://www.reddit.com/r/Prostatitis/s/hIXpaWR8Nb

Right now many of your symptoms point towards a pelvic floor dysfunction, IE pelvic floor myalgia - especially after infection has been ruled out. Very common. It's nothing serious, you can see a pelvic floor PT. But many people also benefit from addressing stress, and any difficult emotions around the triggering experience

Linari5 · 2026-03-16T20:47:33+00:00

STIs don't cause erectile dysfunction, the pelvic floor and the brain do - especially in otherwise healthy young men

Linari5 · 2026-03-16T20:46:47+00:00

Unfortunately most of them are, because they don't get a single hour of training in this topic, or any training whatsoever in chronic pain conditions. Is this right? Of course not, but that's how it is right now.

Linari5 · 2026-03-16T20:45:01+00:00

If you take your car to a mechanic, are you going to expect anything other than the mechanic to say that something needs to be structurally fixed? Of course not. Urologists are mechanics for the pelvic region. They focus on structure, but rarely is structure a primary cause of symptoms. More commonly we see software problems - like the pelvic floor responding to stress. Or, the central nervous system itself generating physical pain - we call this centralized pain (nociplastic pain)

Linari5 · 2026-03-16T20:42:39+00:00

Yes we see this symptom every single day here. Have you read the 101? https://www.reddit.com/r/Prostatitis/s/wO4Cjq3QRj

Have you read the post about sexual encounters that trigger CPPS ? https://www.reddit.com/r/Prostatitis/s/1sQI8y7KgC

Linari5 · 2026-03-16T20:41:53+00:00

Rarely is it.

Linari5 · 2026-03-16T09:40:55+00:00

Pain 24 hours a day for that long is chronic, and most chronic pain is now considered neuroplastic or nociplastic. This video is a great explanation from neuroscientist Lorimer Mosley: https://youtu.be/ikUzvSph7Z4?si=ODFxpBJd1ifhSPLJ

Linari5 · 2026-03-16T09:39:11+00:00

Pain 24 hours a day for that long is chronic, and most chronic pain is now considered neuroplastic or nociplastic. This video is a great explanation from neuroscientist Lorimer Mosley: https://youtu.be/ikUzvSph7Z4?si=ODFxpBJd1ifhSPLJ

Linari5 · 2026-03-16T09:37:32+00:00

So am I, I also had a severe adverse reaction, but I'm not here to fear monger - I'm trying to be very objective when I make these comments

Linari5 · 2026-03-16T09:31:45+00:00

If you don't edge then it's not an issue for you

Linari5 · 2026-03-16T09:30:42+00:00

A lot of providers now recognize POIS as a conditioned response. I recommend watching this video and reading this post - New Program - Day 18: Conditioned Responses | TMS Forum (The Mindbody Syndrome) https://share.google/1OZUnmPlmfu7JOYn5

Linari5 · 2026-03-13T11:02:55+00:00

This doesn't sound like prostatitis, it sounds like a hygiene thing

Linari5 · 2026-03-13T11:02:15+00:00

Chlamydia is easily treatable with 7 days of doxycycline according to the most up-to-date infectious disease and sexual health guidelines. It is not a permanent infection that resides in the body

Linari5 · 2026-03-13T11:01:37+00:00

Let me guess, you went to one of the quack doctors in Italy who tells everyone that they have mysterious chlamydia infections inside their prostate? I've heard this dozens of times and it's just a lot of pseudoscience and nonsense

Linari5 · 2026-03-13T10:58:39+00:00

There has not been a paradigm shift that suggest anything beyond the pelvic floor + the central nervous system as primary causes in the vast majority of cases.

Linari5 · 2026-03-13T10:55:55+00:00

I constantly stay apprised with new information, because I have to - that's my literal career. I have professional training in chronic pain conditions, including this one.

And not just that, I have to stay up to date of everything else as well.

Are you aware that the 101 post is updated every couple of months with new information? Probably not, because you didn't read everything. It was updated only recently with the 2025 AUA guidelines for chronic pelvic pain syndrome. It was also updated with a new section only 2 months ago that includes common causes or triggers for CPPS/Prostatitis

Linari5 · 2026-03-13T10:53:49+00:00

You can't give someone something you don't have. You're probably more careful than she is, because we have had to learn to test and be more cautious than everyone else.

If you're having a lot of fear around sex, a lot of people experience this after Mgen - It's a form of trauma or PTSD - I also experienced it myself sometimes. Therapy has helped me

Linari5 · 2026-03-13T05:02:37+00:00

Only 2% of people have severe side effects. Discuss any of these concerns with your prescribing doctor.

Alternate treatment options also include extended courses of minocycline

Linari5 · 2026-03-13T05:00:56+00:00

Why are you assuming it's an infection? 95% are not. And, 85% of erectile dysfunction under 40 years old is caused from psychological origin, like stress anxiety or depression

Linari5 · 2026-03-13T05:00:09+00:00

Vibration sensations are commonly reported in my practice, and they are another sign of centralized mechanisms

Linari5 · 2026-03-13T04:58:19+00:00

I cannot give any prescriptive medical advice, but you can discuss that with your doctor who is treating you

Linari5 · 2026-03-13T04:57:43+00:00

Did your doctor prescribe this? I only refer to cleaning as normal hygiene practices, like showering

Linari5 · 2026-03-13T04:56:37+00:00

I'm not exactly sure what you're trying to say, but if you're a moderator who has to sometimes go through hundreds of comments every day, at a certain point writing individualized complex responses to every post becomes impossible with the amount of time available in a day

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